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AAFP BOARD REVIEW FINAL
EXAM 2024 /AAFP BOARD REVIEW EXAM WITH 200+
QUESTIONS AND CORRECT VERIFIED ANSWERS/ RECENT
UPDATE-2025/ALREADY GRADED A+
Which one of the following statements is TRUE regarding the use of antidepressants for smoking cessation?
- ANSWER: Bupropion is contraindicated in a patient with an eating disorder The number 1 cause of preventable morbidity and mortality in the UStoday is which of the following? - ANSWER: Tobacco Which of the following statements is true regarding alcohol abuse counseling? - ANSWER: The USPSTF recommends screening andcounseling adults the risks of alcohol misuse Which immunization would be considered safe to administer during pregnancy? - ANSWER: Tdap Self-help measures recommended for patients with NYHA class 2 HF is on optimal medications include which one of the following? - ANSWER: Avoiding NSAID use How much daily vitamin D supplementation do infants need during the first month of life? - ANSWER: Breastfed infants should have 400 IU ofVitamin D Following a scheduled repeat C-section delivery, a term infant has arespiratory rate
- What is the most common cause of this presentation? - ANSWER: Transient tachypnea of the newborn
Breastfeeding jaundice is characterized by
- ANSWER: insufficient feeds What advice would you give parents to reduce the risk of death from sudden infant death syndrome (SIDS) in their infant? - ANSWER: Avoid exposure of the infant to second-hand smoke The majority of failure to thrive cases in infants is due to - ANSWER: inadequate caloric intake What will Medicare cover for an elderly couple asks you how they will pay to live in facility. Which of the following is NOT true? - ANSWER: Medicare will pay once a medical need for services is clearly documented The largest portion of the Medicare budget is spent on - ANSWER: the20% of Medicare recipients with five or more chronic diseases Patient on meds including risperdone, metoclopramide, and valproate presents with Parkinson's symptoms (trouble standing, walking then freezing, flat affect), so your next step is - ANSWER: stop his risperdone,metoclopramide, and valproate Patient with Parkinson's doing well on carbidopa/levodopa therapy, but worried about dyskinesia. Which would be a good choice to decrease longterm effects of this? - ANSWER: Dopamine agonist, such as ropinirole Elderly patient develops C. Diff, so your next step is - ANSWER: beginPO vancomycin 125mg QID What causes peripheral vision loss?
100,000 e. coli. You should prescribe antimicrobials if
- ANSWER: shehas frequency, urgency, dysuria, or suprapubic pain Of the following recommendations, which has not been shown to be helpful for recovery of acute low back strain? - ANSWER: corticosteroids Which of the following is the USPSTF's recommendation regarding dailysupplementation of vitamin D and calcium for postmenopausal women toprevent fracture? - ANSWER: supplementation of vitamin D3 and calcium is not recommended for primary prevention only Type 2 DM, acute low back pain with dorsal foot paresthesias and dorsiflexion weakness, and positive straight leg test on right. Which of thefollowing recommendations is best supported by the clinical evidence? - ANSWER: consider surgical intervention due to motor deficit Which of the following statements best describes an overuse tendonopathysuch as lateral epicondylosis or patellar tendonosis? - ANSWER: rehabilitation with eccentric contractions are recommended to resolve these overuse tendinopathies New overweight runner with pain in patella first late in run and now earlierin run and after run along with crepitus. No acute injury. Which of the following is the most appropriate treatment for her condition? - ANSWER: reduction in running distance and physical therapy Which of the following is the most sensitive finding in patients with carpaltunnel syndrome? - ANSWER: Flick sign Medial left heel pain for 5 weeks. Burning and worse with weight bearing or standing and better with rest. Aggravated by full passive dorsiflexion ofthe ankle .You conclude that: - ANSWER: she has tarsal tunnel syndrome and you provide an orthotic
The developmental examination on a 6-month-old boy reveals an infant who follows past midline, laughs, turns toward your voice, and has clenched fists. With these findings you
- ANSWER: refer to specialist forfurther evaluation A mother brings her 9 - month-old daughter in for routine care. Which of the following should be addressed at this visit? - ANSWER: stating tablefood At his well-child check, a 5-year-old boy is noted to have occasional bedwetting. You advise the parents that - ANSWER: this occurs in 20-25% of boys this age What is the most appropriate automobile seating for a 7-year-old who is 50inches tall? - ANSWER: rear seat in belt-positioning booster seat with lap/shoulderbelt You are seeing a young girl for her pre-high school physical. The form asks for Tanner stage. She has small but developed breasts and a small amount of dark, straight pubic hair. She is Tanner stage - ANSWER: III Which of the following is true of bulimia nervosa in adolescent females? - ANSWER: more prevalent than anorexia nervosa 79 yo F with mild dementia s/p right hip arthroplasty who screams whentold to get out of bed. Picks at sheets and speaks nonsensically. The appropriate next step is - ANSWER: review her outpatient medications 76 yo F with failing memory, unable to pay bills, and unable to knit whichshe liked to do before, and word finding. What is her diagnosis? - ANSWER: dementia What is the most common type of dementia? - ANSWER: Alzheimer'sWhat is the greatest risk factor for
lymphadenopathy. What is the next step?
