Family Medicine EOR Exam (NEW 2023/ 202
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4 Update) Questions and Verified Answers wit
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h Rationales| 100% Correct| Grade A
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QUESTION
Ag13-year-
oldggirlgpresentsgforghergschoolgphysical.gOngexamination,gyougnoticegthegposteriorgcurvaturegofg
hergthoracicgspinegtogbegverygprominentgandgbulginggbackward.gWhatgtypegofgdeformitygofgthegs
pinegdoesgsheghave?
AgKyphosis
BgScoliokyphosis
CgScoliosis
DgLordosis
EgGibbus
Answer:
A
Kyphosisgisgagposteriorgconvexgangulationgofgthegthoracicgspinegasgevaluatedgongagsidegview.gEx
cessivegandgexaggeratedgangulationgresultsgingcosmeticgproblems,gbackgpain,gandgcardio-
grespiratorygproblems.gKyphosisgmaygbegpost-traumaticgorgnon-
traumaticgtype.gScheuermann'sgkyphosis,gpostural,gcongenital,gandgmetabolicgbonegdiseasegaregag
fewgofgthegnon-traumaticgcausesgofgkyphosis.
QUESTION
Ag45-year-oldgwomangwithgag25-yearghistorygofgtypegIgdiabetesgpresentsgforgfollow-
upgofghergdiabetes.gHergspotgalbumin/creatininegratiogwasg100gmg/gg4gmonthsgago,gandgitgwasgco
nfirmedgatg100gmg/ggyesterday.gHergurinaryganalysisgshowsgnogcells,gcasts,gorgblood.gHergcreatin
inegisg0.7mg/dl,gandghergestimatedgglomerulargfiltrationgrategisg95gml/min/1.73m2.gHowgwouldgh
ergproteinuriagbegdescribed?
AgNormoalbuminuria
BgMicroalbuminuria
CgMinialbuminuria
DgMacroalbuminuria
EgNephroticgsyndrome
,Answer:
B
Screeninggforgmicroalbuminuria,gagmarkergofgkidneygdisease,gisgrecommendedgannuallygforgpati
entsgwithgtypegIgdiabetesgofggreatergthang5gyearsgduration;gitgisgrecommendedgannuallygforgallgp
atientsgwithgtypegIIgdiabetes.gThisgscreeninggtestgisgmostgeasilygobtainedgwithgagfirstgvoidgmorni
nggurineg"spot"galbumingtogcreatininegratio.gNormalglevelsgforgspotgsamplesgareg<10gmg/ggforgm
engandg<15gmg/ggforgwomen.gSincegkidneygdiseasesgothergthangdiabeticgkidneygdiseasegmaygcau
segproteinuriagandgalbuminuria,gevaluatinggthegurinegsedimentgofgdiabeticsgwithgpresumedgdiabe
ticgkidneygdiseasegisgadvised.gMinialbuminuriagisgnotgagtruegmedicalgterm.
QUESTION
Ag55-year-oldgwomangwithgag15-yearghistorygofgtypegIIgdiabetesgpresentsgforgfollow-
upgofghergdiabetes.gHergspotgalbumin/creatininegratiogwasg100gmg/gg4gmonthsgagogandgwasgconf
irmedgatg100gmg/ggyesterday.gHergurinaryganalysisgshowsgnogcells,gcasts,gorgblood.gHergcreatini
negisg0.7mg/dlgandghergestimatedgglomerulargfiltrationgrategisg95gml/min/1.73m2.gWhatgmedicati
on(s)gshouldgyougprescribegtoghelpgpreventghergprogressiongfromgmicrogtogmacroalbuminuriagan
dgtoghelpgpreventgagprogressivegdeclinegingglomerulargfiltrationgrate?
