AAFP Family Medicine Board
Questions 2026 Exam All
Answers and Illustrations
Given
A 70yo M with h/o HTN and DM presents with a 2-mo h/o increasing
paroxysmal nocturnal dyspnea and SOB with minimal exertion. An
echocardiogram shows an ejection fraction of 25%. Which one of the
patients current medications should be discontinued?
A. Lisinopril (Zestril)
,B. Pioglitazone (Actos)
C. Glipizide (Glucotrol)
D. Metoprolol (Toprol-XL) - ANSWER ✔✔Pioglitzaone
thiazolidinediones (TZDs) are associated with fluid retention, and their
use can be complicated by the development of heart failure. Caution is
necessary when prescribing TZDs in patients with known heart failure or
other heart diseases, those with preexisting edema, and those on
concurrent insulin therapy
What is the most common cause of hypertension in children under 6
years of age? - ANSWER ✔✔Renal Parenchymal Disease
The most common cause of hypertension is renal parenchymal disease,
and a urinalysis, urine culture, and renal ultrasonography should be
ordered for all children presenting with hypertension.
A 72-year-old African-American male with New York Heart Association
Class III heart failure sees you for follow-up. He has shortness of breath
with minimal exertion. The patient is adherent to his medication regimen.
His current medications include lisinopril (Prinivil, Zestril), 40 mg twice
,daily; carvedilol (Coreg), 25 mg twice daily; and furosemide (Lasix), 80
mg daily. His blood pressure is 100/60 mm Hg, and his pulse rate is 68
beats/min and regular. Findings include a few scattered bibasilar rales
on examination of the lungs, an S3 gallop on examination of the heart,
and no edema on examination of the legs. An EKG reveals a left bundle
branch block, and echocardiography reveals an ejection fraction of 25%,
but no other abnormalities. What's the appropriate next step? -
ANSWER ✔✔Refer for cardiac resynchronization therapy (CRT)
Note: he's already on maximum doses of ACEI, loop diuretic, beta-
blocker
Using a pacemaker-like device, CRT aims to get both ventricles
contracting simultaneously, overcoming the delayed contraction of the
left ventricle caused by the left bundle-branch block. These guidelines
were refined by an April 2005 AHA Science Advisory, which stated that
optimal candidates for CRT have a dilated cardiomyopathy on an
ischemic or nonischemic basis, an LVEF ≤0.35, a QRS complex ≥120
msec, and sinus rhythm, and are NYHA functional class III or IV despite
maximal medical therapy for heart failure.
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
3
, What dietary change recommended for the prevention and treatment of
cardiovascular disease has been shown to decrease the rate of sudden
death? - ANSWER ✔✔increase intake of omega 3 fatty acids
Omega-3 fats contribute to the production of eicosapentaenoic acid
(EPA) and docosahexaenoic acid (DHA), which inhibit the inflammatory
immune response and platelet aggregation, are mild vasodilators, and
may have antiarrhythmic properties. The American Heart Association
guidelines state that omega-3 supplements may be recommended to
patients with preexisting disease, a high risk of disease, or high
triglyceride levels, as well as to patients who do not like or are allergic to
fish. The Italian GISSI study found that the use of 850 mg of EPA and
DHA daily resulted in decreased rates of mortality, nonfatal myocardial
infarction, and stroke, with particular decreases in the rate of sudden
death.
A 75-year-old male presents to the emergency department with a
several-hour history of back pain in the interscapular region. His medical
history includes a previous myocardial infarction (MI) several years ago,
a history of cigarette smoking until the time of the MI, and hypertension
that is well controlled with hydrochlorothiazide and lisinopril (Prinivil,
Zestril). The patient appears anxious, but all pulses are intact. His blood
Questions 2026 Exam All
Answers and Illustrations
Given
A 70yo M with h/o HTN and DM presents with a 2-mo h/o increasing
paroxysmal nocturnal dyspnea and SOB with minimal exertion. An
echocardiogram shows an ejection fraction of 25%. Which one of the
patients current medications should be discontinued?
A. Lisinopril (Zestril)
,B. Pioglitazone (Actos)
C. Glipizide (Glucotrol)
D. Metoprolol (Toprol-XL) - ANSWER ✔✔Pioglitzaone
thiazolidinediones (TZDs) are associated with fluid retention, and their
use can be complicated by the development of heart failure. Caution is
necessary when prescribing TZDs in patients with known heart failure or
other heart diseases, those with preexisting edema, and those on
concurrent insulin therapy
What is the most common cause of hypertension in children under 6
years of age? - ANSWER ✔✔Renal Parenchymal Disease
The most common cause of hypertension is renal parenchymal disease,
and a urinalysis, urine culture, and renal ultrasonography should be
ordered for all children presenting with hypertension.
A 72-year-old African-American male with New York Heart Association
Class III heart failure sees you for follow-up. He has shortness of breath
with minimal exertion. The patient is adherent to his medication regimen.
His current medications include lisinopril (Prinivil, Zestril), 40 mg twice
,daily; carvedilol (Coreg), 25 mg twice daily; and furosemide (Lasix), 80
mg daily. His blood pressure is 100/60 mm Hg, and his pulse rate is 68
beats/min and regular. Findings include a few scattered bibasilar rales
on examination of the lungs, an S3 gallop on examination of the heart,
and no edema on examination of the legs. An EKG reveals a left bundle
branch block, and echocardiography reveals an ejection fraction of 25%,
but no other abnormalities. What's the appropriate next step? -
ANSWER ✔✔Refer for cardiac resynchronization therapy (CRT)
Note: he's already on maximum doses of ACEI, loop diuretic, beta-
blocker
Using a pacemaker-like device, CRT aims to get both ventricles
contracting simultaneously, overcoming the delayed contraction of the
left ventricle caused by the left bundle-branch block. These guidelines
were refined by an April 2005 AHA Science Advisory, which stated that
optimal candidates for CRT have a dilated cardiomyopathy on an
ischemic or nonischemic basis, an LVEF ≤0.35, a QRS complex ≥120
msec, and sinus rhythm, and are NYHA functional class III or IV despite
maximal medical therapy for heart failure.
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
3
, What dietary change recommended for the prevention and treatment of
cardiovascular disease has been shown to decrease the rate of sudden
death? - ANSWER ✔✔increase intake of omega 3 fatty acids
Omega-3 fats contribute to the production of eicosapentaenoic acid
(EPA) and docosahexaenoic acid (DHA), which inhibit the inflammatory
immune response and platelet aggregation, are mild vasodilators, and
may have antiarrhythmic properties. The American Heart Association
guidelines state that omega-3 supplements may be recommended to
patients with preexisting disease, a high risk of disease, or high
triglyceride levels, as well as to patients who do not like or are allergic to
fish. The Italian GISSI study found that the use of 850 mg of EPA and
DHA daily resulted in decreased rates of mortality, nonfatal myocardial
infarction, and stroke, with particular decreases in the rate of sudden
death.
A 75-year-old male presents to the emergency department with a
several-hour history of back pain in the interscapular region. His medical
history includes a previous myocardial infarction (MI) several years ago,
a history of cigarette smoking until the time of the MI, and hypertension
that is well controlled with hydrochlorothiazide and lisinopril (Prinivil,
Zestril). The patient appears anxious, but all pulses are intact. His blood
