BRAINSCAPE1
AAFP 360 Exam with complete
solutions latest version
A 22-year-old female with polycystic ovary syndrome comes in to discuss
contraception. She has no other health conditions and takes no medications. Her
menses are somewhatirregular, occurring every 28-42 days. She also asks about
treatment for her mild hirsutism.Which one of the following medications would be
most likely to address her need for contraception and also improve her
hirsutism? (check one)
A. Spironolactone (Aldactone)
B. Cyclic progesterone
C. Progesterone-only contraceptive pills
D. Oral combined hormonal contraceptives
E. A levonorgestrel-releasing IUD (Mirena) - CORRECT ANSWER-D
Management of polycystic ovary syndrome is typically aimed at addressing
patient symptoms, as well as irregular menses and the risk of endometrial
hyperplasia. Infertility may become a therapeutic target for women who desire
pregnancy at some point in their lives. In this patient, who needs contraception
and hopes to address her hirsutism, combined oral contraceptives are most likely
to address both concerns. In addition to suppressing ovulation they also
suppress gonadotropin and ovarian androgen production. The estrogen
component increases hepatic production of sex hormone binding globulin, thus
decreasing androgen bioavailability. Progestin-only pills and the levonorgestrel
IUD protect against pregnancy but will not improve hirsutism. Cyclic
progesterone every 1-3 months can be used to prevent endometrial hyperplasia
but will not provide contraception or address hirsutism. Spironolactone is an
androgen receptor antagonist that can decrease hair growth, but it will not
provide contraception.
A 53-year-old white female with chronic hepatitis C is concerned about ulcers in
her mouth. She is not currently receiving therapy. Your examination reveals
several ulcers involving the buccal mucosa. The patient also points out a number
of pruritic, reddish-purple plaques on her wrists, ankles, and back. Laboratory
studies are within normal limits except for mildly elevated transaminases.Which
one of the following is the most likely diagnosis? (check one)
A. Behçet's syndrome
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B. Lichen planus
C. Aphthous stomatitis
D. Herpetic stomatitis
E. HIV infection - CORRECT ANSWER-B
Lichen planus is an idiopathic inflammatory disease affecting the skin and oral
mucosa. The characteristic violaceous, polygonal papules may be intensely itchy.
There is a significant association between lichen planus and hepatitis C virus
infection.
Which one of the following is associated with bisphosphonate use for the
treatment ofosteoporosis? (check one)
A. Hypercalcemia
B. Hyperphosphatemia
C. Vitamin D deficiency
D. Atypical femoral shaft fractures
E. Renal failure - CORRECT ANSWER-D
The use of bisphosphonates is associated with a small increase in the risk of
atypical femoral shaft fractures. The risk increases with the duration of use (SOR
B). These drugs are also associated with an increased risk of osteonecrosis of
the jaw, esophagitis, and esophageal ulceration, as well as hypocalcemia. In fact,
bisphosphonates are used as a treatment for hypercalcemia. They do not affect
phosphorus or vitamin D levels.
A 43-year-old female is very distressed about symptoms of postprandial fullness
and early satiety. She has seen several physicians over the last 6 months but said
she was always told "nothing's wrong." You review her most recent workup,
including normal blood tests, normal gallbladder testing, and upper endoscopy
that shows no abnormalities, including negative testing for Helicobacter pylori .
She has tried multiple antacid medications, including omeprazole (Prilosec),
lansoprazole (Prevacid), and ranitidine (Zantac), with no success.Which one of
the following medications has the best chance of providing this patient with
symptom relief? (check one)
A. Clonazepam (Klonopin)
B. Escitalopram (Lexapro)
C. Metoclopramide (Reglan)
D. Ondansetron (Zofran)
E. Sucralfate (Carafate) - CORRECT ANSWER-C
This patient's history fits the diagnosis of functional dyspepsia. Two subtypes of
this disorder have been described. The first, epigastric pain syndrome, is
described as intermittent pain and burning in the epigastrium. The second,
postprandial distress syndrome, is more typical of the symptoms this patient
describes: postprandial fullness and early satiety. Although there is considerable
benefit from reassurance and "naming" a patient's condition, empiric treatment is
also warranted. Patients with epigastric pain syndrome are more likely to respond
BRAINSCAPE1
AAFP 360 Exam with complete
solutions latest version
A 22-year-old female with polycystic ovary syndrome comes in to discuss
contraception. She has no other health conditions and takes no medications. Her
menses are somewhatirregular, occurring every 28-42 days. She also asks about
treatment for her mild hirsutism.Which one of the following medications would be
most likely to address her need for contraception and also improve her
hirsutism? (check one)
A. Spironolactone (Aldactone)
B. Cyclic progesterone
C. Progesterone-only contraceptive pills
D. Oral combined hormonal contraceptives
E. A levonorgestrel-releasing IUD (Mirena) - CORRECT ANSWER-D
Management of polycystic ovary syndrome is typically aimed at addressing
patient symptoms, as well as irregular menses and the risk of endometrial
hyperplasia. Infertility may become a therapeutic target for women who desire
pregnancy at some point in their lives. In this patient, who needs contraception
and hopes to address her hirsutism, combined oral contraceptives are most likely
to address both concerns. In addition to suppressing ovulation they also
suppress gonadotropin and ovarian androgen production. The estrogen
component increases hepatic production of sex hormone binding globulin, thus
decreasing androgen bioavailability. Progestin-only pills and the levonorgestrel
IUD protect against pregnancy but will not improve hirsutism. Cyclic
progesterone every 1-3 months can be used to prevent endometrial hyperplasia
but will not provide contraception or address hirsutism. Spironolactone is an
androgen receptor antagonist that can decrease hair growth, but it will not
provide contraception.
A 53-year-old white female with chronic hepatitis C is concerned about ulcers in
her mouth. She is not currently receiving therapy. Your examination reveals
several ulcers involving the buccal mucosa. The patient also points out a number
of pruritic, reddish-purple plaques on her wrists, ankles, and back. Laboratory
studies are within normal limits except for mildly elevated transaminases.Which
one of the following is the most likely diagnosis? (check one)
A. Behçet's syndrome
BRAINSCAPE1
, BRAINSCAPE1
B. Lichen planus
C. Aphthous stomatitis
D. Herpetic stomatitis
E. HIV infection - CORRECT ANSWER-B
Lichen planus is an idiopathic inflammatory disease affecting the skin and oral
mucosa. The characteristic violaceous, polygonal papules may be intensely itchy.
There is a significant association between lichen planus and hepatitis C virus
infection.
Which one of the following is associated with bisphosphonate use for the
treatment ofosteoporosis? (check one)
A. Hypercalcemia
B. Hyperphosphatemia
C. Vitamin D deficiency
D. Atypical femoral shaft fractures
E. Renal failure - CORRECT ANSWER-D
The use of bisphosphonates is associated with a small increase in the risk of
atypical femoral shaft fractures. The risk increases with the duration of use (SOR
B). These drugs are also associated with an increased risk of osteonecrosis of
the jaw, esophagitis, and esophageal ulceration, as well as hypocalcemia. In fact,
bisphosphonates are used as a treatment for hypercalcemia. They do not affect
phosphorus or vitamin D levels.
A 43-year-old female is very distressed about symptoms of postprandial fullness
and early satiety. She has seen several physicians over the last 6 months but said
she was always told "nothing's wrong." You review her most recent workup,
including normal blood tests, normal gallbladder testing, and upper endoscopy
that shows no abnormalities, including negative testing for Helicobacter pylori .
She has tried multiple antacid medications, including omeprazole (Prilosec),
lansoprazole (Prevacid), and ranitidine (Zantac), with no success.Which one of
the following medications has the best chance of providing this patient with
symptom relief? (check one)
A. Clonazepam (Klonopin)
B. Escitalopram (Lexapro)
C. Metoclopramide (Reglan)
D. Ondansetron (Zofran)
E. Sucralfate (Carafate) - CORRECT ANSWER-C
This patient's history fits the diagnosis of functional dyspepsia. Two subtypes of
this disorder have been described. The first, epigastric pain syndrome, is
described as intermittent pain and burning in the epigastrium. The second,
postprandial distress syndrome, is more typical of the symptoms this patient
describes: postprandial fullness and early satiety. Although there is considerable
benefit from reassurance and "naming" a patient's condition, empiric treatment is
also warranted. Patients with epigastric pain syndrome are more likely to respond
BRAINSCAPE1
