Family Medicine Board Review
MC cause of macular degeneration? - ✔✔- ANS: Hypertension, smoking
Treatment for croup? - ✔✔- ANS: Dexamethasone, .6mg/kg single oral dose (can give racemic
epinephrine if acutely ill)
Which Pap test result most likely to become cancer? - ✔✔- ANS: Atypical glandular cells not
otherwise specified (AGC-NOS)
First line tx for OCD? - ✔✔- ANS: SSRI
What does the P value <0.05 mean? - ✔✔- ANS: P value is the confidence level, and likelihood
of achieving the observed results of a study by chance alone, which is 5%
What are pediatric guidelines for food restrictions before surgery? - ✔✔- ANS: 8 hours for solid
food, 6 hours for formula, 4 hours for breast milk, and 2 hours for clear liquids
What is true about Canadian Drugs? - ✔✔- ANS: 90% are approved by US FDA
Henoch-Schonlein Purpura Sx? - ✔✔- ANS: follows an URI infection, and presents with
low-grade fever, fatigue, arthralgia, and colicky abdominal pain. The hallmark of the disease is
the rash, which begins as pink maculopapules, progresses to petechiae or purpura, which are
clinically palpable, and changes in color from red to dusty brown before fading. Arthritis, usually
involving the knees and ankles, is present in two-thirds of cases, and gastrointestinal tract
involvement results in heme-positive stools in 50% of cases.
Systemic juvenile-onset rheumatoid arthritis usually presents with what physical finding? - ✔✔-
ANS: evanescent salmon-pink rash
Hemolytic anemia is confirmed by what test? - ✔✔- ANS: Decreased Haptoglobin
Standalone High homocysteine seen in what condition? - ✔✔- ANS: Folic acid deficiency
High methylmalonic acid (MMA) and High homocystiene? - ✔✔- ANS: B12 Deficiency
Kawasaki disease sx? - ✔✔- ANS: 1) nonexudative conjunctivitis that spares the limbus; 2)
changes in the oral membranes such as diffuse erythema, injected or fissured lips, or
"strawberry tongue"; 3) erythema of palms and soles, and/or edema of the hands or feet
followed by periungual desquamation; 4) cervical adenopathy in the anterior cervical triangle
with at least one node larger than 1.5 cm in diameter; and, 5) an erythematous polymorphous
rash, which may be targetoid or purpuric. Tx: IVIG and Aspirin
,Celiac sprue sx? - ✔✔- ANS: child has between 4 and 24 months of age with impaired growth,
diarrhea, and abdominal distention. Malabsorption with IDA, that starts after consumption of
gluten containing foods
Waldenstrom macroglobulinemia - ✔✔- ANS: uncontrolled proliferation of lymphocytes and
plasma cells, which produce IgM proteins with KAPPA LIGHT CHAINS. moderate anemia and
MONOCLONAL IgM peaks on serum electrophoresis. BENCE-JONES protein is seen in 80% of
cases. lytic bone lesions are NOT seen. hepatosplenomegaly, and lymphadenopathy.
After a fight bite (fifth distal metacarpal fracture), what should you do? - ✔✔- ANS: Prophylactic
abx and X-rays
Stress fracture of the femoral neck sx? - ✔✔- ANS: persistent groin pain, and limited hip flexion
and internal rotation. Radiographs may be normal early. Seen in runners and military recruits
occurs in runners and presents with stinging pain over the lateral femoral epicondyle - ✔✔-
ANS: IT Band syndrome
Osteitis pubis sx - ✔✔- ANS: occurs in distance runners and presents with pain in the anterior
pelvic area and tenderness over the symphysis pubis
Tx for labial adhesions in peds? - ✔✔- ANS: Topcial estrogen bid till adhesions resolve
Anorexia nervosa severity is based on? - ✔✔- ANS: BMI. Mild is a BMI >17.0 kg/m2, moderate
is a BMI of 16.0-16.99 kg/m2, severe is a BMI of15.0-15.9 kg/m2, and extreme is a BMI <15.0
kg/m2.
In dementia, how do you medically treat wandering and pacing? - ✔✔- ANS: Medically cannot ,
no meds for this.