AgPotassiumgchloride
BgCalciumgcarbonate
CgLisinopril
DgSodiumgbicarbonate
EgCalciumgcitrate
Answer:
C
Lisinopril,gangACEgInhibitor,gshouldghelpgdecreasegalbuminuria,gpreventgprogressiongofgdiabeticg
kidneygdiseasegfromgmicrogtogmacroalbuminuria,gandgpreventgagdeclinegingglomerulargfiltrationgr
ate.gThisgclassgofgmedicationsghasgbeengstudiedgextensivelygforgthesegpurposes.gAngiotensingIIgre
ceptorgblockersg(e.g.,girbesartan)gmaygalsogreducegurinarygalbumingtognormalglevels.
Monotherapygwithgeithergofgthesegclassesgofgmedicationsgshouldgbegattemptedgfirstgingpatientsg
withgmicroalbuminuria.gThisgwillgtestgtolerance,geffectiveness,gandgadversegreactiongsuchgasghy
perkalemia.gForgpatientsgwithggreatergdegreesgofgalbuminuriag(e.g.,g1gg/day),gpoorgresponsegtog
monotherapygandgbloodgpressuregcontrol,gandgnoghyperkalemiagassociatedgwithgtherapy,gcombi
nationgtherapygshouldgbegconsidered.gCombinationgtherapygwithgbothgACEginhibitorsg(e.g.,glisin
opril)gandgangiotensingIIgreceptorgblockersg(e.g.,girbesartan)gisgusedgtogtreatgbothgdiabeticgandgno
n-
diabeticgkidneygdisease.gThesegmedicationsgactgongdifferentgpartsgofgthegreningangiotensingsyste
m.gIngcombination,girbesartangcouldgblockgthegeffectgofgangiotensingproducedgbygnon-
ACEgpathwaysgandglisinoprilgcouldgblockgthegproductiongofgangiotensingstimulatedgbygirbesarta
ngingagnegativegfeedbackgsystem;ghowever,gcombinationgtherapygisgusuallygprecededgbygmonoth
erapy.gAlthoughgcombinationgtherapygisgcurrentlygbeinggusedgingbothgdiabeticgandgnon-
diabeticgkidneygdisease,gthisgtherapygstillgbeinggresearched.gItgisgunknowngwhethergmonotherap
ygalonegis
,sufficient.gItgdoesgnotgappeargtogbegsufficientgingallgpatients,gparticularlygthosegwithgpersistent
gmicrogandgmacroalbuminuriagdespitegmonotherapy.
QUESTION
Ag7-year-oldgboygpresentsgwithgag1-
weekghistorygofgwheezinggandgdyspneagonganygexertiong(withgproductivegcough).gOngphysicalgex
amination,gbilateralgrhonchigaregheard.gAftergagfewgdaysgofgtreatment,gspirometrygisgdonegongtheg
patient.gThegfindingsgaregshowngingthegtable.gTotalglunggcapacityg(TLC)gisg111%gongspirometry.g
Whatgisgthegmostglikelygdiagnosis?
FVC%gbefore/aftergbronchodilators:g49/63gFEV1
%gbefore/aftergbronchodilators:g41/46gFEV1/FVC
gbefore/aftergbronchodilators:g49/55
AgAsthma
BgPneumonia
CgPleuralgeffusion
DgKyphoscoliosis
EgTuberculosis
Answer:
A
Thegspirometrygresultgingthisgpatientgshowsgreductiongingbothgforcedgvitalgcapacityg(FVC)gandg
forcedgexpiratorygvolumeging1gsecondg(FEV1),gbutgFEV1gisgmoregaffectedgthangFVC.gTherefor
e,gtheregisgagdecreasegingthegFEV1/FVCgratiogbelowgthegpredictedglevels.gThegTLCgisgnormalg(
80-
g120%).gThisgconcludesgthatgthisgisgangobstructivegdisordergandgexcludesgthegrestrictivegdisease
sglisted.gTheregisgagmarkedgimprovementgwithgbronchodilators.gIngreversiblegairwaygobstructio
ngsuchgasgingasthma,gtheregisgagrisegingthegFEV1gand/orgFVCgbygapproximatelyg12%gfromgpre-
gtogpost-
bronchodilatorgtesting.gThisgreversibilitygisgcharacteristicgofgbronchialgasthma.gThegspirometryg
findingsgaregnotgsuggestivegofgrestrictiveglunggdiseasesgsuchgasgpneumonia,gpleuralgeffusion,gk
yphoscoliosis,gandgtuberculosis.
QUESTION
Ag29-year-
oldgwomanginquiresgwhengshegshouldghaveghergfirstgmammogram.gHergfamilyghistorygisgsignific
antgforgthegdeathgofghergmothergandggrandmothergduegtogbreastgcancergatgthegagegofg32gyears.gPr
esently,gthegwomangisgasymptomatic.gWhatgisgthegrecommendationgforgmammographygforgthisg
patient?
Ifgyoughavegagstronggfamilyghistory,gthegNationalgComprehensivegCancergNetworkgrecommends,g
startinggatgageg30,gyouggetga:
Clinicalgbreastgexamgeveryg6-12gmonths
, MammogramgeverygyeargBrea
stgMRIgeverygyear
AgImmediately
BgWhengshegisg30gyearsgold
CgWhengshegisg32gyearsgold
DgWhengshegisg34gyearsgold
EgWhengshegisg36gyearsgold
Answer:
A
Breastgcancergisgrecognizedgasgbothgangincreasinglygcommongdisordergandgagpotentiallyghereditar
ygdisorder.gFurthermore,gearlygdetectiongwillgprovidegagwomangwithghergbestgchancegatgagcuregof
gbreastgcancer.gGivengthegpatient'sggeneticgburdengofghavinggbothghergmothergandgherggrandmoth
ergdiegofgmetastaticgbreastgcancergatgthegrelativelygyounggagegofg32gyears,gitgisgreasonablegtogpro
videghergwithgimmediategandgperiodicgmammographygcombinedgwithginstructiongingbreastgself-
gexamination.gWomengatghighgriskgrequiregagmoregaggressivegschedule,gfrequentgexaminations,g
andgothergproceduresgsuchgasgultrasoundgandgMRI.gAmericangCancergSocietygGuidelines
Womengagesg40gtog44gshouldghavegthegchoicegtogstartgannualgbreastgcancergscreeninggwithgmam
mogramsgifgtheygwishgtogdogso.
Womengageg45gtog54gshouldggetgmammogramsgeverygyear.
Womeng55gandgoldergshouldgswitchgtogmammogramsgeveryg2gyearsgorgcangcontinuegyearlygscree
ning.
Screeninggshouldgcontinuegasglonggasgagwomangisginggoodghealthgandgisgexpectedgtogliveg10gmore
gyearsgorglonger.
ThegACSgdoesgnotgrecommendgclinicalgbreastgexaminationgforgbreastgcancergscreeninggamon
ggaverage-riskgwomengatganygage
ACOGgcontinuesgtogrecommendgadherencegtogitsgcurrentgguidelines,gwhichgincludegthegfollowing
:gScreeninggmammographygeveryg1-2gyearsgforgwomengagedg40-49gyears
Screeninggmammographygeverygyeargforgwomengagedg50gyearsgorgolder
QUESTION
Ag42-year-oldgwomangworksgfull-
timegasgagdatagentrygclerkgandgoftengputsgingmanyghoursgofgovertime.gSheghasgstartedgtognoticegn
umbnessgandgtinglingginghergrightgthumb,gindexgfinger,gmiddlegfinger,gandghalfgofghergringgfinger
;gsymptomsgaregespeciallygseveregatgnightgThegnumbnessgandgtinglinggweregintermittentgforgmon
ths,gbutgtheyghavegbecomegpersistentgduringgthegpastgfewgdays.gWhatgcouldgbegconsideredgagpre
disposinggfactorgforgthisgpatient'sgcondition?
