Family Medicine Aquifer Exam-cases|
Questions AND 100% Correct Verified
Answers
A 10-year-old boy comes to the clinic with a chief complaint of progressive cough for
two weeks that began gradually. His cough is described as productive and wet with
whitish sputum. His mother denies throat pain, vomiting, and diarrhea in his review of
systems. His mother reports that he has been febrile up to 101.5°F daily. She thinks
he is fatigued and has not eaten well in the past week. On exam, there is air passage
throughout all lung fields, with crackles in the lower right lung field, but no other
abnormal sounds.
What would you likely find in your workup?
A. Response to inhaled beta-agonist
B. Hyperinflation in one lung field
C. Alevolar consolidation in the RLL
D. Positive PCR for pertussis
E. Fluffy bilateral infiltrates and a large heart on chest x-ray - ANSWER C
A 21-year-old G1P0 female present to clinic as a new patient to establish prenatal care.
Which statement represents something that would not be expected to be a benefit
of group prenatal care for this patient?
A. Decreases the likelihood of preterm delivery
B. Increases physician contact
C. Increases support network
D. Shared education between patients
E. Increases adherence to techniques for pain management during labor - ANSWER E
,A 24-year-old G1P0 female at 38 weeks gestation presents to ED complaining of strong
lower abdominal contractions that are 10 minutes apart for the last hour. Subsequent
cervical examination demonstrates that she is 2cm dilated. FHT are 140 and NST is
non-reactive with early decelerations.
What is the most appropriate management of this patient?
A. Augment labor with oxytocin (Pitocin)
B. C-section
C. Expectant management
D. Immediate vacuum delivery
E. Rupture membranes to increase labor - ANSWER C
You are following a 32-year-old G2P1 female who is in active labor. Her pain is well
managed with an epidural. Her vital signs are normal except for mild tachycardia.
Her external fetal monitor tracing shows early decelerations which coincide with the
beginning and end of a contraction. It is the characteristic "mirror image" of a
contraction.
What condition is the above tracing most consistent with?
A. Cord compression
B. Head compression
C. Uteroplacental insufficiency
D. Fetal bradycardia
E. Fetal tachycardia - ANSWER B
A 32-year-old female at 33 weeks and 5 days gestation (G2P1) presents to the
clinic with headache and RUQ abdominal pain. Blood pressure is 172/121 mmHg on
examination while seated. No visual changes noted. Edema is present in the hands,
bilaterally. Urine dipstick demonstrated 4+ protein. FHT are 117.
,Which of the following is the most appropriate next step in the management of
this patient?
A. Twice-weekly non-stress testing
B. Daily aspirin
C. Expedited delivery of the premature fetus
D. Lisinopril
E. Strict bed rest until 37 weeks - ANSWER C
A 28-year-old, G2P1 female delivers a 6 lb., 7oz. baby boy at 39 weeks gestation. At
one minute, the baby has blue extremities and a pink body; his arms and legs are flexed
and he is moving them vigorously with prompt response to stimulation; HR is 118 bpm
and he is coughing and crying vigorously as well.
What would his APGAR score be at one minute?
A. 6
B. 7
C. 8
D. 9
E. 10 - ANSWER D
A 13-year-old female comes to your clinic stating she has been having fever and chills
for three days, and aching muscles for the last two days. She states she has also had a
mild cough, but is not having any difficulty with breathing. She is up to date on vaccines
and her only other medical history is having her tonsils and adenoids removed last
year. On physical exam, you find her temperature to be 102.6 degrees F, pulse 96, and
her BP to be 108/62 mmHg. She has clear rhinorrhea and her oropharynx is mildly
erythematous. The rest of her physical exam is normal, and a rapid strep test in the
office is negative.
What is the next best step in management?
A. Zanamivir
, B. Aspirin
C. Ibuprofen
D. Amantadine
E. Albuterol - ANSWER C
It is November and you are working in a small, rural, emergency department serving a
community who is currently going through a flu epidemic. Your next patient is a 4-year-
old male who was brought in by his mother for a sore throat and fever that started two
nights ago. She says he has a mild cough, and is complaining of headaches as well.
Since last night, he has had a decreased appetite and hasn't been his normal, active
self. She also wants you to know that he is allergic to eggs and latex, and uses an
inhaler once a month for asthma like symptoms. On physical exam you note an
erythematous throat, clear rhinorrhea, and rhonchi on auscultation. A rapid strep test
was performed in the office and is negative. His last well child check was 14 months
ago, and his mother says she knows he is due for another but her schedule has been
too busy.
What is the next best step in management?
A. Flu Shot
B. Amoxicillin therapy - ANSWER D
A 7-year-old male is brought to your clinic with a fever of 102-103° F (38.9-39.4° C) for
the last three days. He is up-to-date on all vaccinations and has no significant medical
history. His mother notes that he has not had a cough but is eating and drinking less
because "it hurts to swallow." On examination of his neck you notice tender cervical
lymphadenopathy bilaterally, and auscultation of his back shows clear lung sounds on
both sides. His oropharyngeal exam shows erythematous throat, but no tonsillar
exudates.
What would be the most appropriate next step?
A. Empiric Amoxicillin therapy
Questions AND 100% Correct Verified
Answers
A 10-year-old boy comes to the clinic with a chief complaint of progressive cough for
two weeks that began gradually. His cough is described as productive and wet with
whitish sputum. His mother denies throat pain, vomiting, and diarrhea in his review of
systems. His mother reports that he has been febrile up to 101.5°F daily. She thinks
he is fatigued and has not eaten well in the past week. On exam, there is air passage
throughout all lung fields, with crackles in the lower right lung field, but no other
abnormal sounds.
What would you likely find in your workup?
A. Response to inhaled beta-agonist
B. Hyperinflation in one lung field
C. Alevolar consolidation in the RLL
D. Positive PCR for pertussis
E. Fluffy bilateral infiltrates and a large heart on chest x-ray - ANSWER C
A 21-year-old G1P0 female present to clinic as a new patient to establish prenatal care.
Which statement represents something that would not be expected to be a benefit
of group prenatal care for this patient?
A. Decreases the likelihood of preterm delivery
B. Increases physician contact
C. Increases support network
D. Shared education between patients
E. Increases adherence to techniques for pain management during labor - ANSWER E
,A 24-year-old G1P0 female at 38 weeks gestation presents to ED complaining of strong
lower abdominal contractions that are 10 minutes apart for the last hour. Subsequent
cervical examination demonstrates that she is 2cm dilated. FHT are 140 and NST is
non-reactive with early decelerations.
What is the most appropriate management of this patient?
A. Augment labor with oxytocin (Pitocin)
B. C-section
C. Expectant management
D. Immediate vacuum delivery
E. Rupture membranes to increase labor - ANSWER C
You are following a 32-year-old G2P1 female who is in active labor. Her pain is well
managed with an epidural. Her vital signs are normal except for mild tachycardia.
Her external fetal monitor tracing shows early decelerations which coincide with the
beginning and end of a contraction. It is the characteristic "mirror image" of a
contraction.
What condition is the above tracing most consistent with?
A. Cord compression
B. Head compression
C. Uteroplacental insufficiency
D. Fetal bradycardia
E. Fetal tachycardia - ANSWER B
A 32-year-old female at 33 weeks and 5 days gestation (G2P1) presents to the
clinic with headache and RUQ abdominal pain. Blood pressure is 172/121 mmHg on
examination while seated. No visual changes noted. Edema is present in the hands,
bilaterally. Urine dipstick demonstrated 4+ protein. FHT are 117.
,Which of the following is the most appropriate next step in the management of
this patient?
A. Twice-weekly non-stress testing
B. Daily aspirin
C. Expedited delivery of the premature fetus
D. Lisinopril
E. Strict bed rest until 37 weeks - ANSWER C
A 28-year-old, G2P1 female delivers a 6 lb., 7oz. baby boy at 39 weeks gestation. At
one minute, the baby has blue extremities and a pink body; his arms and legs are flexed
and he is moving them vigorously with prompt response to stimulation; HR is 118 bpm
and he is coughing and crying vigorously as well.
What would his APGAR score be at one minute?
A. 6
B. 7
C. 8
D. 9
E. 10 - ANSWER D
A 13-year-old female comes to your clinic stating she has been having fever and chills
for three days, and aching muscles for the last two days. She states she has also had a
mild cough, but is not having any difficulty with breathing. She is up to date on vaccines
and her only other medical history is having her tonsils and adenoids removed last
year. On physical exam, you find her temperature to be 102.6 degrees F, pulse 96, and
her BP to be 108/62 mmHg. She has clear rhinorrhea and her oropharynx is mildly
erythematous. The rest of her physical exam is normal, and a rapid strep test in the
office is negative.
What is the next best step in management?
A. Zanamivir
, B. Aspirin
C. Ibuprofen
D. Amantadine
E. Albuterol - ANSWER C
It is November and you are working in a small, rural, emergency department serving a
community who is currently going through a flu epidemic. Your next patient is a 4-year-
old male who was brought in by his mother for a sore throat and fever that started two
nights ago. She says he has a mild cough, and is complaining of headaches as well.
Since last night, he has had a decreased appetite and hasn't been his normal, active
self. She also wants you to know that he is allergic to eggs and latex, and uses an
inhaler once a month for asthma like symptoms. On physical exam you note an
erythematous throat, clear rhinorrhea, and rhonchi on auscultation. A rapid strep test
was performed in the office and is negative. His last well child check was 14 months
ago, and his mother says she knows he is due for another but her schedule has been
too busy.
What is the next best step in management?
A. Flu Shot
B. Amoxicillin therapy - ANSWER D
A 7-year-old male is brought to your clinic with a fever of 102-103° F (38.9-39.4° C) for
the last three days. He is up-to-date on all vaccinations and has no significant medical
history. His mother notes that he has not had a cough but is eating and drinking less
because "it hurts to swallow." On examination of his neck you notice tender cervical
lymphadenopathy bilaterally, and auscultation of his back shows clear lung sounds on
both sides. His oropharyngeal exam shows erythematous throat, but no tonsillar
exudates.
What would be the most appropriate next step?
A. Empiric Amoxicillin therapy