What med has best evidence for prevention of both vertebral fractures and hip fractures? - ✔✔-
ANS: Zoledronic acid (Reclast)
Treatment for chlamydia - ✔✔- ANS: 1-gram dose of oral azithromycin, (ok including during
pregnancy)
What is the cause of nausea and vomiting begin after 9 weeks' gestation? - ✔✔- ANS:
secondary causes are more likely to be present
What is an important adjunct med in tx of PTSD? - ✔✔- ANS: SSRI (sertraline and paroxetine)
most frequent cause of seizures in the elderly? - ✔✔- ANS: Stroke
,Which circadian sleep disorder responds to Bright light therapy? - ✔✔- ANS: Shift work
insomnia
Thalamotomy and pallidotomy are treatments for? - ✔✔- ANS: disabling unilateral tremor and
dyskinesia from Parkinson's disease
malnutrition, constipation, oliguria, and profound hypochloremic metabolic alkalosis? - ✔✔-
ANS: Hypertrophic pyloric stensosis
Snuffbox tenderness and tenderness over the scaphoid tubercle? - ✔✔- ANS: Scaphoid
fracture: Immobilize in a thumb spica splint for 1-2 weeks and then order repeat radiographs
mcc of urinary incontinence in a 72 yo female, DM, difficulty voiding, frequent dribbling? - ✔✔-
ANS: Autonomic neuropathy
What kind of arrhythmia: Regular narrow complex tachycardia, 156 bpm? - ✔✔- ANS:
supraventricular tachycardia (Tx:give adenosine to slow rate)
MMR vaccine contraindications? - ✔✔- ANS: pt pregnant or immunodeficient
Folestien MiniMental exam affected by? - ✔✔- ANS: Educational attainment
MC seizure disorder in childhood - ✔✔- ANS: febrile seizures
What Abx contraindicated in pt with Statin? - ✔✔- ANS: clarithromycin or erythromycin (CYP
3A4), increases risk of statin toxicity
Intranasal decongestants should not be used over 3 days why? - ✔✔- ANS: Phenylephrine
intranasal causes rhinitis medicamentosa after 3 days.
Detrusor instability sx? - ✔✔- ANS: intense urge to void, which overcomes the patient's
voluntary attempt to hold the sphincter closed; hence, the common term urge incontinence.
severity of DKA? - ✔✔- ANS: determined by the arterial pH, bicarbonate level, anion gap, and
mental status of the patient.
Diagnosis of DKA? - ✔✔- ANS: elevated serum glucose level (>250 mg/dL),an elevated serum
ketone level, a pH <7.3, and a serum bicarbonate level <18 mEq/L.
HELLP Syndrome sx? - ✔✔- ANS: hemolysis, elevated liver enzymes, and low platelets (pt
needs delivery, severe form of preeclampsia).
Acute glomerulonephritis sx? - ✔✔- ANS: brown cola-colored urine, RBC casts, which may be
painless or associated with mild flank or abdominal pain
, Head banging in young children - ✔✔- ANS: most will stop by age 3
Best position to keep woman less than 20w pregnant? - ✔✔- ANS: Left lateral decubitus
position
Best position to keep pregnant with spinal cord injury? - ✔✔- ANS: Supine, with the uterus
manually deflected laterally
Projectile vomiting sx? - ✔✔- ANS: early onset of worsening projectile vomiting and poor
weight gain
Treatment for osteopenia is indicated when the 10-year risk of a major fracture reaches? - ✔✔-
ANS: 20% (or hip fracture risk reaches 3%)
Which fluoroquinolone should NOT be used in UTI? - ✔✔- ANS: Moxifloxacin (cannot get
adequate urinary concentrations)
most common adverse event to complicate the hospital course of patients age 65 and over? -
✔✔- ANS: Drug-related events
Best study to determine ureteral stone? - ✔✔- ANS: helical CT scan of the abdomen and pelvis
without contrast
What is an adequate trial of an antidepressant? - ✔✔- ANS: 4-6 weeks
use of epidural anesthesia in labor and delivery increases the rate of? - ✔✔- ANS: Prolonged
second stage of labor
most common cause of pneumonia in children age 4 months to 4 years? - ✔✔- ANS: RSV
Complaints of discomfort in the eye with blurred vision and a history of striking steel? - ✔✔-
ANS: Intraocular foreign body
USPSTF Grade D - ✔✔- ANS: - Recommends against the service
- There is moderate or high certainty that the service has no net benefit or that the harms
