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. Uterine bleeding between regular cycles
E. Coli O157:H7
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Intermenstrual bleeding

2. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Regular bleeding at intervals of more than 35 days
PE - MI - aortic dissection - pneumothorax
Candida albicans
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

3. What medications can cause heart palpitations?
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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
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

4. Metrorrhagia
Irregular bleeding between cycles
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
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
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

5. What are the signs of cerebral hemorrhage?
Analgesic headache
>3.5g of protein per 24hrs
Acute headache - ataxia - profuse nausea - and vomiting
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

6. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
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.
Temporal arteritis-biopsy of the temporal artery
Slow progression of cervical cancer changes -Availability of effective early treatment
Infectious esophagitis

7. 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
Generalized Anxiety disorder and panic disorder
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
Scabies
Pancreatitis

8. What are the secondly causes of glomerular disease?
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Serotypes 16 - 18 - 31 -52 -58

9. 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)
Candida albicans
Cervical radiculopathy

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
35 (exception for postmenopausal women who have recently been started on HRT)
PE - MI - aortic dissection - pneumothorax
A 24hr urine protein collection and urine creatinine clearance determination

11. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
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
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
E. Coli O157:H7

12. Name the skin lesion: erythema - warmth - edema - pain - fever
Less than 80 ml of blood
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
HIV and syphilis
Cellulitis

13. Where does the development of abnormal cervical cells begin?
Squamocolumnar junction=most common site of cervical cancer
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
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
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

14. Cycle length variabilty is primarily due to what?
Variability in the time for follicle development during the proliferative phase
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Impetigo
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation

15. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
CBC
Loop diuretics (Check serum K+ levels before drug admin)
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
HPV testing -Pos=colposcopy -Neg=repeat pap smear

16. What is the next best step if a patient has two or more positive dipstick tests?
A 24hr urine protein collection and urine creatinine clearance determination
Irregular bleeding between cycles
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Rotator Cuff tendonitis

17. What are the primary glomerular diseases?
Menorrhagia
Cellulitis
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

18. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
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
>3.5g of protein per 24hrs
>150mg per 24hrs
Cervical radiculopathy

19. Irregular cycles with excessive flow - duration - or both
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Irregular bleeding between cycles
Menorrhagia
Rotator Cuff problem

20. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Pts with palpitations and dizziness - near syncope - or syncope
Acute headache - ataxia - profuse nausea - and vomiting

21. What should be considered in younger patients with menorrhagia
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Slow progression of cervical cancer changes -Availability of effective early treatment
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
Coag disorders

22. What is the Epley maneuver?
Paroxysmal atrial fibrillation or supraventricular tachycardia
Upper sternal area burning pain - associated with a productive cough
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.
Impetigo

23. Name some medications that can cause proteinuria
24 hour halter
Slow progression of cervical cancer changes -Availability of effective early treatment
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

24. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
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
HPV testing -Pos=colposcopy -Neg=repeat pap smear
GERD

25. What are the most common viral causes of diarrhea in kids and adults?
Kids: Rotavirus Adults: Norwalk Virus
Pancreatitis
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Irregular bleeding between cycles

26. What should preconception counseling include?
Rotator cuff tendonitis
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
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

27. What the consequences of decreased cardiac output?
Cholelithiasis
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
LH surge triggers ovulation
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

28. HIgh risk pregnant patients should be evaluated for ____ and ____
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
HIV and syphilis
Associated with hypotension
Intermenstrual bleeding

29. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
HIV and syphilis
Less abrupt onset and cessation of palpitations
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

30. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Possibility of Ischemic colitis
Higher filling presure - pulmonary congestion - and decreasd cardiac return
>3.5g of protein per 24hrs
Analgesic headache

31. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Less than 3 stools per week
PE - MI - aortic dissection - pneumothorax

32. What places women at higher risk of getting cervical cancer?
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
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
Hgb - Electrolytes - and TSH
Albumin; low molecular weight proteins

33. What is an acoustic neuroma?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Rotator Cuff tendonitis
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

34. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Temporal arteritis-biopsy of the temporal artery
Less than 3 stools per week
Wolff-Parkinson-White syndrome
HIV and syphilis

35. Carcinoma in situ is generally referred to a gynecologist and requires ______
LH surge triggers ovulation
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
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

36. Name the skin lesion: small tumors of the skin that obscure normal skin lines - have a mosaic surface pattern - and may have thrombosed vessels appeairng as black dots on the surface
Chest pain during pneumonia or PE
RBC casts and old to moderate HTN
Warts
E. Coli O157:H7

37. Describe the presentation tracheobronchitis
Albumin; low molecular weight proteins
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
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
Upper sternal area burning pain - associated with a productive cough

38. SE Of Beta blockers?
Viral gastroenteritis
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
A 24hr urine protein collection and urine creatinine clearance determination
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

39. Lab testing for heart palpitation
Diuretics -BB -CCB -ACEi
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
Hgb - Electrolytes - and TSH
These patients are associated with low renin states=less likely to respond to medication

40. What is the standard tool used for diagnosis of GERD?
Fever with frontal or maxillary tenderness
>150mg per 24hrs
EGD
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

41. What are the features of glomerular nephritis
RBC casts and old to moderate HTN
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Folliculitis

42. What are the three types of lice?
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Slow progression of cervical cancer changes -Availability of effective early treatment
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

43. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
Viral infection of the semicircular apparatus
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
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

44. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
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
Cholelithiasis

45. Discomfort with abducting the arm past 90 degress
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
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Rotator Cuff tendonitis
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

46. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
These patients are associated with low renin states=less likely to respond to medication
Chest pain during pneumonia or PE
Pancreatitis
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

47. What treatments are the cornerstone for treating cases of functional constipation?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Hypertension - CAD - valvular heart disease
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

48. 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.
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Tension headache
Intermenstrual bleeding

49. In regards to a Pap smear - What should be done if a patient has cervical inflammation from infections such as Chlamydia or yeast that may cause cells to appear abnormal.
CT
Repeat Pap after infection treated
Bence-Jones
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

50. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Acute headache - ataxia - profuse nausea - and vomiting
Echocardiogram
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)