- ANSWER-supportive care A 2-year-old child is brought to the emergency department with a barking cough, stridor that worsened tonight, and a temperature of 101º F. What isthe treatment? - ANSWER: nebulized epinephrine and dexamethasone A 9 - month-old child is admitted in Jan. for cough, wheezing, feeding, and fever of 38ºC. CXR shows mild peribronchial cuffing. Which treatment isindicated? - ANSWER: supplemental O2 and fluids A 2-year-old boy has very red cheeks and a fine rash but does not appear ill. He had a fever a couple of days ago. When can he return to day care? - ANSWER: today A 5-year-old male has 7 days of spiking high fevers and a diffuse erythematous rash. His tongue and lips are red, dry, and cracked, and hehas large cervical lymph nodes. In addition to rehydration, what are the next treatment steps? - ANSWER: inpatient immune globulin and high-dose aspirin 3 yo M walking home with mom and cries of pain when elbow is movedand keeping it to left side. Negative x-rays. Using an evidence- based approach to your patient, what would be the best treatment? - ANSWER: hyperpronation of the forearm A 44 yo female tripped and fell on the ice on an outstretched left hand [FOOSH]. She presents with this radiograph showing distal radial fracture.What is the most commonly injured nerve in this injury? - ANSWER: median nerve A 36 yo female presents to your office and reports that she fell on an
outstretched left hand [FOOSH] 3 days ago and presents with left wristpain, minor swelling, and this radiograph showing a scaphoid fracture. What is the best treatment option? - ANSWER: thumb spica cast for 8 weeks Football player injured ring finger after grabbing the jersey of another place and feeling pain in the distal aspect of the affected finger. Can't flexDIP joint and small bony fragment seen at solar surface of the proximal distal phalanx. Which one of the following would be the most appropriatemanagement? - ANSWER: referral to hand surgeon Volleyball player who jammed his left 5th finger with full passive ROMbut not active extension of the distal phalanx. Normal hand x- ray. Whichof the following is the most appropriate treatment? - ANSWER: immobilization of the DIPJ in extension for 6 - 8 weeks 74 yo F with HTN, osteoporosis, and arthritis has had increased back painover 2 months. Radiograph shows vertebral compression fracture. Which statement is correct?
- ANSWER-she has an increased mortality rate of 15% over thosewithout this condition 72 yo M with left hip pain has pain with ambulation after fall. Wants to be non- weightbearing. What is your diagnosis? - ANSWER: left hip fracture Which of the following is NOT a factor in the Ottawa Ankle Rules? - ANSWER: discrete bony tenderness at the anterior distal fibula Examination findings of a 17 yo male athlete with near syncope and suspicion for hypertrophic cardiomyopathy would include the following finding: - ANSWER: a crescendo-decrescendo systolic murmur at the leftsternal border that increases with valsalva The defining characteristic distinguishing between heat exhaustion
concussion? - ANSWER: physical rest is recommended during the first 24 - 48 hours post-concussion You have been invited to present a grand rounds lecture on "Sports Injuriesin High School Athletes." Which of the following statements would you include in your talk? - ANSWER: football has the highest injury rate Which physical exam test is the most sensitive maneuver for the corresponding knee injury? - ANSWER: Thessaly test- meniscal tear Which one of the following statements is true regarding ACL injuries? - ANSWER: in high school sports, football has the highest rate of ACL injury A 26 yo male suffers an inversion ankle injury and ambulates to the ED forevaluation. You find lateral ankle swelling and tenderness over the anteriordistal fibula. The next best course of action includes - ANSWER: recommendation for early range of motion for the ankle Which of the following pharmacokinetic factors changes least with age? - ANSWER: absorption An 80 yo hypertensive woman is switched from atenolol to propranolol totreat tremor. A week later she seems more bradycardic, confused, and despondent. The most likely cause is: - ANSWER: lipophila of propranolol An 84 yo man has been less alert and his balance is deteriorating. He wastaking 5 mg of diazepam twice a day and agrees to stop. One week later, he's no better. Three weeks later he's improved. The most likely explanation is: - ANSWER: active drug metabolites Which pharmacokinetic factor changes the most with age? - ANSWER: elimination An 80 yo on warfarin has an INR of 2.5. The best explanation for
increased bleeding risk compared with a younger patient is - ANSWER: pharmacodynamic differences
is anapophysitis
11 yo male with bilateral posterior heel pain when you passively and fully dorsiflex the ankles. Better with rest and worse with activity. Which one ofthe following is the most likely diagnosis? - ANSWER: Sever's disease Pediatric obesity is associated with each of the following except - ANSWER: decreased risk of herniated lumbar disc You are on a plane ride when a passenger suddenly becomes unresponsive.Which statement below is true? - ANSWER: you should check a pulse, if none present, immediately start chest compressions 65 y/o with a fib on warfarin with acute intracerebral hemorrhage after afall. The ACCP and AHA/ASA recommends - ANSWER: start 4- factor Prothrombin Complex Concentrate (KCentra) + Vitamin K 10mg IV 31 yo M brought to ED after trauma to leg with blood positive in dipstick,but no blood seen under microscope. This patient should be admitted for the management of - ANSWER: rhabdomyolysis A 37 y/o male in good health presents with a laceration of the 5th fingerdue to broken glass. Which one of the following statements is true? - ANSWER: wound irrigation with tap water has been shown to have comparable (if not lower) rates of wound infection than sterile saline Child abuse should be suspected in all of the following EXCEPT - ANSWER: 20 month old with spiral fracture of distal tibia 12 month old M for fever, cough, and pulling on left ear. Afebrile, slightlyred TM but won't allow pneumatic otoscopy. Your diagnosis is?