outweigh the benefits
USPSTF grade I - ✔✔- ANS: Insufficient evidence to recommend
USPSTF grade C - ✔✔- ANS: Selectively recommended Based on professional judgement and
patient choices. Moderate certainty that the net benefit is small
MC cause of macular degeneration? - ✔✔- ANS: Hypertension, smoking
Treatment for croup? - ✔✔- ANS: Dexamethasone, .6mg/kg single oral dose (can give racemic
epinephrine if acutely ill)
Which Pap test result most likely to become cancer? - ✔✔- ANS: Atypical glandular cells not
otherwise specified (AGC-NOS)
First line tx for OCD? - ✔✔- ANS: SSRI
What does the P value <0.05 mean? - ✔✔- ANS: P value is the confidence level, and likelihood
of achieving the observed results of a study by chance alone, which is 5%
What are pediatric guidelines for food restrictions before surgery? - ✔✔- ANS: 8 hours for solid
food, 6 hours for formula, 4 hours for breast milk, and 2 hours for clear liquids
What is true about Canadian Drugs? - ✔✔- ANS: 90% are approved by US FDA
Henoch-Schonlein Purpura Sx? - ✔✔- ANS: follows an URI infection, and presents with
low-grade fever, fatigue, arthralgia, and colicky abdominal pain. The hallmark of the disease is
the rash, which begins as pink maculopapules, progresses to petechiae or purpura, which are
clinically palpable, and changes in color from red to dusty brown before fading. Arthritis, usually
involving the knees and ankles, is present in two-thirds of cases, and gastrointestinal tract
involvement results in heme-positive stools in 50% of cases.
Systemic juvenile-onset rheumatoid arthritis usually presents with what physical finding? - ✔✔-
ANS: evanescent salmon-pink rash
Hemolytic anemia is confirmed by what test? - ✔✔- ANS: Decreased Haptoglobin
Standalone High homocysteine seen in what condition? - ✔✔- ANS: Folic acid deficiency
High methylmalonic acid (MMA) and High homocystiene? - ✔✔- ANS: B12 Deficiency
Kawasaki disease sx? - ✔✔- ANS: 1) nonexudative conjunctivitis that spares the limbus; 2)
changes in the oral membranes such as diffuse erythema, injected or fissured lips, or
"strawberry tongue"; 3) erythema of palms and soles, and/or edema of the hands or feet
followed by periungual desquamation; 4) cervical adenopathy in the anterior cervical triangle
with at least one node larger than 1.5 cm in diameter; and, 5) an erythematous polymorphous
rash, which may be targetoid or purpuric. Tx: IVIG and Aspirin
,Celiac sprue sx? - ✔✔- ANS: child has between 4 and 24 months of age with impaired growth,
diarrhea, and abdominal distention. Malabsorption with IDA, that starts after consumption of
gluten containing foods
Waldenstrom macroglobulinemia - ✔✔- ANS: uncontrolled proliferation of lymphocytes and
plasma cells, which produce IgM proteins with KAPPA LIGHT CHAINS. moderate anemia and
MONOCLONAL IgM peaks on serum electrophoresis. BENCE-JONES protein is seen in 80% of
cases. lytic bone lesions are NOT seen. hepatosplenomegaly, and lymphadenopathy.
After a fight bite (fifth distal metacarpal fracture), what should you do? - ✔✔- ANS: Prophylactic
abx and X-rays
Stress fracture of the femoral neck sx? - ✔✔- ANS: persistent groin pain, and limited hip flexion
and internal rotation. Radiographs may be normal early. Seen in runners and military recruits
occurs in runners and presents with stinging pain over the lateral femoral epicondyle - ✔✔-
ANS: IT Band syndrome
Osteitis pubis sx - ✔✔- ANS: occurs in distance runners and presents with pain in the anterior
pelvic area and tenderness over the symphysis pubis
Tx for labial adhesions in peds? - ✔✔- ANS: Topcial estrogen bid till adhesions resolve
Anorexia nervosa severity is based on? - ✔✔- ANS: BMI. Mild is a BMI >17.0 kg/m2, moderate
is a BMI of 16.0-16.99 kg/m2, severe is a BMI of15.0-15.9 kg/m2, and extreme is a BMI <15.0
kg/m2.
In dementia, how do you medically treat wandering and pacing? - ✔✔- ANS: Medically cannot ,
no meds for this.