AgMyxedema
BgHypoadrenalism
CgHypoprolactinemia
DgHypoglycemia
EgCushinggsyndrome
g g g g g g
4 Update) Questions and Verified Answers wit
g g g g g g
h Rationales| 100% Correct| Grade A
g g g g g
QUESTION
Ag13-year-
oldggirlgpresentsgforghergschoolgphysical.gOngexamination,gyougnoticegthegposteriorgcurvaturegofg
hergthoracicgspinegtogbegverygprominentgandgbulginggbackward.gWhatgtypegofgdeformitygofgthegs
pinegdoesgsheghave?
AgKyphosis
BgScoliokyphosis
CgScoliosis
DgLordosis
EgGibbus
Answer:
A
Kyphosisgisgagposteriorgconvexgangulationgofgthegthoracicgspinegasgevaluatedgongagsidegview.gEx
cessivegandgexaggeratedgangulationgresultsgingcosmeticgproblems,gbackgpain,gandgcardio-
grespiratorygproblems.gKyphosisgmaygbegpost-traumaticgorgnon-
traumaticgtype.gScheuermann'sgkyphosis,gpostural,gcongenital,gandgmetabolicgbonegdiseasegaregag
fewgofgthegnon-traumaticgcausesgofgkyphosis.
QUESTION
Ag45-year-oldgwomangwithgag25-yearghistorygofgtypegIgdiabetesgpresentsgforgfollow-
upgofghergdiabetes.gHergspotgalbumin/creatininegratiogwasg100gmg/gg4gmonthsgago,gandgitgwasgco
nfirmedgatg100gmg/ggyesterday.gHergurinaryganalysisgshowsgnogcells,gcasts,gorgblood.gHergcreatin
inegisg0.7mg/dl,gandghergestimatedgglomerulargfiltrationgrategisg95gml/min/1.73m2.gHowgwouldgh
ergproteinuriagbegdescribed?
AgNormoalbuminuria
BgMicroalbuminuria
CgMinialbuminuria
DgMacroalbuminuria
EgNephroticgsyndrome
,Answer:
B
Screeninggforgmicroalbuminuria,gagmarkergofgkidneygdisease,gisgrecommendedgannuallygforgpati
entsgwithgtypegIgdiabetesgofggreatergthang5gyearsgduration;gitgisgrecommendedgannuallygforgallgp
atientsgwithgtypegIIgdiabetes.gThisgscreeninggtestgisgmostgeasilygobtainedgwithgagfirstgvoidgmorni
nggurineg"spot"galbumingtogcreatininegratio.gNormalglevelsgforgspotgsamplesgareg<10gmg/ggforgm
engandg<15gmg/ggforgwomen.gSincegkidneygdiseasesgothergthangdiabeticgkidneygdiseasegmaygcau
segproteinuriagandgalbuminuria,gevaluatinggthegurinegsedimentgofgdiabeticsgwithgpresumedgdiabe
ticgkidneygdiseasegisgadvised.gMinialbuminuriagisgnotgagtruegmedicalgterm.
QUESTION
Ag55-year-oldgwomangwithgag15-yearghistorygofgtypegIIgdiabetesgpresentsgforgfollow-
upgofghergdiabetes.gHergspotgalbumin/creatininegratiogwasg100gmg/gg4gmonthsgagogandgwasgconf
irmedgatg100gmg/ggyesterday.gHergurinaryganalysisgshowsgnogcells,gcasts,gorgblood.gHergcreatini
negisg0.7mg/dlgandghergestimatedgglomerulargfiltrationgrategisg95gml/min/1.73m2.gWhatgmedicati
on(s)gshouldgyougprescribegtoghelpgpreventghergprogressiongfromgmicrogtogmacroalbuminuriagan
dgtoghelpgpreventgagprogressivegdeclinegingglomerulargfiltrationgrate?
AgPotassiumgchloride
BgCalciumgcarbonate
CgLisinopril
DgSodiumgbicarbonate
EgCalciumgcitrate
Answer:
C
Lisinopril,gangACEgInhibitor,gshouldghelpgdecreasegalbuminuria,gpreventgprogressiongofgdiabeticg
kidneygdiseasegfromgmicrogtogmacroalbuminuria,gandgpreventgagdeclinegingglomerulargfiltrationgr
ate.gThisgclassgofgmedicationsghasgbeengstudiedgextensivelygforgthesegpurposes.gAngiotensingIIgre
ceptorgblockersg(e.g.,girbesartan)gmaygalsogreducegurinarygalbumingtognormalglevels.
Monotherapygwithgeithergofgthesegclassesgofgmedicationsgshouldgbegattemptedgfirstgingpatientsg
withgmicroalbuminuria.gThisgwillgtestgtolerance,geffectiveness,gandgadversegreactiongsuchgasghy
perkalemia.gForgpatientsgwithggreatergdegreesgofgalbuminuriag(e.g.,g1gg/day),gpoorgresponsegtog
monotherapygandgbloodgpressuregcontrol,gandgnoghyperkalemiagassociatedgwithgtherapy,gcombi
nationgtherapygshouldgbegconsidered.gCombinationgtherapygwithgbothgACEginhibitorsg(e.g.,glisin
opril)gandgangiotensingIIgreceptorgblockersg(e.g.,girbesartan)gisgusedgtogtreatgbothgdiabeticgandgno
n-
diabeticgkidneygdisease.gThesegmedicationsgactgongdifferentgpartsgofgthegreningangiotensingsyste
m.gIngcombination,girbesartangcouldgblockgthegeffectgofgangiotensingproducedgbygnon-
ACEgpathwaysgandglisinoprilgcouldgblockgthegproductiongofgangiotensingstimulatedgbygirbesarta
ngingagnegativegfeedbackgsystem;ghowever,gcombinationgtherapygisgusuallygprecededgbygmonoth
erapy.gAlthoughgcombinationgtherapygisgcurrentlygbeinggusedgingbothgdiabeticgandgnon-
diabeticgkidneygdisease,gthisgtherapygstillgbeinggresearched.gItgisgunknowngwhethergmonotherap
ygalonegis
,sufficient.gItgdoesgnotgappeargtogbegsufficientgingallgpatients,gparticularlygthosegwithgpersistent
gmicrogandgmacroalbuminuriagdespitegmonotherapy.
QUESTION
Ag7-year-oldgboygpresentsgwithgag1-
weekghistorygofgwheezinggandgdyspneagonganygexertiong(withgproductivegcough).gOngphysicalgex
amination,gbilateralgrhonchigaregheard.gAftergagfewgdaysgofgtreatment,gspirometrygisgdonegongtheg
patient.gThegfindingsgaregshowngingthegtable.gTotalglunggcapacityg(TLC)gisg111%gongspirometry.g
Whatgisgthegmostglikelygdiagnosis?
FVC%gbefore/aftergbronchodilators:g49/63gFEV1
%gbefore/aftergbronchodilators:g41/46gFEV1/FVC
gbefore/aftergbronchodilators:g49/55
AgAsthma
BgPneumonia
CgPleuralgeffusion
DgKyphoscoliosis
EgTuberculosis
Answer:
A
Thegspirometrygresultgingthisgpatientgshowsgreductiongingbothgforcedgvitalgcapacityg(FVC)gandg
forcedgexpiratorygvolumeging1gsecondg(FEV1),gbutgFEV1gisgmoregaffectedgthangFVC.gTherefor
e,gtheregisgagdecreasegingthegFEV1/FVCgratiogbelowgthegpredictedglevels.gThegTLCgisgnormalg(
80-
g120%).gThisgconcludesgthatgthisgisgangobstructivegdisordergandgexcludesgthegrestrictivegdisease
sglisted.gTheregisgagmarkedgimprovementgwithgbronchodilators.gIngreversiblegairwaygobstructio
ngsuchgasgingasthma,gtheregisgagrisegingthegFEV1gand/orgFVCgbygapproximatelyg12%gfromgpre-
gtogpost-
bronchodilatorgtesting.gThisgreversibilitygisgcharacteristicgofgbronchialgasthma.gThegspirometryg
findingsgaregnotgsuggestivegofgrestrictiveglunggdiseasesgsuchgasgpneumonia,gpleuralgeffusion,gk
yphoscoliosis,gandgtuberculosis.
QUESTION
Ag29-year-
oldgwomanginquiresgwhengshegshouldghaveghergfirstgmammogram.gHergfamilyghistorygisgsignific
antgforgthegdeathgofghergmothergandggrandmothergduegtogbreastgcancergatgthegagegofg32gyears.gPr
esently,gthegwomangisgasymptomatic.gWhatgisgthegrecommendationgforgmammographygforgthisg
patient?
Ifgyoughavegagstronggfamilyghistory,gthegNationalgComprehensivegCancergNetworkgrecommends,g
startinggatgageg30,gyouggetga:
Clinicalgbreastgexamgeveryg6-12gmonths
, MammogramgeverygyeargBrea
stgMRIgeverygyear
AgImmediately
BgWhengshegisg30gyearsgold
CgWhengshegisg32gyearsgold
DgWhengshegisg34gyearsgold
EgWhengshegisg36gyearsgold
Answer:
A
Breastgcancergisgrecognizedgasgbothgangincreasinglygcommongdisordergandgagpotentiallyghereditar
ygdisorder.gFurthermore,gearlygdetectiongwillgprovidegagwomangwithghergbestgchancegatgagcuregof
gbreastgcancer.gGivengthegpatient'sggeneticgburdengofghavinggbothghergmothergandgherggrandmoth
ergdiegofgmetastaticgbreastgcancergatgthegrelativelygyounggagegofg32gyears,gitgisgreasonablegtogpro
videghergwithgimmediategandgperiodicgmammographygcombinedgwithginstructiongingbreastgself-
gexamination.gWomengatghighgriskgrequiregagmoregaggressivegschedule,gfrequentgexaminations,g
andgothergproceduresgsuchgasgultrasoundgandgMRI.gAmericangCancergSocietygGuidelines
Womengagesg40gtog44gshouldghavegthegchoicegtogstartgannualgbreastgcancergscreeninggwithgmam
mogramsgifgtheygwishgtogdogso.
Womengageg45gtog54gshouldggetgmammogramsgeverygyear.
Womeng55gandgoldergshouldgswitchgtogmammogramsgeveryg2gyearsgorgcangcontinuegyearlygscree
ning.
Screeninggshouldgcontinuegasglonggasgagwomangisginggoodghealthgandgisgexpectedgtogliveg10gmore
gyearsgorglonger.
ThegACSgdoesgnotgrecommendgclinicalgbreastgexaminationgforgbreastgcancergscreeninggamon
ggaverage-riskgwomengatganygage
ACOGgcontinuesgtogrecommendgadherencegtogitsgcurrentgguidelines,gwhichgincludegthegfollowing
:gScreeninggmammographygeveryg1-2gyearsgforgwomengagedg40-49gyears
Screeninggmammographygeverygyeargforgwomengagedg50gyearsgorgolder
QUESTION
Ag42-year-oldgwomangworksgfull-
timegasgagdatagentrygclerkgandgoftengputsgingmanyghoursgofgovertime.gSheghasgstartedgtognoticegn
umbnessgandgtinglingginghergrightgthumb,gindexgfinger,gmiddlegfinger,gandghalfgofghergringgfinger
;gsymptomsgaregespeciallygseveregatgnightgThegnumbnessgandgtinglinggweregintermittentgforgmon
ths,gbutgtheyghavegbecomegpersistentgduringgthegpastgfewgdays.gWhatgcouldgbegconsideredgagpre
disposinggfactorgforgthisgpatient'sgcondition?
AgMyxedema
BgHypoadrenalism
CgHypoprolactinemia
DgHypoglycemia
EgCushinggsyndrome