- ANSWER: URI, acute otitis media uncertain A 22-month-old male patient is brought to you crying and in obvious
who weighs 20 kg (44 lb). What is the most appropriate treatment? - ANSWER: amoxicillin 1800 mg/day You treated a child with AOM with antibiotics and see him back 4 weekslater. The child is asymptomatic, but you determine he has a middle ear effusion. Your recommendation would be? - ANSWER: reassurance andreevaluate in 2 months A 43-year-old male presents to your office with five days of nasal congestion and headache. His temperature is 100.8oF, he has purulent rhinorrhea, and minimal tenderness to palpation over the frontal and maxillary sinuses. Your next step would be? - ANSWER: treat with decongestants/mucolytics 57 yo with brief episodes of sensation of spinning and dizziness with quickmovement that last a few seconds. No hearing symptoms. The most likely diagnosis would be? - ANSWER: benign paroxysmal positional vertigo Which of the following bites has the highest risk of infection? - ANSWER: cat bite to the hand 24 yo M with 3 day rash that is getting bigger with central clearing. No other symptoms or bites that he knows of. Went to Martha's Vineyard. Inthis case, you would treat with
- ANSWER-doxycycline 100mg BID for 10 days Allergic reaction with rash that has diffuse pruritus and erythema alongwith facial and oral swelling. The first medication this patient should receive is - ANSWER: epinephrine 21 yo college student who swallowed a bunch of Tylenol along with drinking alcohol. Which of the following would be the best course ofaction - ANSWER: administer activated charcoal 38 yo F with Hx of lap cholecystectomy 8 weeks ago. 2+ bilateral pitting
ankle edema. Your choice of an initial diagnostic study would be: - ANSWER: D-dimer
A patient presents to you having had a single new unprovoked seizure withnegative workup. Your first step in treatment would be - ANSWER: start no medications at this time
46 yo M with fever, arthralgia, and erythoderma with fever, elevated WBC, eosinophils and abnormal LFTS. The most likely diagnosis is - ANSWER: DRESS syndrome 46 yo M smoker with unilateral, cyclical, nocturnal headaches for 30min. The best prophylactic medication for his headaches would be - ANSWER: verapamil Because of the prevalence and its lethality, the USPSTF recommends thatultrasound screening be performed in which patients? - ANSWER: one time screening for men ages 65 - 75 who have ever smoked You identified an abdominal aortic aneurysm (AAA) in your patient. At what size (in centimeters) should you refer your patient for surgical intervention? - ANSWER: 5 - 5.5cm A 68 yo male presents with complaints of an aching pain in both thighs when he walks about one block. The pain subsides within about 1- 2 minutes after he stops ambulating. The best initial test in this case is to seeif there is decreased blood flow - ANSWER: perform an ankle- brachial index (ABI) When obtaining an ABI, AHA/ACC recommends obtaining the brachial (arm) systolic BP in both arms and using the higher of the 2 readings. However, if a difference in systolic BP > 20 mm between the arms, themost likely diagnosis is? - ANSWER: subclavian artery stenosis 72 yo F with sudden severe R leg pain in the setting of tachycardia and irregular heart rhythm. Leg is cool to touch, pale in color, and no pulses.At this point, you should - ANSWER: start heparin and immediately consult vascular surgeon 76 yo M with Hx of HTN, HLD, and smoking presents with with blue painful toes in the setting of intact pulses. The most likely diagnosis is - ANSWER: Blue toe syndrome
