Test your basic knowledge |

Family Medicine Shelf

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Holter monitor: 24 hours - detect an arrhythmia; patient keeps a log of symptoms Event monitor: can be carried for 30 days or more and are patient activated at the time of symptoms; event recroding ca nbe transmitted by telephone to a monitoring symp
Irregular bleeding between cycles
Albumin; low molecular weight proteins
Tension headache

2. What test done in PE measures instability of shoulder?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Paroxysmal atrial fibrillation or supraventricular tachycardia
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

3. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
True
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
E. Coli O157:H7

4. How do you know if heart palpitations are due to stimulant or medication use?
Less abrupt onset and cessation of palpitations
Irregular bleeding between cycles
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Adhesive capsulitis (frozen shoulder): most common in middle age women

5. How does CHF present on X-ray?
True
Cellulitis
HSV1: oral HSV2: genital -primary infection: transmitted by respiratory droplets or by direct contact with an active lesion or infected secretions -secondary phase: reactivation of the latent virus from dorsal root ganglia -grouped vesicles on an ery
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

6. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
Pts with palpitations and dizziness - near syncope - or syncope
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
It is a test for BPV. Rotate the patients through a series of positions in an attempt to relocate the debris in the semicircular canal into the vestibule of the labyrinth.
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

7. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Coronary artery disease/ angina
Hx: Scratchy throat - runny nose - nasal congestion - rhinorrhea - malaise - fever - hoarsenss - cough - low grade fever - headache PE: Swollen red nasal mucosa - fever - purulent discharge - facial tenderness
Genetic screening - medical assessment for chronic diseases - screening for infectious diseases - and updating of immunizations - advice on proper nutrition and exercise - help with quitting unhealthy habits - and advice on avoiding environmental haz
Paroxysmal atrial fibrillation or supraventricular tachycardia

8. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Temporal arteritis-biopsy of the temporal artery
Common problem that resolves spontaneously and is most often seen in children and young adults
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

9. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Cholelithiasis
Candida albicans
Viral infection of the semicircular apparatus
Generalized Anxiety disorder and panic disorder

10. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
RBC casts and old to moderate HTN
Supraspinatus and bicipital tendons
Scleroderma/polymyositis with secondary gastroesophageal reflux

11. After treatment of dysplasia - women need Pap smears every...
Increase; 200 g/day
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

12. Mainstay treatment for soft tissue inflammation (Shoulder)
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Peptic ulcer disease or gastritis
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

13. What are the features of nephrotic syndrome?
Cellulitis
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

14. Where does the development of abnormal cervical cells begin?
Upper sternal area burning pain - associated with a productive cough
Squamocolumnar junction=most common site of cervical cancer
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Viral gastroenteritis

15. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
DM - HTN - DVT - seizures - depression - or anxiety
Bronchitis: Antecedent URI - Cough - No or low-grade fever - clear lungs or coarse rhonchi - Normal CXR Pneumonia: Acute onset of cough - fever - and tachypnea - chest pain - leukocytosis - pulmonary infiltrate on CXR
Tension headache

16. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Chest pain during pneumonia or PE
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
S. Aureus
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

17. What treatments are the cornerstone for treating cases of functional constipation?
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Viral infection of the semicircular apparatus
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Increasing fluid (8 - 8oz glasses of water/day) -fiber

18. What is the caUse of Meniere disease? What are the cardinal symptoms?
E. Coli O157:H7
Stabilize on oxygen - nitroglycerin - morphine for pain - aspirin (to decrease mortality by 20%) - clopidogrel or ticolodipine. (beta blockers - heparin - nitrates - ACEi - thrombolytics (if <75 with ST segment elevation - and a history consistent wi
Rotator Cuff tendonitis
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

19. Describe the presentation tracheobronchitis
Hx: High fever - dyspnea - chills - chest pain - develop hypoxia or cardiopulmonary failure - PE: Abnormal Vital signs (fever - tachypnea - tachycardia) - Lungs (localized rales - bronchial breath sounds - wheezing - signs of consolidation-dullness t
Upper sternal area burning pain - associated with a productive cough
Dehydration - anemia - cardiac causes
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

20. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
Genetic screening - medical assessment for chronic diseases - screening for infectious diseases - and updating of immunizations - advice on proper nutrition and exercise - help with quitting unhealthy habits - and advice on avoiding environmental haz
Staphylococcal scalded skin syndrome
Hx: Onset of menarche and duration and frequency of the menstrual period - Bleeding pattern - hx of liver - renal - thyroid disease - Use of anticoags - oral contraception - hormone replacement - ROS: weight change - hirsutism (indicating PCOS=LH:FSH
Coronary artery disease/ angina

21. What is the standard tool used for diagnosis of GERD?
Jugular venous distension: elevated venous pressures -PMI is displaced laterally and downward: cardiomegaly -bibasilar rales -third and fourth heart sounds: fluid overloaded - stiff ventricles -murmurs: valvular pathology -hepatomegaly: right sided
EGD
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Echocardiogram

22. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
EGD
Molluscum contagiosum- pox virus
Systolic dysfunction- ejection fraction is reduced to less than 45% - diastolic dysfunction- ejection fraction is preserved or high; use doppler techniques- abnormal flow across the mitral valve
Staphylococcal scalded skin syndrome

23. What should preconception counseling include?
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Activation of the RAAS - increased levels of catecholamines - secretion of atrial natriuretic hormone -This leads to vasoconstriction - fluid retention - increased afterload - which further inhibits cardiac output -late changes are mycoardial and vas
Less abrupt onset and cessation of palpitations
Genetic screening - medical assessment for chronic diseases - screening for infectious diseases - and updating of immunizations - advice on proper nutrition and exercise - help with quitting unhealthy habits - and advice on avoiding environmental haz

24. What is considered normal blood loss during a menstrual cycle?
Rotator Cuff tendonitis
Less than 80 ml of blood
S. Aureus
Hypertension - CAD - valvular heart disease

25. What diagnosis does the 'worse headache of my life' suggest?
Presence of proteinuria on at least two separate ocassion
PVC or Premature atrial contraction (PAC)
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Subarachnoid hemorrhage

26. Diagnosis of HTN
Polymenorrhea
Muscular chest pain (inflammation or overuse pf chest wall muscles); costochondral joint (reproduced on palpation and patient may not want to take a deep breath in); rib fractures
Folliculitis
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

27. Describe the presentation of myocardial pain?
Acute headache - ataxia - profuse nausea - and vomiting
Influenza - Rhinovirus - Adenovirus - Parainfluenza
BB or CCB - catheter ablation of identified bypass tract
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

28. Metrorrhagia
Repeat Pap after infection treated
LH surge triggers ovulation
Kids: Rotavirus Adults: Norwalk Virus
Irregular bleeding between cycles

29. What places women at higher risk of getting cervical cancer?
These patients are associated with low renin states=less likely to respond to medication
Early sexuality and multiple pregnancies (immature cells are more common at menarche and ruing the postpartum period) - hx of STDs - smoking - HIV - current or prior history of condyloma - and previously abnormal Pap smears
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Diuretics -BB -CCB -ACEi

30. Lab testing for heart palpitation
Activation of the RAAS - increased levels of catecholamines - secretion of atrial natriuretic hormone -This leads to vasoconstriction - fluid retention - increased afterload - which further inhibits cardiac output -late changes are mycoardial and vas
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Hgb - Electrolytes - and TSH
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

31. What are the secondly causes of glomerular disease?
Muscular chest pain (inflammation or overuse pf chest wall muscles); costochondral joint (reproduced on palpation and patient may not want to take a deep breath in); rib fractures
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
A central clear area
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

32. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Medication or chemical esophagitis
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Fever with frontal or maxillary tenderness
Viral gastroenteritis

33. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
35 (exception for postmenopausal women who have recently been started on HRT)
Supraspinatus and bicipital tendons

34. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
EGD
Scabies
MSK - pulmonary - GI - or psychological
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

