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Family Medicine Shelf Exam Review – Diagnosis, Screening & Treatment Guidelines – 310 Practice Questions with Answers – NBME / COMAT Family Medicine 2026

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This document contains 310 practice questions with expert-verified answers for the Family Medicine Shelf Examination 2026. The material is structured in a concise question-and-answer format designed to help medical students rapidly review high-yield clinical concepts frequently tested on the NBME Family Medicine Shelf Exam, COMAT Family Medicine exam, and USMLE Step 2 CK clinical knowledge assessments. The resource covers a broad range of core primary care and outpatient medicine topics, including cardiovascular disease, endocrinology, infectious diseases, pulmonology, dermatology, rheumatology, gastroenterology, nephrology, neurology, psychiatry, and women’s health. Early sections review common diagnostic presentations such as celiac disease with dermatitis herpetiformis, resistant hypertension caused by secondary conditions like primary hyperaldosteronism, and pediatric community-acquired pneumonia management. These topics highlight practical clinical decision-making used in family medicine and outpatient internal medicine settings. The material also includes diagnostic criteria, physical examination findings, and first-line management strategies for a wide range of medical conditions. Examples include the evaluation of plantar fasciitis, ACL tears using the Lachman test, late-onset male hypogonadism screening with serum testosterone levels, and the management of hypercalcemia of malignancy with intravenous fluid resuscitation. Additional clinical pearls address complex conditions such as MEN syndromes, SIADH, inflammatory bowel disease complications, and opportunistic infections in patients with HIV based on CD4 counts. Preventive medicine and screening guidelines are also extensively covered. The document reviews USPSTF screening recommendations, including mammography intervals, colon cancer screening protocols, lung cancer screening criteria for smokers, diabetes screening recommendations, and abdominal aortic aneurysm screening in high-risk patients. The guide also discusses vaccination schedules, cardiovascular risk prevention, and lifestyle interventions, which are essential topics frequently tested on clinical shelf exams and licensing board assessments. In addition to diagnosis and treatment algorithms, the material highlights high-yield pharmacology and medication safety considerations relevant to primary care practice. Topics include contraindications for medications such as doxycycline in pregnancy, drug-induced pancreatitis from valproic acid, lithium-induced diabetes insipidus, ACE-inhibitor monitoring, and adverse effects of drugs like amiodarone or cyclophosphamide. These pharmacologic principles help learners recognize medication complications commonly tested in board-style clinical questions. Because the document compiles concise clinical facts across multiple specialties encountered in outpatient care, it serves as an effective rapid review and exam preparation tool for learners preparing for family medicine rotations and board examinations. This document may be useful for students and professionals studying or preparing for courses such as Family Medicine, Primary Care Medicine, Clinical Medicine, Preventive Medicine, Internal Medicine for Primary Care, and Community Health. It is particularly relevant for learners enrolled in medical schools, osteopathic medical schools, physician assistant programs, and nurse practitioner programs preparing for NBME Family Medicine Shelf Exam, COMAT Family Medicine, USMLE Step 2 CK, or COMLEX-USA Level 2 clinical examinations. Keywords family medicine shelf exam review, primary care clinical guidelines, preventive medicine screening recommendations, hypertension secondary causes evaluation, primary hyperaldosteronism screening aldosterone renin ratio, plantar fasciitis heel pain diagnosis, MEN syndrome endocrine tumors, SIADH diagnosis hyponatremia, inflammatory bowel disease complications, HIV opportunistic infections CD4 thresholds, colon cancer screening guidelines USPSTF, mammography screening intervals USPSTF, lung cancer screening smokers criteria, diabetes screening HbA1c guidelines, medication contraindications pregnancy doxycycline, ACE inhibitor monitoring creatinine increase, amiodarone adverse effects pulmonary fibrosis, lithium induced diabetes insipidus, dermatology lesions melanoma ABCDE rule, clinical board exam preparation family medicine

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Family Medicine
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Family Medicine Shelf 2026
Expert Verified | Ace the Test



Celiac Sprue - 🧠 ANSWER ✔✔otherwise known as celiac diseae. Look for

history of nonbloody diarrhea with weight loss and a vesicular rash

(dermatitis herpetiform). Serum ttransfluatminase is highly sensitivie. Small

bowel biopsy wold show villous atrophy.


