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. 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
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Scabies
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

2. What are the primary glomerular diseases?
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

3. Regular bleeding at intervals of less than 21 days
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Polymenorrhea

4. When should invasive eletrophysiologic study should be considered?
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
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.
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

5. What HPV serotypes are most commonly associated with cervical cancer?
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Rotator Cuff problem
Scabies
Serotypes 16 - 18 - 31 -52 -58

6. What is the difference between a Holter monitor or an event monitor?
Cholelithiasis
Streptococci
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
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

7. History for Sinusitis

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

8. What is the role of FSH in one's menstrual cycle
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Kids: Rotavirus Adults: Norwalk Virus
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Paroxysmal atrial fibrillation or supraventricular tachycardia

9. What are the common causes for laryngitis?
Supraspinatus and bicipital tendons
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Influenza - Rhinovirus - Adenovirus - Parainfluenza
A central clear area

10. When should a patient get a stress test?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
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

11. Discomfort with abducting the arm past 90 degress
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
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
Bence-Jones
Rotator Cuff tendonitis

12. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
Scleroderma/polymyositis with secondary gastroesophageal reflux
Giardia
Pancreatitis
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

13. What is the role of LH in the menstrual cycle
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Streptococci
LH surge triggers ovulation
Pain

14. Cycle length variabilty is primarily due to what?
Variability in the time for follicle development during the proliferative phase
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
ACEi - ARBS - thiazide diuretics
Rotator Cuff problem

15. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Viral infection of the semicircular apparatus
HIV and syphilis
Paroxysmal atrial fibrillation or supraventricular tachycardia

16. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

17. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Nonulcer dyspepsia
Menorrhagia
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

18. How can GERD (or esophageal motility disorders) lead to chest pain?
Scleroderma/polymyositis with secondary gastroesophageal reflux
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Presence of proteinuria on at least two separate ocassion
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

19. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
Paroxysmal atrial fibrillation or supraventricular tachycardia
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Nonulcer dyspepsia
These patients are associated with low renin states=less likely to respond to medication

20. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
>3.5g of protein per 24hrs
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Echocardiogram
Common problem that resolves spontaneously and is most often seen in children and young adults

21. What is the caUse of benign positional vertigo?
Cluster headache
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
Viral infection of the semicircular apparatus
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.

22. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
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
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Diuretics -BB -CCB -ACEi

23. What are the 2 psych disorders most commonly associated with palpitations?
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Generalized Anxiety disorder and panic disorder
Variability in the time for follicle development during the proliferative phase
Pts with palpitations and dizziness - near syncope - or syncope

24. What are the three types of lice?
Presence of proteinuria on at least two separate ocassion
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Wolff-Parkinson-White syndrome

25. Things that need to be included in history of shoulder pain
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.
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Chest pain during pneumonia or PE
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)

26. Isolated - extra pounding beats
A 24hr urine protein collection and urine creatinine clearance determination
PVC or Premature atrial contraction (PAC)
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
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

27. Predictors of cardiac etiology
Kids: Rotavirus Adults: Norwalk Virus
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
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
When the patient has symptoms in association with exercise or who describe chest pain or pressure

28. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
S. Aureus
Kids: Rotavirus Adults: Norwalk Virus
Viral infection of the semicircular apparatus

29. Describe the presentation of angina?
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Kids: Rotavirus Adults: Norwalk Virus
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

30. Where does the development of abnormal cervical cells begin?
>3.5g of protein per 24hrs
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Squamocolumnar junction=most common site of cervical cancer
E. Coli O157:H7

31. What medications can cause heart palpitations?
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
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
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
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

32. Metrorrhagia
Irregular bleeding between cycles
Non-cardiac causes of palpitations
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Lightheadedness - dizziness - syncope

33. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
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
Other brainstem or cranial nerve findings
Loop diuretics (Check serum K+ levels before drug admin)

34. What is a markers of CNS vertigo?
Echocardiogram
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
Other brainstem or cranial nerve findings
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

35. Name the diagnosis of heartburn: regurgitation - dysphagia
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
GERD
Pleurisy
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

36. Describe the history and PE of patient presenting with common cold
PE - MI - aortic dissection - pneumothorax
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
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
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

37. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
24 hour halter
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
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

38. 1+ protein level on urine dipstick usually represents how much protein in the urine?
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Chest pain during pneumonia or PE

39. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
PVC or Premature atrial contraction (PAC)
Echocardiogram
Colposcopy - Endocervical curettage - and directed cervical biopsy
Fever with frontal or maxillary tenderness

40. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
Kids: Rotavirus Adults: Norwalk Virus
24 hour halter
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Upper sternal area burning pain - associated with a productive cough

41. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
High blood pressure - focal neurologic defecit - or papilledema
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
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

42. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
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
Less than 80 ml of blood
Paroxysmal atrial fibrillation or supraventricular tachycardia

43. Who should have Xray testing for shoulder pain?
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
24 hour halter
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

44. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Scleroderma/polymyositis with secondary gastroesophageal reflux
Rotator cuff tendonitis
Loop diuretics (Check serum K+ levels before drug admin)

45. What are the signs of malignant hypertension?
Menorrhagia
High blood pressure - focal neurologic defecit - or papilledema
Generalized Anxiety disorder and panic disorder
Increasing fluid (8 - 8oz glasses of water/day) -fiber

46. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
Cervical radiculopathy
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
PVC or Premature atrial contraction (PAC)
ACEi - ARBS - thiazide diuretics

47. Describe the presentation of pericardial pain
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
HPV
PE - MI - aortic dissection - pneumothorax
These patients are associated with low renin states=less likely to respond to medication

48. Natural history of cervical cancer
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Upper sternal area burning pain - associated with a productive cough
Scabies

49. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Varicella virus

50. What are the symptoms of palpitations?
Viral infection of the semicircular apparatus
Slow progression of cervical cancer changes -Availability of effective early treatment
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Lightheadedness - dizziness - syncope