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. Describes what occurs during squamous metaplasia of the cervix.
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
100mg; means patient can be trace protein positive and not be detected
Headache of recent onset (<6 months) -headache beginning after 50 years of age -worsening headaches -headache that does not fit primary headache pattern -associated seizure -focal neurologic signs or symptoms -personality change-severe headaches unre
LH surge triggers ovulation

2. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
Kids: Rotavirus Adults: Norwalk Virus
Generalized Anxiety disorder and panic disorder
MSK - pulmonary - GI - or psychological
Echocardiogram

3. What is the caUse of Meniere disease? What are the cardinal symptoms?
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

4. What is the caUse of benign positional vertigo?
Non-cardiac causes of palpitations
Loop diuretics (Check serum K+ levels before drug admin)
Particulate matter or otoliths may form in the semicircular canal. The otoliths become dislodged and stimulate the sensory hair cells in the semicircular canals - leading to vertigo.
Pleurisy

5. When does troponin rise following myocardial injury or infarction?
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Coronary artery disease/ angina
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

6. Metrorrhagia
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
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
Pancreatitis
Irregular bleeding between cycles

7. What is the role of LH in the menstrual cycle
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
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
LH surge triggers ovulation
Cholelithiasis

8. Describe the presentation of pneumonia
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Serotypes 16 - 18 - 31 -52 -58
Dysfunctional Uterine bleeding: caused by hormonal imbalances from a functionally abnormal hypothalamic-pitu-ovarian axis resulting in abnormal follicle development and anovulation (metorrhagia) -Corpus luteum does not develop=progesterone-deficient
Pleurisy

9. Uterine bleeding between regular cycles
Cervical radiculopathy
100mg; means patient can be trace protein positive and not be detected
Intermenstrual bleeding
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

10. Name types of laxatives
Less abrupt onset and cessation of palpitations
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Coronary artery disease/ angina
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

11. How is constipation clinically defined?
Less than 3 stools per week
Temporal arteritis-biopsy of the temporal artery
Coag disorders
CT

12. Name the skin lesion: pustule in association with a hair follice
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
PE - MI - aortic dissection - pneumothorax
Dehydration - anemia - cardiac causes
Folliculitis

13. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Echocardiogram
Menorrhagia
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Less than 80 ml of blood

14. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Menorrhagia
>3.5g of protein per 24hrs
Polymenorrhea
Paroxysmal atrial fibrillation or supraventricular tachycardia

15. What are the signs of acute sinusitis?
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Fever with frontal or maxillary tenderness
>150mg per 24hrs
Typically brought on exercise - eating - emotional excitement; pain lasts 5 - 15mins - disappears with nitroglycerin or at rest; if the pain lasts <1 or >30mins it should not be considered anginal

16. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Peptic ulcer disease or gastritis
Intermenstrual bleeding
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Cervical radiculopathy

17. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
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
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Conization (or LEEP): removeal of a portion of the cervix and thus patients are at risk of preterm labor - incompetent cervix - or cervical stenosis in future pregnancies
Scleroderma/polymyositis with secondary gastroesophageal reflux

18. What lab tests are recommended for newly diagnosed hypertensive patients?
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

19. The degenerative process that results in bursitis - tendonitis - and shoulder impingement often begins in the _____ or ____ tendons - which have a poor blood supply and are often under stress.
Supraspinatus and bicipital tendons
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Hypertension - CAD - valvular heart disease
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

20. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Other brainstem or cranial nerve findings
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Albumin; low molecular weight proteins
Streptococci

21. Define proteinuria
Warts
>150mg per 24hrs
HPV
Possibility of Ischemic colitis

22. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Molluscum contagiosum- pox virus
Bence-Jones
CT
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

23. After treatment of dysplasia - women need Pap smears every...
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
High blood pressure - focal neurologic defecit - or papilledema
Squamocolumnar junction=most common site of cervical cancer
Subarachnoid hemorrhage

24. What are the most common viral causes of diarrhea in kids and adults?
Kids: Rotavirus Adults: Norwalk Virus
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Conization (or LEEP): removeal of a portion of the cervix and thus patients are at risk of preterm labor - incompetent cervix - or cervical stenosis in future pregnancies
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

25. What is considered normal blood loss during a menstrual cycle?
BB or CCB - catheter ablation of identified bypass tract
Less than 80 ml of blood
Kids: Rotavirus Adults: Norwalk Virus
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

26. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
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
HPV testing -Pos=colposcopy -Neg=repeat pap smear
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Particulate matter or otoliths may form in the semicircular canal. The otoliths become dislodged and stimulate the sensory hair cells in the semicircular canals - leading to vertigo.