Absolutely contraindications to ECT - 🧠 ANSWER ✔✔there are none. ECt

can be used safely in those with cardiac pacemakers and defibirilators and

the very elderly It may also be used in preganncy.

,Diffiuclt to control HTN - 🧠 ANSWER ✔✔noadheerence, use hof alcohol,

NSAIDs, certain antidepressants, or sympathomimetics. Or secondary HTN


Secondary HTN - 🧠 ANSWER ✔✔caused by CKD, obstructve sleep apnea,

or primary hyperaldoseteronism. The omost common is primary

hyperaldosteronism (20%) and is common in women and otherwise

asympatomatic. They may be hypokalemic as a clue since aldosterone

does this. Screen with a morning plasma aldosterone/renin ratio- if ratio is

> 20 and aldosteorne is >15, primary hyperaldosteronism is leading ddx.


CAP in a 15 month old - 🧠 ANSWER ✔✔when there is a focal sound in teh

lung fields- not diffuese wehezing could be a bacterrial infeciton with strept

pneumo. Amoxicllin high dose with close outpatinet follow up would b

eapprorpiate if the child does not appear toxic, hypoxemic, with signs of

respiratory distress, or dehydration.


Introduction of solid food - 🧠 ANSWER ✔✔at 6 months of age.


Midshaft posteromedial tibial stress fracture in a runner - 🧠 ANSWER ✔✔tx:

relative rest from running and avoid activities with pain. Once pain

subsides, start agian slowly. A pneumatic stirrup air leg brace /Aircast. can

be helpful in treatment.

,Late-onset (60) male hypogonadism - 🧠 ANSWER ✔✔screen with a serum

total testosterone level. Get free tesotterone only if total is borderline

because more expswensive. LH and FSH can help distinguish primary from

secondary hypogonadism.


Plantar Fascitis - 🧠 ANSWER ✔✔common cause of heel pain. Can be

unilateral or bilaterlal. The etiology is unkown, although it is thought to be

due to cumulative overload stress. It is worse when patient first stands up

when getting out of bed or after prolonged sitting. Get better with walking

but then worse after prolonged walking. Point tendernes to palpationon the

plantar surface of the heal. Condition lasts for months or years, and

resolves in most patinets over time. First line treatment is common off the

shelf insoles like Dr. sholes.


ACL tear - 🧠 ANSWER ✔✔Lachman's test is actually more sensitive then

anterior drawaer


MGUs - 🧠 ANSWER ✔✔becomes mulitple myeloma when thre is end organ

damage.




COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
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, femorla neuroapthy - 🧠 ANSWER ✔✔can resutl form diabetes. symptoms

would be weakness of lower leg, giving way of the knee, and idscomfort in

the anteiror htigh.


oral contracptties - 🧠 ANSWER ✔✔decreases risk of ovarian cancer by

50%.

along with endometrial cancer and colorectal cancers.


frontotemporal dmetnia - 🧠 ANSWER ✔✔common cuase of demtnia in

those <65.. Often memory is preserved bu tinsight is gone.


Refeeding syndrome - 🧠 ANSWER ✔✔hallmark sign is hypophosphatemia.


Hoarness - 🧠 ANSWER ✔✔if it hasn't gone away in 3 months- time for a

laryngoscopy.


Urine drug tests - 🧠 ANSWER ✔✔morphine can show up in a perosn taking

cough medicine containing cough medicine


mono - 🧠 ANSWER ✔✔teenager with sorethroat, adenoapthy, and

myalgias, and fatigue.

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