35. Complete the sentence: pericarditis can cause frictional rub and......
Viral gastroenteritis
Repeat Pap after infection treated
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

36. MI - pericardial tamponade - PE - GI bleed - are...
Associated with hypotension
Generalized Anxiety disorder and panic disorder
Rotator cuff tendonitis
W/in 4hrs and peaks 24hrs; it is important to obtain serial markers since the first set of cardiac markers are negative in 25 - 50% of patients with an acute MI

37. Name the type of headache: mild to moderate intensity; located in the bilateral occipital-frontal areas; dull or band-like; lasts for hours; often assoc. with stress.
Tension headache
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Early sexuality and multiple pregnancies (immature cells are more common at menarche and ruing the postpartum period) - hx of STDs - smoking - HIV - current or prior history of condyloma - and previously abnormal Pap smears
Intermenstrual bleeding

38. Menometrorrhagia
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
The patient is seated with the head turned to the right and is quickly lowered to the supine position with the head over the edge of the examination table 30 degrees below horizontal. The test is then repeated with the head turned to the left. The te
Excessive bleeding in amount - duration - or both at irregular intervals

39. SE Of Beta blockers?
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Hgb - Electrolytes - and TSH
Anticoag with warfarin to prevent thromboembolism

40. What is the Barany maneuver?
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Peptic ulcer disease or gastritis
Pap Smear (unless recent normal pap) -CBC -Pregnancy test -Ultrasound if uterus is enlarged -Cervical culture in patients high risk of infection -Thyroid test and testing for systemic diseases
The patient is seated with the head turned to the right and is quickly lowered to the supine position with the head over the edge of the examination table 30 degrees below horizontal. The test is then repeated with the head turned to the left. The te

41. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Generalized Anxiety disorder and panic disorder
Viral gastroenteritis
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

42. What are the consequences of diastolic dysfunction?
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
A 24hr urine protein collection and urine creatinine clearance determination
Temporal arteritis-biopsy of the temporal artery
Higher filling presure - pulmonary congestion - and decreasd cardiac return

43. Pneumonia tx: suitable for healthy adults less than 60
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Menorrhagia
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Wolff-Parkinson-White syndrome

44. Name the type of headache: severe - unilateral - localized to the periorbital/ temporal area; usually accompanied by one of the following symptoms- lacrimation - rhinorrhea - ptosis - miosis - nasal congestion - and eyelid edema; attacks occur every
Preconception visit: up to 1 yr before conception -1st prenatal visit: 6-8wks after missed menses -Every 4 wks: up to 28 wks gestational age -Every 2 wks: up to 36 weeks gestational age -Every week: until delivery
Cluster headache
ACEi
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

45. What the consequences of decreased cardiac output?
Activation of the RAAS - increased levels of catecholamines - secretion of atrial natriuretic hormone -This leads to vasoconstriction - fluid retention - increased afterload - which further inhibits cardiac output -late changes are mycoardial and vas
Chest pain during pneumonia or PE
Varicella virus
Refractory constipation - a new onset of constipation in an older individual - heme-positive stools - and situations in which the etiology is unclear or the clinical evaluation suggests underlying pathology

46. Describe the presentation of pericardial pain
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Tension headache
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

47. Define the patient population typically affected by orthostatic or postural proteinuria
Chest pain during pneumonia or PE
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Affects 60% of patients with asymptomatic proteinuria; patients are usually <30 - secrete less than 2g protein/day: proteinuria occurs in the upright - but not supine position
24 hour halter

48. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Squamocolumnar junction=most common site of cervical cancer
Upper sternal area burning pain - associated with a productive cough
Pleurisy
Subarachnoid hemorrhage

49. What type of imaging is need for chronic sinusitis?
35 (exception for postmenopausal women who have recently been started on HRT)
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
CT
Anticoag with warfarin to prevent thromboembolism

50. When is a lumbar puncture contraindicated?
Serotypes 16 - 18 - 31 -52 -58
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
BB or CCB - catheter ablation of identified bypass tract
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides