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 lab tests are recommended for newly diagnosed hypertensive patients?
PE - MI - aortic dissection - pneumothorax
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Rotator Cuff problem
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

2. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
Bence-Jones
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Rotator Cuff tendonitis
ACEi

3. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
PVC or Premature atrial contraction (PAC)
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Giardia
>150mg per 24hrs

4. What does treatment for migrans include?
Generalized Anxiety disorder and panic disorder
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
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

5. Define nephrotic range proteinuria
Possibility of Ischemic colitis
Influenza - Rhinovirus - Adenovirus - Parainfluenza
>3.5g of protein per 24hrs
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

6. After treatment of dysplasia - women need Pap smears every...
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
EGD
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

7. MI - pericardial tamponade - PE - GI bleed - are...
Less than 80 ml of blood
Associated with hypotension
100mg; means patient can be trace protein positive and not be detected
Fever with frontal or maxillary tenderness

8. When is a lumbar puncture contraindicated?
Excessive bleeding in amount - duration - or both at irregular intervals
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
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

9. True or false: Migraine headaches require two of these four headache characteristics for diagnosis: unilateral location - pulsatile quality - moderate to severe intensity - or aggravation by movement. They must also be associated with one of the foll
Influenza - Rhinovirus - Adenovirus - Parainfluenza
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
Hypertension - CAD - valvular heart disease
True

10. What is the difference between a Holter monitor or an event monitor?
Furucnle
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
Possibility of Ischemic colitis

11. What does the classic ring worm lesion have?
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Warts
Molluscum contagiosum- pox virus
A central clear area

12. Why is the pap smear one of the most effective cancer screening tools?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Varicella virus
Slow progression of cervical cancer changes -Availability of effective early treatment
Polymenorrhea

13. What are the indiciations for neuroimaging?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
ACEi
Squamocolumnar junction=most common site of cervical cancer
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

14. What are the primary glomerular diseases?
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Bence-Jones

15. What occurs after ovulation
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
>150mg per 24hrs
EGD
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

16. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Echocardiogram
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Coronary artery disease/ angina

17. What are the most common viral causes of diarrhea in kids and adults?
Less abrupt onset and cessation of palpitations
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Kids: Rotavirus Adults: Norwalk Virus
Coronary artery disease/ angina

18. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Upper sternal area burning pain - associated with a productive cough
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
Subarachnoid hemorrhage
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

19. What is the peripheral caUse of vertigo?
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Cholelithiasis
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

20. What are the common causes for laryngitis?
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Hgb - Electrolytes - and TSH

21. What is the Barany maneuver?
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
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
Less than 80 ml of blood
Anticoag with warfarin to prevent thromboembolism

22. Predictors of cardiac etiology
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Cholelithiasis
Infectious esophagitis
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

23. Metrorrhagia
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Irregular bleeding between cycles
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
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

24. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
Viral infection of the semicircular apparatus
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
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

25. History for Sinusitis

26. Cycle length variabilty is primarily due to what?
Tension headache
Variability in the time for follicle development during the proliferative phase
Cervical radiculopathy
Serotypes 16 - 18 - 31 -52 -58

27. Describe the presentation of angina?
Dehydration - anemia - cardiac causes
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
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
Associated with hypotension

28. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
Less than 3 stools per week
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
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
Viral infection of the semicircular apparatus

29. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
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
Increase; 200 g/day
Giardia

30. What are the features of glomerular nephritis
CT
Furucnle
Nonulcer dyspepsia
RBC casts and old to moderate HTN

31. What HPV serotypes are most commonly associated with cervical cancer?
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
EGD
Serotypes 16 - 18 - 31 -52 -58
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

32. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
CT
Nonulcer dyspepsia
S. aureus- beta hemolytic streptococcus
Other brainstem or cranial nerve findings

33. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Rotator cuff tendonitis
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Analgesic headache
Nonulcer dyspepsia

34. Diarrhea from custard filled pastries
S. Aureus
Polymenorrhea
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
PE - MI - aortic dissection - pneumothorax

35. When should a patient get a stress test?
Wolff-Parkinson-White syndrome
Albumin; low molecular weight proteins
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Pancreatitis

36. What test done in PE measures instability of shoulder?
Scabies
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
HPV
E. Coli O157:H7

37. How is constipation clinically defined?
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)
Less than 3 stools per week
HIV and syphilis

38. What drugs do you use to treat H.pylori + PUD?
Warts
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
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

39. What is afterload?
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.
Common problem that resolves spontaneously and is most often seen in children and young adults
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
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

40. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Temporal arteritis-biopsy of the temporal artery
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria

41. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
Impetigo
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Preconception visit: up to 1 yr before conception -1st prenatal visit: 6-8wks after missed menses -Every 4 wks: up to 28 wks gestational age -Every 2 wks: up to 36 weeks gestational age -Every week: until delivery
Staphylococcal scalded skin syndrome

42. What are the consequences of diastolic dysfunction?
Less than 80 ml of blood
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
When the patient has symptoms in association with exercise or who describe chest pain or pressure

43. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
ACEi - ARBS - thiazide diuretics
Analgesic headache

44. Lab testing for heart palpitation
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
Hgb - Electrolytes - and TSH
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
EGD

45. How can GERD (or esophageal motility disorders) lead to chest pain?
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
24 hour halter
True
Bence-Jones

46. Carcinoma in situ is generally referred to a gynecologist and requires ______
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
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
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
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

47. What diagnosis does the 'worse headache of my life' suggest?
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
CT
Subarachnoid hemorrhage
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

48. What should blood work include for suspected heart failure?
ACEi - ARBS - thiazide diuretics
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Diuretics -BB -CCB -ACEi
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

49. What is the role of FSH in one's menstrual cycle
True
Non-cardiac causes of palpitations
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
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

50. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Scleroderma/polymyositis with secondary gastroesophageal reflux
Staphylococcal scalded skin syndrome
Molluscum contagiosum- pox virus
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually