AAFP Family Medicine Board EXAM Review 785 Questions with 100% Correct Answers

AAFP Family Medicine Board EXAM Review 785 Questions with 100% Correct Answers Which tests are most accurate for detecting ACL tears? Correct Answer: Lachman -- anterior drawer -- pivot shift test What is McMurray test used for? Correct Answer: Meniscal tears What evidence suggests MGUS has progressed to Multiple Myeloma? Correct Answer: Evidence of end-organ damage; 1% annual risk of progression *hypercalcemia *renal failure *anemia *skeletal lesions DM w/ lower left leg weakness giving away at the knee, dicomfort in anterior thigh. Decreased sensation to pinprick and light touch over left anterior thigh and reduced motor strength on hip flexion and knee expansion? Correct Answer: Femoral neuropathy What is meralgia paresthetica? Correct Answer: numbnes and paresthesia over the anterolateral thigh with NO MOTOR DYSFUNCTION Spinal stenosis? Correct Answer: Pain in legs; no knee problems DM w/ intermittent claudication involving one or both calf muscles w/ NO motor weakness? Correct Answer: Iliofemoral atherosclerosis Low doese estrogen OCP reduces risk of what cancer by 50%? Correct Answer: Epithelial ovarian cancer *also reduced risk of postmenopausal fractures *less endometrial and colorectal cancers Hallmarks of polymyalgia rheumatica? Correct Answer: *inflammatory disorder 50yo *white women of european ancestry *pain and stiffness in shoulder and pelvic girdle *4-13% have normal ESR *systemic sx: fever common, night sweats, depression, fatigue, malaise, anorexia, weight loss Treatment for polymyalgia rheumatica? Correct Answer: Corticosteroids *dramatic response w/in 2-3 days Classic electroyle abnl in refeeding syndrome? Correct Answer: Hypophosphatemia How can oral candidiasis be reduced when using inhaled corticosteroid for asthma? Correct Answer: Using a valved cholding chamber & rinsing mouth after administration *AE of corticosteroids -- sore throat, coughing on inhalation of medication, hoarseness, oral candidiasis When is laryngoscopy indicated in hoarness? Correct Answer: 3 months or when serious underlying cause is suspected What's a common cause of hoarseness? Correct Answer: Inhaled corticosteroids Morphine may be positive in UTOX screen in what type of patient? Correct Answer: Taking coideine or codeine-containing medication Treatment of mono? Correct Answer: Supportive: hydration, NSAIDs, throat sprays or lozenges *avoid contact or collision type activities for 3-4 weeks bc of increased splenic rupture When would steroids be used in patient w/ mono? Correct Answer: When airway is compromised/acute airway obstruction What organ is enlarged in mono? Correct Answer: Spleen How is hypercalcemia of malignancy managed? Correct Answer: Fluid replacement w/ normal saline IV to correct volume depletion that is invariable present and to enhance renal calcium excretion What is the mainstay tx of hypercalcemia of malignancy? Correct Answer: IV pamidronate. Considered only after pt has been rendered euvolemic by saline repletion myomectomy over hysterectomy? Correct Answer: If patient desires future pregnancy *general anesthesia not required *blood transfusion unlikely Brown to black leopard spotting o the colonic mucosa in sigmoidoscopy? next step? Correct Answer: Review meds. this is MELANOSIS COLI. Look for laxative use *anthraquinone laxatives such as cascara, senna, or aloe What does valsalva maneuver do to venous return of heart? Correct Answer: DECREASES -- decreased cardiac output What murmur INCREASES doing a valsalva? Correct Answer: Hypertrophic obstructive cardiomyopathy Age group for slipped capital femoral epiphysis? Correct Answer: 8-15; common in overweight/obese children Presentation of slipped capital femoral epiphysis? Correct Answer: Limping and pain, limited INTERNAL rotation of the hip What is associated w/ PEG tube use? Correct Answer: Discomfort and agitation -- increased use of restraints What is the best test for dx of COPD? Correct Answer: spirometry FEV/FVC ratio 70% Pain w/ eye movement suggests? Correct Answer: Orbital inflammation, infection, or tumor invasion Colon cancer screening guidelines? Correct Answer: *first degree relative 60yo or 2 second degree reatives are the highest risk group. -- start at 40 or 10 years before earliest age at which affected relative was dx; RE SCREEN q5 YEARS What drugs can induce pleurisy? Correct Answer: Hydralazine, procainamide, quinidine, amiodarone, bleomycin, bromocriptine, cyclophosphamide, MTX, minoxidil and mitomycin What should be avoided in WPW syndrome? Correct Answer: adenosine, digoxin, and calcium channel antagonists bc they block conduction through AV node -- increase ventricular rate paradoxically -- initiating V fib TOC for WPW syndrome? Correct Answer: Procainamide *amiodarone may be used too Doxy CI in 2nd/3rd trimesters of prego? Correct Answer: Risk of discoloration of tooth enamel in the fetus Initial tx for newly diagnosed mild persistent asthma? Correct Answer: Low dose inhaled corticosteroid daily + short acting B agnost PRN What type of drug is infliximab (remicade)? Correct Answer: Tumor necrosis factor inhibitor -- increased risk of infections including TB What do you need to screen before starting infliximab for rheumatoid arthritis? Correct Answer: Hep B and C + TB Initial test to detect HCV? Correct Answer: Enzyme immunoassay If enzyme immonoassay is positive for HCV, next step? Correct Answer: Confirm w/ recombinant immunoblot assay if this is negative -- false positive antibody test If recombinant immunoblot assay is positive in HCV, next step? Correct Answer: HCV RNA PCR used to measure amount of virus If lots of RNA -- active infection If negative RNA -- past infection that is now resolved In which procedure would you stop metformin use? Correct Answer: CT Angio Nursing home acquired pna sx? Correct Answer: New infiltrate on chest radiograph, fever, leukocytosis, purulent sputum, hypoxia ABX for nursing home acquired pna? Correct Answer: empiric coverage: for MRSA and pseudomonas ceftazidime, levofloxacin, vancomycin In pregnancy, which drugs may cause cleft lip/palate? Correct Answer: Benzos such as alprazolam Which SSRI is CI in prego? Correct Answer: Paroxetine for concern of increased first trimester cardiac malformations Fluoxetine OK in prego? Correct Answer: Yes Paroxysms of colicky abd pain in 11mo boy? palpable mass in 2/3 pts. Correct Answer: Intussusception RUQ pain, jaundice and palpable mass? Correct Answer: Choledochal cyst