Family Medicine shelf NBME Exam
Questions And Correct Answers, Verified
Child 3-16 weeks old presents with cough for the past 2 weeks, tachypneic,
diffuse crackles, wheezes, may have conjunctivitis, chest film shows
hyperinflation and diffuse interstitial patchy infiltrates. No fever
Chlamydial pneumonia
Child had rhinorrhea and pharyngitis for 1-3 days then cough and wheezing.
Lungs have diffuse rhonchi, fine crackles and wheezing
RSV
Cold symptoms (fever, runny nose and cough) develops into severe cough
Parainfluenza
Recommended treatment for Mallet fracture?
Splinting the DIP joint in flexion
Vaccines at age 11-12?
influenza, meningococcal, HPV and Tdap
colorectal screening?
Cervical cancer screening?
21- 65 stop at 65 if negative results in the past
Mammography screening?
When should pregnant women receive the Tdap?
27-36 weeks gestation regardless of when they last received it
Men who have sex with men but are in a monogamous relationship, should be
screened for?
Hep C and Hep B
the Get up and Go test is used for screening?
for mobility/risk of falling/ balance or gait impairment
,Diagnostic criteria for Sepsis? severe Sepsis?
Septic shock?
sepsis: leukocytosis
severe sepsis: increase in creatinine level >0.5, thrombocytopenia, hyperbilirubinemia
Septic shock: hyperlactatemia or hypotension refractory to IV fluids
If a relative has a peanut allergy, when should a baby be exposed to peanuts?
early!
begin introducing peanuts prior to 12 months of age. If child was high risk, aka severe
eczema or had a first degree relative with severe allergy, then allergy testing can be
considered first.
Who is at risk for acute mountain sickness?
those with previous history mountain sickness, fast ascent, lack of acclimatization,
female, less than 46 years of age.
Most effective medication for motion sickness?
Scopolamine
Dimenhydrinate? Diphenhydramine? Meclizine? Promethazine?
In obese patients what has been shown to be most effective in reducing cardiac
risk?
Bariatric surgery. Reduces all cause mortality.
3 week old infant with a fever and does not appear toxic. How would you
manage?
Admit to hospital! Any child 29 days old and younger with a fever should undergo a
complete sepsis workup. Obtain urine, blood, CSF culture then start antibiotics.
If a patient is allergic to sulfas what can you give them for altitude sickness?
dexamethasone rather than acetazolamide
What change in the elderly causes a change in pharmicokinetics?
increase in the percentage of body fat
What Vit D level should be checked? when checking Vit D?
25 hydroxyvitmain D level
What are the USPSTF recommendations on folic acid?
All women capable fo pregnancy take a daily folic acid supplement with 0.4-0.8 mg
, What are the USPSTF recommendations on chlamydia?
screen all sexually active females 25 and under as well as older individuals at a higher
risk
USPSTF recommendations on Beta carotene and Vitamin E?
Class D, do not recommend. no benefit on cancer or heart disease. One study said E
can increase the risk of hemorrhagic stroke and Beta carotene increases the risk of lung
cancer in persons already at risk for lung cancer.
6 months of pathologic fatigue, post exertional fatigue, impaired
focus/concentration, orthostatic intolerance and unrefreshing sleep. Headache,
diffuse myalgias, tender lymph nodes, GI or GU impairments.???
What symptoms would change your diagnosis?
Myalgic encephalomyelitis/chronic fatigue syndrome.
2) Red Flag symptoms like chest pain, focal neurologic defects, joint erythema/swelling,
enlarged lymph nodes, or SOB
Outpatient therapy for salpingitis/PID
IM ceftriaxone and oral doxy
Pneumococcal vaccine regulation?
Who gets revaccinated
all those 65 or older, all adults with cardiopulmonary diesase, cigarrete smokers, and all
immunocompromised individuals. They all get the 23 and 13.
Those who are immunocompromised or dont ahve a functioning spleen must be
revaccinated after 5 years
Patient has pneumonia and a pleural effusion but conintues to have a fever
despite appropriate antibiotics?
Empyema
treat pneumonia
1) outpt
2) in hospital
Questions And Correct Answers, Verified
Child 3-16 weeks old presents with cough for the past 2 weeks, tachypneic,
diffuse crackles, wheezes, may have conjunctivitis, chest film shows
hyperinflation and diffuse interstitial patchy infiltrates. No fever
Chlamydial pneumonia
Child had rhinorrhea and pharyngitis for 1-3 days then cough and wheezing.
Lungs have diffuse rhonchi, fine crackles and wheezing
RSV
Cold symptoms (fever, runny nose and cough) develops into severe cough
Parainfluenza
Recommended treatment for Mallet fracture?
Splinting the DIP joint in flexion
Vaccines at age 11-12?
influenza, meningococcal, HPV and Tdap
colorectal screening?
Cervical cancer screening?
21- 65 stop at 65 if negative results in the past
Mammography screening?
When should pregnant women receive the Tdap?
27-36 weeks gestation regardless of when they last received it
Men who have sex with men but are in a monogamous relationship, should be
screened for?
Hep C and Hep B
the Get up and Go test is used for screening?
for mobility/risk of falling/ balance or gait impairment
,Diagnostic criteria for Sepsis? severe Sepsis?
Septic shock?
sepsis: leukocytosis
severe sepsis: increase in creatinine level >0.5, thrombocytopenia, hyperbilirubinemia
Septic shock: hyperlactatemia or hypotension refractory to IV fluids
If a relative has a peanut allergy, when should a baby be exposed to peanuts?
early!
begin introducing peanuts prior to 12 months of age. If child was high risk, aka severe
eczema or had a first degree relative with severe allergy, then allergy testing can be
considered first.
Who is at risk for acute mountain sickness?
those with previous history mountain sickness, fast ascent, lack of acclimatization,
female, less than 46 years of age.
Most effective medication for motion sickness?
Scopolamine
Dimenhydrinate? Diphenhydramine? Meclizine? Promethazine?
In obese patients what has been shown to be most effective in reducing cardiac
risk?
Bariatric surgery. Reduces all cause mortality.
3 week old infant with a fever and does not appear toxic. How would you
manage?
Admit to hospital! Any child 29 days old and younger with a fever should undergo a
complete sepsis workup. Obtain urine, blood, CSF culture then start antibiotics.
If a patient is allergic to sulfas what can you give them for altitude sickness?
dexamethasone rather than acetazolamide
What change in the elderly causes a change in pharmicokinetics?
increase in the percentage of body fat
What Vit D level should be checked? when checking Vit D?
25 hydroxyvitmain D level
What are the USPSTF recommendations on folic acid?
All women capable fo pregnancy take a daily folic acid supplement with 0.4-0.8 mg
, What are the USPSTF recommendations on chlamydia?
screen all sexually active females 25 and under as well as older individuals at a higher
risk
USPSTF recommendations on Beta carotene and Vitamin E?
Class D, do not recommend. no benefit on cancer or heart disease. One study said E
can increase the risk of hemorrhagic stroke and Beta carotene increases the risk of lung
cancer in persons already at risk for lung cancer.
6 months of pathologic fatigue, post exertional fatigue, impaired
focus/concentration, orthostatic intolerance and unrefreshing sleep. Headache,
diffuse myalgias, tender lymph nodes, GI or GU impairments.???
What symptoms would change your diagnosis?
Myalgic encephalomyelitis/chronic fatigue syndrome.
2) Red Flag symptoms like chest pain, focal neurologic defects, joint erythema/swelling,
enlarged lymph nodes, or SOB
Outpatient therapy for salpingitis/PID
IM ceftriaxone and oral doxy
Pneumococcal vaccine regulation?
Who gets revaccinated
all those 65 or older, all adults with cardiopulmonary diesase, cigarrete smokers, and all
immunocompromised individuals. They all get the 23 and 13.
Those who are immunocompromised or dont ahve a functioning spleen must be
revaccinated after 5 years
Patient has pneumonia and a pleural effusion but conintues to have a fever
despite appropriate antibiotics?
Empyema
treat pneumonia
1) outpt
2) in hospital
