Page 1 of 41
Clinical Cases in Family Medicine Assessment 2025 EXAM 2025- 2026 Review
GRADED A+ QUESTIONS WIT H CORRECT ANSWERS GRADED A+
What is the effect of Valsalva maneuver in patients with overflow
incontinence?
They may experience loss of urine due to increased abdominopelvic pressure.
What is the relationship between type 1 diabetes mellitus and overflow
incontinence?
Type 1 diabetes increases the risk for diabetic neuropathy, which can lead to
overflow incontinence.
What is the role of medication in functional incontinence?
Certain medications can contribute to the inability to void in a timely manner.
What is the primary symptom of stress incontinence?
Leakage of urine triggered by activities that increase abdominal pressure.
What is a common diagnostic test for urinary incontinence?
Urodynamic studies.
What is the typical presentation of stress incontinence?
Leakage occurs with activities like sneezing or lifting.
What can be inferred if a patient has a normal physical examination regarding
stress incontinence?
It makes the diagnosis of stress incontinence less likely.
What is Oxybutynin used to treat?
Urge incontinence from an overactive bladder and detrusor instability.
What are common symptoms of a urinary tract infection?
Frequency, urgency, urge incontinence, dysuria, and suprapubic pain.
What findings on urinalysis are typical for a urinary tract infection?
Presence of bacteria and white blood cells.
What is a vesicovaginal fistula?
A condition that presents with painless urinary leakage from the bladder into the
vagina, often due to gynecologic surgery, pelvic malignancy, or radiation therapy.
What physical examination finding is typical for a vesicovaginal fistula?
, Page 2 of 41
A pool of urine in the vaginal canal.
What is overflow incontinence?
A condition that occurs when bladder emptying is impaired, leading to leakage of
urine due to increased intravesical hydrostatic pressure.
What are common causes of overflow incontinence?
Neurologic insults, such as diabetic neuropathy, and bladder outlet obstruction.
What is a characteristic finding in overflow incontinence?
Increased postvoid residual volume.
At what age is cervical cancer screening recommended to begin according to
USPSTF guidelines?
Age 21.
What is the recommended cervical cancer screening for women aged 21 to 29?
Pap smear testing every 3 years.
What is the recommended cervical cancer screening for women aged 30 to 65?
Pap smear every 5 years with co-testing for HPV or every 3 years with Pap smear
alone.
What screening is not indicated for a 20-year-old woman with no history of
serious illness and no sexual infections?
Cervical cancer screening.
What should be screened for in sexually active women with multiple partners?
Sexually transmitted infections, such as Chlamydia trachomatis and Neisseria
gonorrhoeae.
Why is high-risk HPV genotyping not recommended as a screening modality
for cervical cancer?
It is not recommended for asymptomatic patients as infections are typically transient
and may be cleared by the immune system.
What is the purpose of a Pap smear?
To collect cells from the transformation zone of the cervix for cervical cancer
screening.
What is the correct answer for cervical cancer screening in a 20-year-old
woman with no abnormalities?
No screening is indicated at this time.
What is the significance of strains 6 and 11 of HPV?
They are most commonly implicated in condyloma acuminata (genital warts).
, Page 3 of 41
What strains of HPV confer the highest risk for progression to cervical cancer?
Strains 16, 18, 31, and 33.
What is the recommended interval for Pap smear testing for women aged 30 to
65?
Every 5 years with HPV co-testing or every 3 years with Pap smear alone.
What is the role of the immune system in HPV infections?
The immune system can typically clear transient infections.
Why is a Pap smear and high-risk HPV genotyping not recommended for
women under 21?
Screening is not recommended before age 21 according to guidelines.
What is the typical presentation of a patient with a vesicovaginal fistula?
Painless urinary leakage into the vagina.
What is the typical clinical approach for a patient with an overactive bladder?
Consider anticholinergic medications like Oxybutynin.
What is the purpose of Pap smear testing?
To collect cells from the transformation zone of the cervix for the detection of cervical
carcinoma.
What are the USPSTF recommendations for Pap smear testing for women aged
21 to 29?
Screening every 3 years.
What are the USPSTF recommendations for Pap smear testing for women aged
30 to 65?