What med has best evidence for prevention of both vertebral fractures and hip fractures? - ✔✔-
ANS: Zoledronic acid (Reclast)
Treatment for chlamydia - ✔✔- ANS: 1-gram dose of oral azithromycin, (ok including during
pregnancy)
What is the cause of nausea and vomiting begin after 9 weeks' gestation? - ✔✔- ANS:
secondary causes are more likely to be present
What is an important adjunct med in tx of PTSD? - ✔✔- ANS: SSRI (sertraline and paroxetine)
most frequent cause of seizures in the elderly? - ✔✔- ANS: Stroke
,Which circadian sleep disorder responds to Bright light therapy? - ✔✔- ANS: Shift work
insomnia
Thalamotomy and pallidotomy are treatments for? - ✔✔- ANS: disabling unilateral tremor and
dyskinesia from Parkinson's disease
malnutrition, constipation, oliguria, and profound hypochloremic metabolic alkalosis? - ✔✔-
ANS: Hypertrophic pyloric stensosis
Snuffbox tenderness and tenderness over the scaphoid tubercle? - ✔✔- ANS: Scaphoid
fracture: Immobilize in a thumb spica splint for 1-2 weeks and then order repeat radiographs
mcc of urinary incontinence in a 72 yo female, DM, difficulty voiding, frequent dribbling? - ✔✔-
ANS: Autonomic neuropathy
What kind of arrhythmia: Regular narrow complex tachycardia, 156 bpm? - ✔✔- ANS:
supraventricular tachycardia (Tx:give adenosine to slow rate)
MMR vaccine contraindications? - ✔✔- ANS: pt pregnant or immunodeficient
Folestien MiniMental exam affected by? - ✔✔- ANS: Educational attainment
MC seizure disorder in childhood - ✔✔- ANS: febrile seizures
What Abx contraindicated in pt with Statin? - ✔✔- ANS: clarithromycin or erythromycin (CYP
3A4), increases risk of statin toxicity
Intranasal decongestants should not be used over 3 days why? - ✔✔- ANS: Phenylephrine
intranasal causes rhinitis medicamentosa after 3 days.
Detrusor instability sx? - ✔✔- ANS: intense urge to void, which overcomes the patient's
voluntary attempt to hold the sphincter closed; hence, the common term urge incontinence.
severity of DKA? - ✔✔- ANS: determined by the arterial pH, bicarbonate level, anion gap, and
mental status of the patient.
Diagnosis of DKA? - ✔✔- ANS: elevated serum glucose level (>250 mg/dL),an elevated serum
ketone level, a pH <7.3, and a serum bicarbonate level <18 mEq/L.
HELLP Syndrome sx? - ✔✔- ANS: hemolysis, elevated liver enzymes, and low platelets (pt
needs delivery, severe form of preeclampsia).
Acute glomerulonephritis sx? - ✔✔- ANS: brown cola-colored urine, RBC casts, which may be
painless or associated with mild flank or abdominal pain
, Head banging in young children - ✔✔- ANS: most will stop by age 3
Best position to keep woman less than 20w pregnant? - ✔✔- ANS: Left lateral decubitus
position
Best position to keep pregnant with spinal cord injury? - ✔✔- ANS: Supine, with the uterus
manually deflected laterally
Projectile vomiting sx? - ✔✔- ANS: early onset of worsening projectile vomiting and poor
weight gain
Treatment for osteopenia is indicated when the 10-year risk of a major fracture reaches? - ✔✔-
ANS: 20% (or hip fracture risk reaches 3%)
Which fluoroquinolone should NOT be used in UTI? - ✔✔- ANS: Moxifloxacin (cannot get
adequate urinary concentrations)
most common adverse event to complicate the hospital course of patients age 65 and over? -
✔✔- ANS: Drug-related events
Best study to determine ureteral stone? - ✔✔- ANS: helical CT scan of the abdomen and pelvis
without contrast
What is an adequate trial of an antidepressant? - ✔✔- ANS: 4-6 weeks
use of epidural anesthesia in labor and delivery increases the rate of? - ✔✔- ANS: Prolonged
second stage of labor
most common cause of pneumonia in children age 4 months to 4 years? - ✔✔- ANS: RSV
Complaints of discomfort in the eye with blurred vision and a history of striking steel? - ✔✔-
ANS: Intraocular foreign body
USPSTF Grade D - ✔✔- ANS: - Recommends against the service
- There is moderate or high certainty that the service has no net benefit or that the harms
outweigh the benefits
USPSTF grade I - ✔✔- ANS: Insufficient evidence to recommend
USPSTF grade C - ✔✔- ANS: Selectively recommended Based on professional judgement and
patient choices. Moderate certainty that the net benefit is small
