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. What is the difference between a Holter monitor or an event monitor?
Molluscum contagiosum- pox virus
Intermenstrual bleeding
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
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

2. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Presence of proteinuria on at least two separate ocassion
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

3. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Medication or chemical esophagitis
Generalized Anxiety disorder and panic disorder
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
Slow progression of cervical cancer changes -Availability of effective early treatment

4. What are the features of nephrotic syndrome?
Infectious esophagitis
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Intermenstrual bleeding
Colposcopy - Endocervical curettage - and directed cervical biopsy

5. Predictors of cardiac etiology
Nonulcer dyspepsia
Kids: Rotavirus Adults: Norwalk Virus
Candida albicans
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

6. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Squamocolumnar junction=most common site of cervical cancer
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
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

7. What are the indiciations for neuroimaging?
A central clear area
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
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
Less abrupt onset and cessation of palpitations

8. Where does the development of abnormal cervical cells begin?
Squamocolumnar junction=most common site of cervical cancer
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
35 (exception for postmenopausal women who have recently been started on HRT)
Scabies

9. Pneumothorax - sudden sharp chest pain - preceded by viral illness
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
Pleurisy
Intermenstrual bleeding
Coronary artery disease/ angina

10. What is the Epley maneuver?
Serotypes 16 - 18 - 31 -52 -58
These patients are associated with low renin states=less likely to respond to medication
100mg; means patient can be trace protein positive and not be detected
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.

11. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac 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
Common problem that resolves spontaneously and is most often seen in children and young adults
Wolff-Parkinson-White syndrome

12. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
Rotator cuff tendonitis
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Slow progression of cervical cancer changes -Availability of effective early treatment
Loop diuretics (Check serum K+ levels before drug admin)

13. What does treatment for migrans include?
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
Medication or chemical esophagitis
Variability in the time for follicle development during the proliferative phase
Menorrhagia

14. What are signs of pulmonary congestion?
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Less abrupt onset and cessation of palpitations
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

15. What is afterload?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Pts with palpitations and dizziness - near syncope - or syncope
Cervical radiculopathy
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

16. At was quantity does urine dipstick test detect elevated protein?
Dehydration - anemia - cardiac causes
100mg; means patient can be trace protein positive and not be detected
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
BB or CCB - catheter ablation of identified bypass tract

17. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
ACEi - ARBS - thiazide diuretics
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
>3.5g of protein per 24hrs
Excessive bleeding in amount - duration - or both at irregular intervals

18. What is the goal of CHF treatment? What drugs should be used?
HPV
Staphylococcal scalded skin syndrome
Reduce symptoms - prevent complications - improve survival-diuretics - ACE inhibitors (slow progression of heart failure - decrease the number of hospitalizations and decrease mortality) - beta blockers (decrease mortality and sudden death) - spirono
Loop diuretics (Check serum K+ levels before drug admin)

19. How to NSAIDs contribute to gastritis and ulcer formation?
Candida albicans
NSAIDs block COX-1 production of prostaglandins that maintain mucosal blood flow - secretion of mucus - and bicarbonate. Without these protective factors - acid-induced inflammation and ulcers my result.
S. Aureus
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

20. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
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.
Variability in the time for follicle development during the proliferative phase
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
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

21. When is a lumbar puncture contraindicated?
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
>3.5g of protein per 24hrs
35 (exception for postmenopausal women who have recently been started on HRT)

22. What is the standard tool used for diagnosis of GERD?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
EGD
Peptic ulcer disease or gastritis
Analgesic headache

23. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
HIV and syphilis
Viral gastroenteritis
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
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

24. 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
Excessive bleeding in amount - duration - or both at irregular intervals
PVC or Premature atrial contraction (PAC)
Temporal arteritis-biopsy of the temporal artery

25. How does systolic vs. diastolic heart failure present on the echocardiogram?
Other brainstem or cranial nerve findings
PVC or Premature atrial contraction (PAC)
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
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

26. Name the diagnosis of heartburn: severe constant mid abdominal pain
Viral infection of the semicircular apparatus
Pancreatitis
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
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

27. Complete the sentence: pericarditis can cause frictional rub and......
Acute headache - ataxia - profuse nausea - and vomiting
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
1)Promoting Na+retention 2) Promoting hypertrophy and hyperplasia of vascular smooth muscles through its mitogenic properties 3) Modifying ion transport - leading to increase in intracellular Ca2+ 4) Sympathetic activation

28. What should preconception counseling include?
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
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
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

29. Describe the presentation of pericardial pain
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
35 (exception for postmenopausal women who have recently been started on HRT)
Rotator cuff tendonitis
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

30. 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
Pleurisy
Nonulcer dyspepsia
Varicella virus

31. Oligomenorrhea
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
Regular bleeding at intervals of more than 35 days
PE - MI - aortic dissection - pneumothorax
Squamocolumnar junction=most common site of cervical cancer

32. Name the skin lesion: honey colored crusts
Regular bleeding at intervals of more than 35 days
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
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
Impetigo

33. Diagnosis of HTN
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
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Temporal arteritis-biopsy of the temporal artery

34. What lab tests are recommended for newly diagnosed hypertensive patients?
Colposcopy - Endocervical curettage - and directed cervical biopsy
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
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Wolff-Parkinson-White syndrome

35. Clinical Manifestations of HTN
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Hypertension - CAD - valvular heart disease
Echocardiogram
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

36. What drugs do you use to treat H.pylori + PUD?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
S. aureus- beta hemolytic streptococcus
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
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. What is considered normal blood loss during a menstrual cycle?
Upper sternal area burning pain - associated with a productive cough
Less than 80 ml of blood
ACEi - ARBS - thiazide diuretics
MSK - pulmonary - GI - or psychological

38. How is constipation clinically defined?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Less than 3 stools per week
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Anticoag with warfarin to prevent thromboembolism

39. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Cholelithiasis
These patients are associated with low renin states=less likely to respond to medication
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

40. What is an acoustic neuroma?
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Serotypes 16 - 18 - 31 -52 -58
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

41. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
HPV testing -Pos=colposcopy -Neg=repeat pap smear
ACEi
Diuretics -BB -CCB -ACEi
True

42. Describe the presentation tracheobronchitis
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Kids: Rotavirus Adults: Norwalk Virus
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
Upper sternal area burning pain - associated with a productive cough

43. Define nephrotic range proteinuria
>3.5g of protein per 24hrs
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Wolff-Parkinson-White syndrome

44. What is benign transient proteinuria?
Pleurisy
Common problem that resolves spontaneously and is most often seen in children and young adults
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

45. After treatment of dysplasia - women need Pap smears every...
DM - HTN - DVT - seizures - depression - or anxiety
Intermenstrual bleeding
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

46. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
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
Less than 3 stools per week
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

47. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Non-cardiac causes of palpitations
Bulk forming: Psyllium - Methycellulose - Polycarbophil
NSAIDs block COX-1 production of prostaglandins that maintain mucosal blood flow - secretion of mucus - and bicarbonate. Without these protective factors - acid-induced inflammation and ulcers my result.
High blood pressure - focal neurologic defecit - or papilledema

48. Difference between Pneumonia and Bronchitis
Supraspinatus and bicipital tendons
Impetigo
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
Rotator Cuff tendonitis

49. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Giardia
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
LH surge triggers ovulation

50. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
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
1)Promoting Na+retention 2) Promoting hypertrophy and hyperplasia of vascular smooth muscles through its mitogenic properties 3) Modifying ion transport - leading to increase in intracellular Ca2+ 4) Sympathetic activation
Less abrupt onset and cessation of palpitations
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)