Pap smear screening every 5 years with co-testing for HPV or every 3 years with
Pap smear testing alone.
Is screening recommended for women under the age of 21?
No, screening is not recommended before age 21.
What should a patient with a history of unprotected intercourse undergo
screening for?
Sexually transmitted infections, such as Chlamydia trachomatis and Neisseria
gonorrhoeae.
Which HPV strains are most commonly implicated in condyloma acuminata?
HPV strains 6 and 11.
Which HPV strains confer the highest risk for progression to cervical cancer?
HPV strains 16, 18, 31, and 33.
, Page 4 of 41
What is the recommendation regarding high-risk HPV genotyping for cervical
cancer screening?
It is not recommended as a screening modality for sexually transmitted infections or
cervical cancer.
What is the recommendation for Pap smear and high-risk HPV genotyping for
patients aged 30 to 65?
It is typically reserved as a cervical cancer screening modality.
What is the recommendation for Pap smear with reflex HPV testing for patients
under age 21?
It is not recommended, as neither test is advised for this age group.
What is the recommendation for Pap smear only for patients under age 21?
It is not recommended by the USPSTF.
What is the educational objective regarding Pap smear testing?
It is an important screening tool for the detection of cervical carcinoma.
What is the most appropriate recommendation for a 28-year-old woman with
type 2 diabetes to prevent disease-related morbidity?
Annual eye examination.
What is the most predictive factor of future complications in a patient with an
abdominal aortic aneurysm (AAA)?
Blood pressure.
What condition does the 72-year-old patient in the case study likely have?
Abdominal aortic aneurysm (AAA).
What are the common risk factors for developing an AAA?
Male gender, smoking, and a family or personal history of atherosclerotic disease.
What is the typical presentation of a large AAA?
A palpable, pulsatile abdominal mass.
What is the recommended screening for AAA in men aged 65 to 75?
Ultrasonography, especially for those with a history of tobacco use.
What is the patient's BMI, and what does it indicate?
25 kg/m², indicating he is at a healthy weight.
What is the significance of the patient's alcohol consumption in relation to
AAA?
Moderate alcohol consumption may be protective, while high levels may slightly
increase risk.
Clinical Cases in Family Medicine Assessment 2025 EXAM 2025- 2026 Review
GRADED A+ QUESTIONS WIT H CORRECT ANSWERS GRADED A+
What is the effect of Valsalva maneuver in patients with overflow
incontinence?
They may experience loss of urine due to increased abdominopelvic pressure.
What is the relationship between type 1 diabetes mellitus and overflow
incontinence?
Type 1 diabetes increases the risk for diabetic neuropathy, which can lead to
overflow incontinence.
What is the role of medication in functional incontinence?
Certain medications can contribute to the inability to void in a timely manner.
What is the primary symptom of stress incontinence?
Leakage of urine triggered by activities that increase abdominal pressure.
What is a common diagnostic test for urinary incontinence?
Urodynamic studies.
What is the typical presentation of stress incontinence?
Leakage occurs with activities like sneezing or lifting.
What can be inferred if a patient has a normal physical examination regarding
stress incontinence?
It makes the diagnosis of stress incontinence less likely.
What is Oxybutynin used to treat?
Urge incontinence from an overactive bladder and detrusor instability.
What are common symptoms of a urinary tract infection?
Frequency, urgency, urge incontinence, dysuria, and suprapubic pain.
What findings on urinalysis are typical for a urinary tract infection?
Presence of bacteria and white blood cells.
What is a vesicovaginal fistula?
A condition that presents with painless urinary leakage from the bladder into the
vagina, often due to gynecologic surgery, pelvic malignancy, or radiation therapy.
What physical examination finding is typical for a vesicovaginal fistula?
, Page 2 of 41
A pool of urine in the vaginal canal.
What is overflow incontinence?
A condition that occurs when bladder emptying is impaired, leading to leakage of
urine due to increased intravesical hydrostatic pressure.
What are common causes of overflow incontinence?
Neurologic insults, such as diabetic neuropathy, and bladder outlet obstruction.
What is a characteristic finding in overflow incontinence?
Increased postvoid residual volume.
At what age is cervical cancer screening recommended to begin according to
USPSTF guidelines?
Age 21.
