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 HPV serotypes are most commonly associated with cervical cancer?
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Serotypes 16 - 18 - 31 -52 -58
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

2. What occurs after ovulation
PE - MI - aortic dissection - pneumothorax
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Repeat Pap after infection treated
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

3. What is the difference between a Holter monitor or an event monitor?
RBC casts and old to moderate HTN
Kids: Rotavirus Adults: Norwalk Virus
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
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

4. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
24 hour halter
Pleurisy
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
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

5. How do you define persistent protein uria?
Presence of proteinuria on at least two separate ocassion
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Loop diuretics (Check serum K+ levels before drug admin)

6. 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.
Nonulcer dyspepsia
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
Supraspinatus and bicipital tendons
Regular bleeding at intervals of more than 35 days

7. What are the signs of acute sinusitis?
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Fever with frontal or maxillary tenderness
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
24 hour halter

8. Pneumonia tx: suitable for healthy adults older than 60
Staphylococcal scalded skin syndrome
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
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Slow progression of cervical cancer changes -Availability of effective early treatment

9. What is the standard tool used for diagnosis of GERD?
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
EGD
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
Rotator Cuff tendonitis

10. After treatment of dysplasia - women need Pap smears every...
Excessive bleeding in amount - duration - or both at irregular intervals
Furucnle
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Possibility of Ischemic colitis

11. Diagnosis of HTN
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
E. Coli O157:H7
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
EGD

12. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
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
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Rotator cuff tendonitis
Temporal arteritis-biopsy of the temporal artery

13. What are the indiciations for neuroimaging?
Bulk forming: Psyllium - Methycellulose - Polycarbophil
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
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
Nonulcer dyspepsia

14. Why don't ACEi work well for the elderly and African Americans when treating HTN?
ACEi - ARBS - thiazide diuretics
Chest pain during pneumonia or PE
These patients are associated with low renin states=less likely to respond to medication
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

15. What places women at higher risk of getting cervical cancer?
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
Rotator cuff tendonitis
24 hour halter
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

16. Where does the development of abnormal cervical cells begin?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Squamocolumnar junction=most common site of cervical cancer
Excessive bleeding in amount - duration - or both at irregular intervals
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

17. Carcinoma in situ is generally referred to a gynecologist and requires ______
Cellulitis
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
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
Common problem that resolves spontaneously and is most often seen in children and young adults

18. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Repeat Pap after infection treated
Bence-Jones
Cluster headache
Cholelithiasis

19. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Rotator Cuff problem
Colposcopy - Endocervical curettage - and directed cervical biopsy
Repeat Pap after infection treated
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

20. What are the signs of cerebral hemorrhage?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Acute headache - ataxia - profuse nausea - and vomiting
Increase; 200 g/day
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

21. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

22. Mainstay treatment for soft tissue inflammation (Shoulder)
Higher filling presure - pulmonary congestion - and decreasd cardiac return
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

23. Natural history of cervical cancer
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Acute headache - ataxia - profuse nausea - and vomiting
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

24. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
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
Pts with palpitations and dizziness - near syncope - or syncope
HPV
Hgb - Electrolytes - and TSH

25. What is the caUse of benign positional vertigo?
Rotator Cuff problem
LH surge triggers ovulation
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.
A 24hr urine protein collection and urine creatinine clearance determination

26. Complete the sentence: pericarditis can cause frictional rub and......
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Polymenorrhea
Slow progression of cervical cancer changes -Availability of effective early treatment

27. Define proteinuria
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
>150mg per 24hrs
Less than 3 stools per week
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

28. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Hypertension - CAD - valvular heart disease
Slow progression of cervical cancer changes -Availability of effective early treatment
Hgb - Electrolytes - and TSH
Viral infection of the semicircular apparatus

29. What lab tests are recommended for newly diagnosed hypertensive patients?
ACEi - ARBS - thiazide diuretics
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
CBC
100mg; means patient can be trace protein positive and not be detected

30. What diagnosis does the 'worse headache of my life' suggest?
>150mg per 24hrs
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
ACEi
Subarachnoid hemorrhage

31. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Presence of proteinuria on at least two separate ocassion
Infectious esophagitis
MSK - pulmonary - GI - or psychological
Scabies

32. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
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
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

33. Things that need to be included in history of shoulder pain
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
HPV

34. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
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
Bence-Jones

35. Treatment for supraventricular tachycardias
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
BB or CCB - catheter ablation of identified bypass tract
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

36. Constipation: What are indications for lab testing?
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
Chest pain during pneumonia or PE
Candida albicans
Scleroderma/polymyositis with secondary gastroesophageal reflux

37. Describe the presentation of pneumonia
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
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
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

38. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
Furucnle
A 24hr urine protein collection and urine creatinine clearance determination
MSK - pulmonary - GI - or psychological
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

39. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
Varicella virus
Analgesic headache
HIV and syphilis
Subarachnoid hemorrhage

40. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
Pleurisy
Temporal arteritis-biopsy of the temporal artery
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

41. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
Chest pain during pneumonia or PE
Coag disorders
Impetigo
ACEi

42. What is benign transient proteinuria?
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Common problem that resolves spontaneously and is most often seen in children and young adults
ACEi - ARBS - thiazide diuretics
CT

43. What should preconception counseling include?
Peptic ulcer disease or gastritis
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
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
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

44. What is the goal of CHF treatment? What drugs should be used?
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Pleurisy

45. name the 4 emergent causes of chest pain
Cluster headache
PE - MI - aortic dissection - pneumothorax
Nonulcer dyspepsia
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

46. patients with herpes zoster may experience what symptom before the rash appear?
Acute headache - ataxia - profuse nausea - and vomiting
Pain
Cluster headache
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

47. Who should have Xray testing for shoulder pain?
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Common problem that resolves spontaneously and is most often seen in children and young adults
Candida albicans
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

48. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
S. aureus- beta hemolytic streptococcus
35 (exception for postmenopausal women who have recently been started on HRT)
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Cellulitis

49. What are the most common causes for the common cold?
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
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Adhesive capsulitis (frozen shoulder): most common in middle age women
MSK - pulmonary - GI - or psychological

50. What are the three major risk factors for heart failure?
Hypertension - CAD - valvular heart disease
Regular bleeding at intervals of more than 35 days
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp