AAFP Family Medicine Board EXAM Review 785
Questions with 100% Correct Answers
Which tests are most accurate for detecting ACL tears? Correct Answer: Lachman --> anterior
drawer --> pivot shift test
What is McMurray test used for? Correct Answer: Meniscal tears
What evidence suggests MGUS has progressed to Multiple Myeloma? Correct Answer:
Evidence of end-organ damage; 1% annual risk of progression
*hypercalcemia
*renal failure
*anemia
*skeletal lesions
DM w/ lower left leg weakness giving away at the knee, dicomfort in anterior thigh. Decreased
sensation to pinprick and light touch over left anterior thigh and reduced motor strength on hip
flexion and knee expansion? Correct Answer: Femoral neuropathy
What is meralgia paresthetica? Correct Answer: numbnes and paresthesia over the anterolateral
thigh with NO MOTOR DYSFUNCTION
Spinal stenosis? Correct Answer: Pain in legs; no knee problems
DM w/ intermittent claudication involving one or both calf muscles w/ NO motor weakness?
Correct Answer: Iliofemoral atherosclerosis
Low doese estrogen OCP reduces risk of what cancer by 50%? Correct Answer: Epithelial
ovarian cancer
*also reduced risk of postmenopausal fractures
*less endometrial and colorectal cancers
Hallmarks of polymyalgia rheumatica? Correct Answer: *inflammatory disorder >50yo
*white women of european ancestry
*pain and stiffness in shoulder and pelvic girdle
*4-13% have normal ESR
*systemic sx: fever common, night sweats, depression, fatigue, malaise, anorexia, weight loss
Treatment for polymyalgia rheumatica? Correct Answer: Corticosteroids
*dramatic response w/in 2-3 days
Classic electroyle abnl in refeeding syndrome? Correct Answer: Hypophosphatemia
,How can oral candidiasis be reduced when using inhaled corticosteroid for asthma? Correct
Answer: Using a valved cholding chamber & rinsing mouth after administration
*AE of corticosteroids --> sore throat, coughing on inhalation of medication, hoarseness, oral
candidiasis
When is laryngoscopy indicated in hoarness? Correct Answer: >3 months or when serious
underlying cause is suspected
What's a common cause of hoarseness? Correct Answer: Inhaled corticosteroids
Morphine may be positive in UTOX screen in what type of patient? Correct Answer: Taking
coideine or codeine-containing medication
Treatment of mono? Correct Answer: Supportive: hydration, NSAIDs, throat sprays or lozenges
*avoid contact or collision type activities for 3-4 weeks bc of increased splenic rupture
When would steroids be used in patient w/ mono? Correct Answer: When airway is
compromised/acute airway obstruction
What organ is enlarged in mono? Correct Answer: Spleen
How is hypercalcemia of malignancy managed? Correct Answer: Fluid replacement w/ normal
saline IV to correct volume depletion that is invariable present and to enhance renal calcium
excretion
What is the mainstay tx of hypercalcemia of malignancy? Correct Answer: IV pamidronate.
Considered only after pt has been rendered euvolemic by saline repletion
myomectomy over hysterectomy? Correct Answer: If patient desires future pregnancy
*general anesthesia not required
*blood transfusion unlikely
Brown to black leopard spotting o the colonic mucosa in sigmoidoscopy? next step? Correct
Answer: Review meds. this is MELANOSIS COLI. Look for laxative use
*anthraquinone laxatives such as cascara, senna, or aloe
What does valsalva maneuver do to venous return of heart? Correct Answer: DECREASES -->
decreased cardiac output
What murmur INCREASES doing a valsalva? Correct Answer: Hypertrophic obstructive
cardiomyopathy
,Age group for slipped capital femoral epiphysis? Correct Answer: 8-15; common in
overweight/obese children
Presentation of slipped capital femoral epiphysis? Correct Answer: Limping and pain, limited
INTERNAL rotation of the hip
What is associated w/ PEG tube use? Correct Answer: Discomfort and agitation --> increased
use of restraints
What is the best test for dx of COPD? Correct Answer: spirometry
FEV/FVC ratio <70%
Pain w/ eye movement suggests? Correct Answer: Orbital inflammation, infection, or tumor
invasion
Colon cancer screening guidelines? Correct Answer: *first degree relative <60yo or 2 second
degree reatives are the highest risk group. --> start at 40 or 10 years before earliest age at which
affected relative was dx; RE SCREEN q5 YEARS
What drugs can induce pleurisy? Correct Answer: Hydralazine, procainamide, quinidine,
amiodarone, bleomycin, bromocriptine, cyclophosphamide, MTX, minoxidil and mitomycin
What should be avoided in WPW syndrome? Correct Answer: adenosine, digoxin, and calcium
channel antagonists bc they block conduction through AV node --> increase ventricular rate
paradoxically --> initiating V fib
TOC for WPW syndrome? Correct Answer: Procainamide
*amiodarone may be used too
Doxy CI in 2nd/3rd trimesters of prego? Correct Answer: Risk of discoloration of tooth enamel
in the fetus
Initial tx for newly diagnosed mild persistent asthma? Correct Answer: Low dose inhaled
corticosteroid daily
+
short acting B agnost PRN
What type of drug is infliximab (remicade)? Correct Answer: Tumor necrosis factor inhibitor
--> increased risk of infections including TB
, What do you need to screen before starting infliximab for rheumatoid arthritis? Correct Answer:
Hep B and C + TB
Initial test to detect HCV? Correct Answer: Enzyme immunoassay
If enzyme immonoassay is positive for HCV, next step? Correct Answer: Confirm w/
recombinant immunoblot assay
if this is negative --> false positive antibody test
If recombinant immunoblot assay is positive in HCV, next step? Correct Answer: HCV RNA
PCR used to measure amount of virus
If lots of RNA --> active infection
If negative RNA --> past infection that is now resolved
In which procedure would you stop metformin use? Correct Answer: CT Angio
Nursing home acquired pna sx? Correct Answer: New infiltrate on chest radiograph, fever,
leukocytosis, purulent sputum, hypoxia
ABX for nursing home acquired pna? Correct Answer: empiric coverage: for MRSA and
pseudomonas
ceftazidime, levofloxacin, vancomycin
In pregnancy, which drugs may cause cleft lip/palate? Correct Answer: Benzos such as
alprazolam
Which SSRI is CI in prego? Correct Answer: Paroxetine for concern of increased first trimester
cardiac malformations
Fluoxetine OK in prego? Correct Answer: Yes
Paroxysms of colicky abd pain in 11mo boy? palpable mass in 2/3 pts. Correct Answer:
Intussusception
RUQ pain, jaundice and palpable mass? Correct Answer: Choledochal cyst
Painless lower GI bleeding in 11mo boy? Correct Answer: Meckel diverticulum
Tx for severe osteoporosis? Correct Answer: Teriparatide (forteo) SQ
*indicated in multiple osteoporosis risk factors & bisphosphonate therapy failure
Questions with 100% Correct Answers
Which tests are most accurate for detecting ACL tears? Correct Answer: Lachman --> anterior
drawer --> pivot shift test
What is McMurray test used for? Correct Answer: Meniscal tears
What evidence suggests MGUS has progressed to Multiple Myeloma? Correct Answer:
Evidence of end-organ damage; 1% annual risk of progression
*hypercalcemia
*renal failure
*anemia
*skeletal lesions
DM w/ lower left leg weakness giving away at the knee, dicomfort in anterior thigh. Decreased
sensation to pinprick and light touch over left anterior thigh and reduced motor strength on hip
flexion and knee expansion? Correct Answer: Femoral neuropathy
What is meralgia paresthetica? Correct Answer: numbnes and paresthesia over the anterolateral
thigh with NO MOTOR DYSFUNCTION
Spinal stenosis? Correct Answer: Pain in legs; no knee problems
DM w/ intermittent claudication involving one or both calf muscles w/ NO motor weakness?
Correct Answer: Iliofemoral atherosclerosis
Low doese estrogen OCP reduces risk of what cancer by 50%? Correct Answer: Epithelial
ovarian cancer
*also reduced risk of postmenopausal fractures
*less endometrial and colorectal cancers
Hallmarks of polymyalgia rheumatica? Correct Answer: *inflammatory disorder >50yo
*white women of european ancestry
*pain and stiffness in shoulder and pelvic girdle
*4-13% have normal ESR
*systemic sx: fever common, night sweats, depression, fatigue, malaise, anorexia, weight loss
Treatment for polymyalgia rheumatica? Correct Answer: Corticosteroids
*dramatic response w/in 2-3 days
Classic electroyle abnl in refeeding syndrome? Correct Answer: Hypophosphatemia
,How can oral candidiasis be reduced when using inhaled corticosteroid for asthma? Correct
Answer: Using a valved cholding chamber & rinsing mouth after administration
*AE of corticosteroids --> sore throat, coughing on inhalation of medication, hoarseness, oral
candidiasis
When is laryngoscopy indicated in hoarness? Correct Answer: >3 months or when serious
underlying cause is suspected
What's a common cause of hoarseness? Correct Answer: Inhaled corticosteroids
Morphine may be positive in UTOX screen in what type of patient? Correct Answer: Taking
coideine or codeine-containing medication
Treatment of mono? Correct Answer: Supportive: hydration, NSAIDs, throat sprays or lozenges
*avoid contact or collision type activities for 3-4 weeks bc of increased splenic rupture
When would steroids be used in patient w/ mono? Correct Answer: When airway is
compromised/acute airway obstruction
What organ is enlarged in mono? Correct Answer: Spleen
How is hypercalcemia of malignancy managed? Correct Answer: Fluid replacement w/ normal
saline IV to correct volume depletion that is invariable present and to enhance renal calcium
excretion
What is the mainstay tx of hypercalcemia of malignancy? Correct Answer: IV pamidronate.
Considered only after pt has been rendered euvolemic by saline repletion
myomectomy over hysterectomy? Correct Answer: If patient desires future pregnancy
*general anesthesia not required
*blood transfusion unlikely
Brown to black leopard spotting o the colonic mucosa in sigmoidoscopy? next step? Correct
Answer: Review meds. this is MELANOSIS COLI. Look for laxative use
*anthraquinone laxatives such as cascara, senna, or aloe
What does valsalva maneuver do to venous return of heart? Correct Answer: DECREASES -->
decreased cardiac output
What murmur INCREASES doing a valsalva? Correct Answer: Hypertrophic obstructive
cardiomyopathy
,Age group for slipped capital femoral epiphysis? Correct Answer: 8-15; common in
overweight/obese children
Presentation of slipped capital femoral epiphysis? Correct Answer: Limping and pain, limited
INTERNAL rotation of the hip
What is associated w/ PEG tube use? Correct Answer: Discomfort and agitation --> increased
use of restraints
What is the best test for dx of COPD? Correct Answer: spirometry
FEV/FVC ratio <70%
Pain w/ eye movement suggests? Correct Answer: Orbital inflammation, infection, or tumor
invasion
Colon cancer screening guidelines? Correct Answer: *first degree relative <60yo or 2 second
degree reatives are the highest risk group. --> start at 40 or 10 years before earliest age at which
affected relative was dx; RE SCREEN q5 YEARS
What drugs can induce pleurisy? Correct Answer: Hydralazine, procainamide, quinidine,
amiodarone, bleomycin, bromocriptine, cyclophosphamide, MTX, minoxidil and mitomycin
What should be avoided in WPW syndrome? Correct Answer: adenosine, digoxin, and calcium
channel antagonists bc they block conduction through AV node --> increase ventricular rate
paradoxically --> initiating V fib
TOC for WPW syndrome? Correct Answer: Procainamide
*amiodarone may be used too
Doxy CI in 2nd/3rd trimesters of prego? Correct Answer: Risk of discoloration of tooth enamel
in the fetus
Initial tx for newly diagnosed mild persistent asthma? Correct Answer: Low dose inhaled
corticosteroid daily
+
short acting B agnost PRN
What type of drug is infliximab (remicade)? Correct Answer: Tumor necrosis factor inhibitor
--> increased risk of infections including TB
, What do you need to screen before starting infliximab for rheumatoid arthritis? Correct Answer:
Hep B and C + TB
Initial test to detect HCV? Correct Answer: Enzyme immunoassay
If enzyme immonoassay is positive for HCV, next step? Correct Answer: Confirm w/
recombinant immunoblot assay
if this is negative --> false positive antibody test
If recombinant immunoblot assay is positive in HCV, next step? Correct Answer: HCV RNA
PCR used to measure amount of virus
If lots of RNA --> active infection
If negative RNA --> past infection that is now resolved
In which procedure would you stop metformin use? Correct Answer: CT Angio
Nursing home acquired pna sx? Correct Answer: New infiltrate on chest radiograph, fever,
leukocytosis, purulent sputum, hypoxia
ABX for nursing home acquired pna? Correct Answer: empiric coverage: for MRSA and
pseudomonas
ceftazidime, levofloxacin, vancomycin
In pregnancy, which drugs may cause cleft lip/palate? Correct Answer: Benzos such as
alprazolam
Which SSRI is CI in prego? Correct Answer: Paroxetine for concern of increased first trimester
cardiac malformations
Fluoxetine OK in prego? Correct Answer: Yes
Paroxysms of colicky abd pain in 11mo boy? palpable mass in 2/3 pts. Correct Answer:
Intussusception
RUQ pain, jaundice and palpable mass? Correct Answer: Choledochal cyst
Painless lower GI bleeding in 11mo boy? Correct Answer: Meckel diverticulum
Tx for severe osteoporosis? Correct Answer: Teriparatide (forteo) SQ
*indicated in multiple osteoporosis risk factors & bisphosphonate therapy failure