What is the recommended cervical cancer screening for women aged 21 to 29?
Pap smear testing every 3 years.
What is the recommended cervical cancer screening for women aged 30 to 65?
Pap smear every 5 years with co-testing for HPV or every 3 years with Pap smear
alone.
What screening is not indicated for a 20-year-old woman with no history of
serious illness and no sexual infections?
Cervical cancer screening.
What should be screened for in sexually active women with multiple partners?
Sexually transmitted infections, such as Chlamydia trachomatis and Neisseria
gonorrhoeae.
Why is high-risk HPV genotyping not recommended as a screening modality
for cervical cancer?
It is not recommended for asymptomatic patients as infections are typically transient
and may be cleared by the immune system.
What is the purpose of a Pap smear?
To collect cells from the transformation zone of the cervix for cervical cancer
screening.
What is the correct answer for cervical cancer screening in a 20-year-old
woman with no abnormalities?
No screening is indicated at this time.
What is the significance of strains 6 and 11 of HPV?
They are most commonly implicated in condyloma acuminata (genital warts).
, Page 3 of 41
What strains of HPV confer the highest risk for progression to cervical cancer?
Strains 16, 18, 31, and 33.
What is the recommended interval for Pap smear testing for women aged 30 to
65?
Every 5 years with HPV co-testing or every 3 years with Pap smear alone.
What is the role of the immune system in HPV infections?
The immune system can typically clear transient infections.
Why is a Pap smear and high-risk HPV genotyping not recommended for
women under 21?
Screening is not recommended before age 21 according to guidelines.
What is the typical presentation of a patient with a vesicovaginal fistula?
Painless urinary leakage into the vagina.
What is the typical clinical approach for a patient with an overactive bladder?
Consider anticholinergic medications like Oxybutynin.
What is the purpose of Pap smear testing?
To collect cells from the transformation zone of the cervix for the detection of cervical
carcinoma.
What are the USPSTF recommendations for Pap smear testing for women aged
21 to 29?
Screening every 3 years.
What are the USPSTF recommendations for Pap smear testing for women aged
30 to 65?
Pap smear screening every 5 years with co-testing for HPV or every 3 years with
Pap smear testing alone.
Is screening recommended for women under the age of 21?
No, screening is not recommended before age 21.
What should a patient with a history of unprotected intercourse undergo
screening for?
Sexually transmitted infections, such as Chlamydia trachomatis and Neisseria
gonorrhoeae.
Which HPV strains are most commonly implicated in condyloma acuminata?
HPV strains 6 and 11.
Which HPV strains confer the highest risk for progression to cervical cancer?
HPV strains 16, 18, 31, and 33.
, Page 4 of 41
What is the recommendation regarding high-risk HPV genotyping for cervical
cancer screening?
It is not recommended as a screening modality for sexually transmitted infections or
cervical cancer.
What is the recommendation for Pap smear and high-risk HPV genotyping for
patients aged 30 to 65?
It is typically reserved as a cervical cancer screening modality.
What is the recommendation for Pap smear with reflex HPV testing for patients
under age 21?
It is not recommended, as neither test is advised for this age group.
What is the recommendation for Pap smear only for patients under age 21?
It is not recommended by the USPSTF.
What is the educational objective regarding Pap smear testing?
It is an important screening tool for the detection of cervical carcinoma.
What is the most appropriate recommendation for a 28-year-old woman with
type 2 diabetes to prevent disease-related morbidity?
Annual eye examination.
What is the most predictive factor of future complications in a patient with an
abdominal aortic aneurysm (AAA)?
Blood pressure.
What condition does the 72-year-old patient in the case study likely have?
Abdominal aortic aneurysm (AAA).
What are the common risk factors for developing an AAA?
Male gender, smoking, and a family or personal history of atherosclerotic disease.
What is the typical presentation of a large AAA?
A palpable, pulsatile abdominal mass.
What is the recommended screening for AAA in men aged 65 to 75?
Ultrasonography, especially for those with a history of tobacco use.
What is the patient's BMI, and what does it indicate?
25 kg/m², indicating he is at a healthy weight.
What is the significance of the patient's alcohol consumption in relation to
AAA?
Moderate alcohol consumption may be protective, while high levels may slightly
increase risk.
