AAFP Board Exam Review
AAFP Board Exam Review
, AAFP Board Exam Review
1. What screening test has most potential for overdx?: PSA- Overdiagnosis
is the diagnosis of a disease that will not produce symptoms during a patient's
lifetime. It tends to occur with cancers that have very slow rates of growth.
Prostate cancer is most often a slow-growing cancer and is often present without
symptoms in older men. The introduction of prostate-specific antigen (PSA)
screening was
accompanied by a marked rise in the rate of diagnosis of prostate cancer while
mortality
decreased much less significantly, and this decrease was probably largely
attributable to improved treatment.
2. What is the treatment for mallet fracture?: The recommended treatment
for a mallet fracture is splinting the distal interphalangeal (DIP) joint in
extension (SOR B). The usual duration of splinting is 8 weeks. It is important that
extension be maintained
, AAFP Board Exam Review
throughout the duration of treatment because flexion can affect healing and
prolong the time needed for treatment. If the finger fracture involves >30% of the
intra-articular surface, referral to a hand or orthopedic surgeon can be considered.
However, conservative therapy appears to have outcomes similar to those of
surgical treatment and therefore is generally preferred.
3. If subluxed radial head is suspected in a child, is imaging needed?: As
long as there are no outward signs of fracture or abuse it is considered safe and
appropriate to attempt reduction of the radial head before moving on to imaging
studies. With the child's elbow in 90° of flexion, the hand is fully supinated by the
examiner and the elbow is then brought into full flexion. Usually the child will begin
to use the affected arm again within a couple of minutes. If ecchymosis, significant
swelling, or pain away from the joint is present, or if symptoms do not improve
after attempts at reduction, then a plain radiograph is recommended.
4. A 17-year-old female sees you for a preparticipation evaluation. She has
run 5 miles a day for the last 6 months, and has lost 6 lb over the past 2
, AAFP Board Exam Review
months. Her last menstrual period was 3 months ago. Other than the fact
that she appears to be slightly underweight, her examination is normal.
To fit the criteria for the female athlete triad, she must have which one of the
following?: The initial definition of the female athlete triad was amenorrhea,
osteoporosis, and disordered eating. The American College of Sports Medicine
modified this in 2007, emphasizing that the triad components occur on a
continuum rather than as individual pathologic conditions. The definitions have
therefore expanded. Disordered eating is no longer defined as the formal
diagnosis of an eating disorder. Energy availability,defined as dietary energy
intake minus exercise energy expenditures, is now considered a risk factor for the
triad, as dietary restrictions and substantial energy expenditures disrupt pituitary
and ovarian function.
Athletes who have amenorrhea for 6 months, disordered eating, and/or a history of
a stress fracture resulting from minimal trauma should have a bone density test.
Low bone mineral density for age is the term used to describe at-risk female
AAFP Board Exam Review
, AAFP Board Exam Review
1. What screening test has most potential for overdx?: PSA- Overdiagnosis
is the diagnosis of a disease that will not produce symptoms during a patient's
lifetime. It tends to occur with cancers that have very slow rates of growth.
Prostate cancer is most often a slow-growing cancer and is often present without
symptoms in older men. The introduction of prostate-specific antigen (PSA)
screening was
accompanied by a marked rise in the rate of diagnosis of prostate cancer while
mortality
decreased much less significantly, and this decrease was probably largely
attributable to improved treatment.
2. What is the treatment for mallet fracture?: The recommended treatment
for a mallet fracture is splinting the distal interphalangeal (DIP) joint in
extension (SOR B). The usual duration of splinting is 8 weeks. It is important that
extension be maintained
, AAFP Board Exam Review
throughout the duration of treatment because flexion can affect healing and
prolong the time needed for treatment. If the finger fracture involves >30% of the
intra-articular surface, referral to a hand or orthopedic surgeon can be considered.
However, conservative therapy appears to have outcomes similar to those of
surgical treatment and therefore is generally preferred.
3. If subluxed radial head is suspected in a child, is imaging needed?: As
long as there are no outward signs of fracture or abuse it is considered safe and
appropriate to attempt reduction of the radial head before moving on to imaging
studies. With the child's elbow in 90° of flexion, the hand is fully supinated by the
examiner and the elbow is then brought into full flexion. Usually the child will begin
to use the affected arm again within a couple of minutes. If ecchymosis, significant
swelling, or pain away from the joint is present, or if symptoms do not improve
after attempts at reduction, then a plain radiograph is recommended.
4. A 17-year-old female sees you for a preparticipation evaluation. She has
run 5 miles a day for the last 6 months, and has lost 6 lb over the past 2
, AAFP Board Exam Review
months. Her last menstrual period was 3 months ago. Other than the fact
that she appears to be slightly underweight, her examination is normal.
To fit the criteria for the female athlete triad, she must have which one of the
following?: The initial definition of the female athlete triad was amenorrhea,
osteoporosis, and disordered eating. The American College of Sports Medicine
modified this in 2007, emphasizing that the triad components occur on a
continuum rather than as individual pathologic conditions. The definitions have
therefore expanded. Disordered eating is no longer defined as the formal
diagnosis of an eating disorder. Energy availability,defined as dietary energy
intake minus exercise energy expenditures, is now considered a risk factor for the
triad, as dietary restrictions and substantial energy expenditures disrupt pituitary
and ovarian function.
Athletes who have amenorrhea for 6 months, disordered eating, and/or a history of
a stress fracture resulting from minimal trauma should have a bone density test.
Low bone mineral density for age is the term used to describe at-risk female
