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. Shoulder pain with pain radiating to elbow
Non-cardiac causes of palpitations
Impetigo
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
Cervical radiculopathy

2. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
>3.5g of protein per 24hrs
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

3. Menometrorrhagia
EGD
CT
Excessive bleeding in amount - duration - or both at irregular intervals
100mg; means patient can be trace protein positive and not be detected

4. When should a patient get a stress test?
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
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
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
When the patient has symptoms in association with exercise or who describe chest pain or pressure

5. Who should have Xray testing for shoulder pain?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
35 (exception for postmenopausal women who have recently been started on HRT)
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Folliculitis

6. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
MSK - pulmonary - GI - or psychological
Generalized Anxiety disorder and panic disorder
A 24hr urine protein collection and urine creatinine clearance determination

7. Describe the presentation of myocardial pain?
Bence-Jones
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
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
Excessive bleeding in amount - duration - or both at irregular intervals

8. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Rotator Cuff problem
Fever with frontal or maxillary tenderness
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
Infectious esophagitis

9. 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
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
ACEi
MSK - pulmonary - GI - or psychological

10. Treatment for supraventricular tachycardias
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
BB or CCB - catheter ablation of identified bypass tract

11. What is benign transient proteinuria?
Common problem that resolves spontaneously and is most often seen in children and young adults
CBC
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
Echocardiogram

12. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Adhesive capsulitis (frozen shoulder): most common in middle age women
Medication or chemical esophagitis
S. Aureus
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

13. MI - pericardial tamponade - PE - GI bleed - are...
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Furucnle
Associated with hypotension
Viral infection of the semicircular apparatus

14. Name the skin lesion: erythema - warmth - edema - pain - fever
Cholelithiasis
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Cellulitis

15. What lab tests are recommended for newly diagnosed hypertensive patients?
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Upper sternal area burning pain - associated with a productive cough
Cluster headache
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

16. What are the three major risk factors for heart failure?
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
Varicella virus
Hypertension - CAD - valvular heart disease
Staphylococcal scalded skin syndrome

17. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Scleroderma/polymyositis with secondary gastroesophageal reflux
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
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
Excessive bleeding in amount - duration - or both at irregular intervals

18. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Pts with palpitations and dizziness - near syncope - or syncope
Repeat Pap after infection treated
CT
Infectious esophagitis

19. What are the common causes for laryngitis?
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Cervical radiculopathy
Irregular bleeding between cycles

20. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
>3.5g of protein per 24hrs
S. aureus- beta hemolytic streptococcus
Wolff-Parkinson-White syndrome
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

21. Isolated - extra pounding beats
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Higher filling presure - pulmonary congestion - and decreasd cardiac return
PVC or Premature atrial contraction (PAC)
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

22. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Peptic ulcer disease or gastritis
Serotypes 16 - 18 - 31 -52 -58
Cholelithiasis
These patients are associated with low renin states=less likely to respond to medication

23. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
24 hour halter
100mg; means patient can be trace protein positive and not be detected
Analgesic headache
Polymenorrhea

24. Name the diagnosis: umbilicated skin lesion that is spread by autoinoculation - scratching - or touching a lesion. Discrete 2 to 5 mm slightly umbilicated flesh-colored - dome shaped papules occurring on the face - trunk - axillae - and extremities i
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
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
Molluscum contagiosum- pox virus
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

25. What are the secondly causes of glomerular disease?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
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
MSK - pulmonary - GI - or psychological

26. What are the signs of acute sinusitis?
Fever with frontal or maxillary tenderness
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
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Less than 80 ml of blood

27. Describe the presentation tracheobronchitis
Polymenorrhea
Upper sternal area burning pain - associated with a productive cough
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Generalized Anxiety disorder and panic disorder

28. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
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
Nonulcer dyspepsia
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

29. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
Pleurisy
Presence of proteinuria on at least two separate ocassion
24 hour halter
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

30. What are the symptoms of palpitations?
Coronary artery disease/ angina
Lightheadedness - dizziness - syncope
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Less abrupt onset and cessation of palpitations

31. Describe the history and PE of patient presenting with common cold
Bulk forming: Psyllium - Methycellulose - Polycarbophil
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
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 abrupt onset and cessation of palpitations

32. What diagnosis does the 'worse headache of my life' suggest?
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Subarachnoid hemorrhage

33. Name the diagnosis of heartburn: severe constant mid abdominal pain
Streptococci
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Pancreatitis
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

34. What type of imaging is need for chronic sinusitis?
DM - HTN - DVT - seizures - depression - or anxiety
CT
24 hour halter
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

35. Name 4 factors that predispose an individual to develop pneumonia.
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Echocardiogram
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

36. What are the indiciations for neuroimaging?
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Increase; 200 g/day
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
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

37. What is the peripheral caUse of vertigo?
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Temporal arteritis-biopsy of the temporal artery
Varicella virus
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

38. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Colposcopy - Endocervical curettage - and directed cervical biopsy
PVC or Premature atrial contraction (PAC)
Hgb - Electrolytes - and TSH
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

39. Oligomenorrhea
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
100mg; means patient can be trace protein positive and not be detected
Adhesive capsulitis (frozen shoulder): most common in middle age women
Regular bleeding at intervals of more than 35 days

40. Name the diagnosis: a fertilized female mite burrow through the stratum corneum to being a 30 day life cycle of egg laying and deposition of fecal matter. After the eggs have hatched - the mites can migrate to other areas such as the finger webs - wr
Adhesive capsulitis (frozen shoulder): most common in middle age women
Possibility of Ischemic colitis
Scabies
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

41. How does CHF present on X-ray?
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Infectious esophagitis

42. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Menorrhagia
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
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

43. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
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
Echocardiogram
Intermenstrual bleeding
Non-cardiac causes of palpitations

44. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
PE - MI - aortic dissection - pneumothorax
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
Bulk forming: Psyllium - Methycellulose - Polycarbophil
HPV

45. What is the difference between a Holter monitor or an event monitor?
Polymenorrhea
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
Wolff-Parkinson-White syndrome
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.

46. How does systolic vs. diastolic heart failure present on the echocardiogram?
Less abrupt onset and cessation of palpitations
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
Variability in the time for follicle development during the proliferative phase
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.

47. What drugs do you use to treat H.pylori + PUD?
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Coronary artery disease/ angina

48. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Anticoag with warfarin to prevent thromboembolism
Pancreatitis
Chest pain during pneumonia or PE
Pleurisy

49. 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.
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Possibility of Ischemic colitis
Folliculitis
Supraspinatus and bicipital tendons

50. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
Temporal arteritis-biopsy of the temporal artery
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
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
24 hour halter