27. Describe the presentation of angina?
Typically brought on exercise - eating - emotional excitement; pain lasts 5 - 15mins - disappears with nitroglycerin or at rest; if the pain lasts <1 or >30mins it should not be considered anginal
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

28. Name the skin lesion: honey colored crusts
Pain
Adhesive capsulitis (frozen shoulder): most common in middle age women
CT
Impetigo

29. How does CHF present on X-ray?
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
HIV and syphilis
>150mg per 24hrs
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

30. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
BB or CCB - catheter ablation of identified bypass tract
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
PVC or Premature atrial contraction (PAC)
ACEi

31. What does the classic ring worm lesion have?
A central clear area
Upper sternal area burning pain - associated with a productive cough
Generalized Anxiety disorder and panic disorder
Cluster headache

32. 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.
S. Aureus
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
BB or CCB - catheter ablation of identified bypass tract
Tension headache

33. Carcinoma in situ is generally referred to a gynecologist and requires ______
Kids: Rotavirus Adults: Norwalk Virus
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
Conization (or LEEP): removeal of a portion of the cervix and thus patients are at risk of preterm labor - incompetent cervix - or cervical stenosis in future pregnancies
Tension headache

34. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
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
Common problem that resolves spontaneously and is most often seen in children and young adults
Varicella virus
Irregular bleeding between cycles

35. What treatments are the cornerstone for treating cases of functional constipation?
Excessive bleeding in amount - duration - or both at irregular intervals
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Increasing fluid (8 - 8oz glasses of water/day) -fiber
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

36. What HPV serotypes are most commonly associated with cervical cancer?
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Repeat Pap after infection treated
Serotypes 16 - 18 - 31 -52 -58

37. History for Acute bronchitis
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

38. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Furucnle
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Rotator cuff tendonitis

39. Define nephrotic range proteinuria
Serotypes 16 - 18 - 31 -52 -58
100mg; means patient can be trace protein positive and not be detected
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
>3.5g of protein per 24hrs

40. name the 4 emergent causes of chest pain
Headache of recent onset (<6 months) -headache beginning after 50 years of age -worsening headaches -headache that does not fit primary headache pattern -associated seizure -focal neurologic signs or symptoms -personality change-severe headaches unre
Pancreatitis
Viral infection of the semicircular apparatus
PE - MI - aortic dissection - pneumothorax

41. Regular bleeding at intervals of less than 21 days
Fever with frontal or maxillary tenderness
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
True
Polymenorrhea

42. What are the features of glomerular nephritis
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
RBC casts and old to moderate HTN
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

43. HIgh risk pregnant patients should be evaluated for ____ and ____
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
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
Scleroderma/polymyositis with secondary gastroesophageal reflux
HIV and syphilis

44. MI - pericardial tamponade - PE - GI bleed - are...
HPV
Associated with hypotension
Fever with frontal or maxillary tenderness
Dehydration - anemia - cardiac causes

45. What is the role of FSH in one's menstrual cycle
Pleurisy
Intermenstrual bleeding
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Temporal arteritis-biopsy of the temporal artery

46. Mainstay treatment for soft tissue inflammation (Shoulder)
Higher filling presure - pulmonary congestion - and decreasd cardiac return
100mg; means patient can be trace protein positive and not be detected
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
CT

47. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
S. Aureus
Rotator Cuff problem
Supraspinatus and bicipital tendons

48. Diagnosis of HTN
Scleroderma/polymyositis with secondary gastroesophageal reflux
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
PE - MI - aortic dissection - pneumothorax
Serotypes 16 - 18 - 31 -52 -58

49. Menometrorrhagia
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Excessive bleeding in amount - duration - or both at irregular intervals
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

50. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Cholelithiasis
Upper sternal area burning pain - associated with a productive cough
Triptans - ergotamine - DHE (emergency); prophylaxis- beta blockeres - tricyclic antidepressants - CCBs - anticonvulsants - serotonin antagonists - MAOIs; avoidance of stress - alcohol - caffeine - tyramine (red wine and cheese) - nitrates (cured mea