FAMILY MEDICINE PART 2 ROSH QUESTIONS WITH
COMPLETE SOLUTIONS
acute mononucleosis, which is a viral illness caused by
the Epstein-Barr virus (EBV)
rapid mononuclear spot test, which detects the presence
of heterophile antibodies
patients to refrain from contact sports for 4 weeks due to the
risk of splenic rupture.
A 62-year-old man presents to the office with a 2-month history
of fatigue, shortness of breath, and intermittent headaches. His
physical examination is pertinent for conjunctival pallor, dried
blood in the nares, and ecchymosis on the shins and arms. No
lymphadenopathy or organomegaly is appreciated. A complete
blood count with differential is obtained and reveals
pancytopenia. Peripheral smear shows the above cell. What is
the most likely diagnosis?
AAcute lymphoid leukemia
BAcute myeloid leukemia
CChronic lymphoid leukemia
,DChronic myeloid leukemia
Acute myeloid leukemia
The malignancy is associated with exposure to radiation,
tobacco, and certain genetic abnormalities (trisomy 21)
Acute Myeloid Leukemia (AML)
Patient will be an adult
Fever, fatigue, anemia, easy
bruising or bleeding, petechiae, bone and joint pain,
and persistent orfrequent infections
PE will show hepatosplenomegaly
Labs will show Auer rods, normocytic, normochromic
anemia, blast cells
What are the metabolic abnormalities associated with tumor
lysis syndrome?
Answer: Hyperphosphatemia, hypocalcemia, hyperuricemia,
and hyperkalemia. "PKU ca"
A 65-year-old woman presents to her primary care provider for
her annual visit. She is concerned about developing osteoporosis
because of her age. She has no significant past medical or
,surgical history and is not currently taking any medications.
Which of the following should be recommended to this patient?
AAvoid fatty foods
BBegin estrogen hormone replacement
CLimit exposure to ultraviolet radiation
D Participate in an exercise program
Participate in an exercise program
look at image for 3 key things
What is the difference between the T-score and Z-score?
Answer: The T-score compares a patient with a healthy 30-year-
old of the same sex, while the Z-score compares a patient with
an average person of the same age and sex.
Osteoporosis
Decline in bone mass that results in increased bone fragility and
fracture risk
Risk factors: female sex, advancing age,
chronic steroid use, alcohol or tobacco use, family history of
fragility fracture
Diagnosis is made by DXA scan: T-score ≤ −2.5 or presence of
a fragility fractureOsteopenia: T-score -1.0 to -2.5
Tx: Lifestyle: calcium, vitamin D, weight bearing exercise,
smoking cessation First line pharmacotherapy: bisphosphonates
((e.g., alendronate, pamidronate, zoledronic acid))
Second line: SERMs, recombinant PTH, denosumab
, Most common fracture: vertebral body compression fractures
==============================
begin estrogen hormone replacement (B), as this would
increase her risk of endometrial hyperplasia and cancer.
limit exposure to ultraviolet radiation (C), as this would
increase her risk of vitamin D deficiency and
osteoporosis.
avoid fatty foods (A). Avoiding fatty foods is not directly
correlated to the reduction of osteoporosis risk.
A 2-year-old boy presents to the pediatric clinic with right ear
pulling. On exam, the right tympanic membrane is bulging.
Which of the following pathogens is most likely to cause this
condition?
tx vs alternative when anaphylaxic?
Haemophilus influenzae and Streptococcus pneumoniae are
the most common bacterial causes of acute otitis media.
Acute Otitis Media
Patient will be an infant or young child
Ear pain, fever, URI symptoms
COMPLETE SOLUTIONS
acute mononucleosis, which is a viral illness caused by
the Epstein-Barr virus (EBV)
rapid mononuclear spot test, which detects the presence
of heterophile antibodies
patients to refrain from contact sports for 4 weeks due to the
risk of splenic rupture.
A 62-year-old man presents to the office with a 2-month history
of fatigue, shortness of breath, and intermittent headaches. His
physical examination is pertinent for conjunctival pallor, dried
blood in the nares, and ecchymosis on the shins and arms. No
lymphadenopathy or organomegaly is appreciated. A complete
blood count with differential is obtained and reveals
pancytopenia. Peripheral smear shows the above cell. What is
the most likely diagnosis?
AAcute lymphoid leukemia
BAcute myeloid leukemia
CChronic lymphoid leukemia
,DChronic myeloid leukemia
Acute myeloid leukemia
The malignancy is associated with exposure to radiation,
tobacco, and certain genetic abnormalities (trisomy 21)
Acute Myeloid Leukemia (AML)
Patient will be an adult
Fever, fatigue, anemia, easy
bruising or bleeding, petechiae, bone and joint pain,
and persistent orfrequent infections
PE will show hepatosplenomegaly
Labs will show Auer rods, normocytic, normochromic
anemia, blast cells
What are the metabolic abnormalities associated with tumor
lysis syndrome?
Answer: Hyperphosphatemia, hypocalcemia, hyperuricemia,
and hyperkalemia. "PKU ca"
A 65-year-old woman presents to her primary care provider for
her annual visit. She is concerned about developing osteoporosis
because of her age. She has no significant past medical or
,surgical history and is not currently taking any medications.
Which of the following should be recommended to this patient?
AAvoid fatty foods
BBegin estrogen hormone replacement
CLimit exposure to ultraviolet radiation
D Participate in an exercise program
Participate in an exercise program
look at image for 3 key things
What is the difference between the T-score and Z-score?
Answer: The T-score compares a patient with a healthy 30-year-
old of the same sex, while the Z-score compares a patient with
an average person of the same age and sex.
Osteoporosis
Decline in bone mass that results in increased bone fragility and
fracture risk
Risk factors: female sex, advancing age,
chronic steroid use, alcohol or tobacco use, family history of
fragility fracture
Diagnosis is made by DXA scan: T-score ≤ −2.5 or presence of
a fragility fractureOsteopenia: T-score -1.0 to -2.5
Tx: Lifestyle: calcium, vitamin D, weight bearing exercise,
smoking cessation First line pharmacotherapy: bisphosphonates
((e.g., alendronate, pamidronate, zoledronic acid))
Second line: SERMs, recombinant PTH, denosumab
, Most common fracture: vertebral body compression fractures
==============================
begin estrogen hormone replacement (B), as this would
increase her risk of endometrial hyperplasia and cancer.
limit exposure to ultraviolet radiation (C), as this would
increase her risk of vitamin D deficiency and
osteoporosis.
avoid fatty foods (A). Avoiding fatty foods is not directly
correlated to the reduction of osteoporosis risk.
A 2-year-old boy presents to the pediatric clinic with right ear
pulling. On exam, the right tympanic membrane is bulging.
Which of the following pathogens is most likely to cause this
condition?
tx vs alternative when anaphylaxic?
Haemophilus influenzae and Streptococcus pneumoniae are
the most common bacterial causes of acute otitis media.
Acute Otitis Media
Patient will be an infant or young child
Ear pain, fever, URI symptoms
