CCFP Exam with Complete Solutions
An 80-year-old woman presents with a 2-day history of abdominal pain and vomiting. She has
a history of previous abdominal surgeries. What is the most likely cause of her symptoms?
What imaging study would you order to confirm the diagnosis? Correct Ans-Bowel
obstruction due to adhesions. Abdominal CT scan
A 28-year-old woman presents with a 1-day history of right upper quadrant pain. She
mentions that the pain is associated with meals, especially fatty foods. What is the most likely
diagnosis for her symptoms? What investigation would you order to confirm the diagnosis?
Correct Ans-Cholecystitis or Cholelithiasis. Ultrasound of the gallbladder.
A 40-year-old man presents with a 3-day history of diffuse abdominal pain, nausea, and
vomiting. He has a history of heavy alcohol consumption. What is the most likely diagnosis for
his symptoms? List two management strategies for this patient. Correct Ans-Abstinence
from alcohol and pain management.
A 35-year-old woman presents with a 4-hour history of severe, colicky pain in the left flank
that radiates to the groin. She also reports having hematuria. What is the most likely
diagnosis for her symptoms? What investigation would you order to confirm the diagnosis?
Correct Ans-Nephrolithiasis (Kidney stone). Non-contrast CT of the abdomen and pelvis.
A 55-year-old man presents with a 2-week history of dull, aching pain in the epigastric region.
He mentions that the pain is relieved by eating. What is the most likely diagnosis for his
symptoms? What medication would you prescribe for this patient? Correct Ans-Peptic
ulcer disease. Proton pump inhibitor (PPI).
, CCFP Exam with Complete Solutions
A 20-year-old woman presents with a 3-day history of lower abdominal pain and vaginal
discharge. She is sexually active and does not use any form of contraception. What are two
differential diagnoses for her symptoms? What investigation would you order to confirm the
diagnosis? Correct Ans-Pelvic inflammatory disease (PID), Ectopic pregnancy. Pelvic
ultrasound and/or pregnancy test.
A 65-year-old man presents with a 1-day history of severe, sharp pain in the right lower
quadrant of his abdomen. On examination, you note rebound tenderness in the same area.
What is the most likely diagnosis for his symptoms? What is the next step in managing this
patient? Correct Ans-Appendicitis. Surgical consultation for possible appendectomy.
A 7-year-old girl presents with a 2-day history of abdominal pain and vomiting. Her mother
mentions that she has not passed stools for the past 3 days. What is the most likely diagnosis
for her symptoms? What investigation would you order to confirm the diagnosis? Correct
Ans-Intussusception. Abdominal ultrasound.
A 50-year-old woman presents with a 6-month history of recurrent, crampy abdominal pain.
She also reports having diarrhea and occasional blood in her stools. What is the most likely
diagnosis for her symptoms? List two medications that can help manage her symptoms.
Correct Ans-Mesalamine and corticosteroids
A 30-year-old woman presents with a 1-day history of sharp, localized pain in the right lower
quadrant of her abdomen. She mentions that she is currently menstruating. What gynecologic
etiology should be considered for her abdominal pain? What investigation would you order to
, CCFP Exam with Complete Solutions
confirm the diagnosis? Correct Ans-Mittelschmerz (ovulation pain). Clinical diagnosis, no
further investigation needed
A 60-year-old man presents with a 3-day history of diffuse abdominal pain and distension. He
also reports having constipation for the past week. What is the most likely diagnosis for his
symptoms? What imaging study would you order to confirm the diagnosis? Correct Ans-
Bowel obstruction. Abdominal CT scan.
A 25-year-old woman presents with a 2-day history of lower abdominal pain and spotting. She
mentions that her last menstrual period was 6 weeks ago and she is sexually active. What life-
threatening condition should be considered in this patient? What is the first step in managing
this patient? Correct Ans-Ruptured ectopic pregnancy. Immediate surgical consultation.
A 45-year-old presents to your clinic with abdominal pain. They describe the pain as sharp
and sudden, localized to the right lower quadrant, and started 6 hours ago.
Questions:
List five potential differential diagnoses for this patient's pain.
What investigations would you order for this patient? Correct Ans-Appendicitis, ectopic
pregnancy, nephrolithiasis, IBD, bowel obstruction.
Labs (CBC, ALT/AST, lipase, sodium, potassium), Ultrasound (especially if RUQ pain), CT with IV
contrast for RLQ pain.
A 52-year-old female has been diagnosed with gastroesophageal reflux disease (GERD). She
complains of frequent heartburn, especially after eating spicy foods.
, CCFP Exam with Complete Solutions
Questions:
What lifestyle modifications would you recommend?
Name two medications suitable for managing her condition.
What complications can arise if GERD is left untreated? Correct Ans-Avoid spicy foods,
elevate head of bed, avoid lying down immediately after meals, reduce alcohol and caffeine
intake.
Proton pump inhibitors (e.g., omeprazole), H2 blockers (e.g., ranitidine).
Esophagitis, Barrett's esophagus, esophageal stricture.
A 3-year-old boy is brought in by his mother with complaints of abdominal pain and vomiting
for the past day. The mother reports no fever but mentions the child has been crying a lot.
Questions:
List three urgent differential diagnoses for this age group.
What are two red flags in children with abdominal pain?
Which imaging modality would you consider first? Correct Ans-Acute gastroenteritis, HSP (
Henoch-Schönlein purpura), pneumonia.
Bilious vomiting, rebound tenderness.
Ultrasound.
A 55-year-old male collapses at a gym. Bystanders start CPR and you arrive with an AED. The
AED shows a shockable rhythm.
What is the most likely rhythm?
What is the immediate action to be taken?
An 80-year-old woman presents with a 2-day history of abdominal pain and vomiting. She has
a history of previous abdominal surgeries. What is the most likely cause of her symptoms?
What imaging study would you order to confirm the diagnosis? Correct Ans-Bowel
obstruction due to adhesions. Abdominal CT scan
A 28-year-old woman presents with a 1-day history of right upper quadrant pain. She
mentions that the pain is associated with meals, especially fatty foods. What is the most likely
diagnosis for her symptoms? What investigation would you order to confirm the diagnosis?
Correct Ans-Cholecystitis or Cholelithiasis. Ultrasound of the gallbladder.
A 40-year-old man presents with a 3-day history of diffuse abdominal pain, nausea, and
vomiting. He has a history of heavy alcohol consumption. What is the most likely diagnosis for
his symptoms? List two management strategies for this patient. Correct Ans-Abstinence
from alcohol and pain management.
A 35-year-old woman presents with a 4-hour history of severe, colicky pain in the left flank
that radiates to the groin. She also reports having hematuria. What is the most likely
diagnosis for her symptoms? What investigation would you order to confirm the diagnosis?
Correct Ans-Nephrolithiasis (Kidney stone). Non-contrast CT of the abdomen and pelvis.
A 55-year-old man presents with a 2-week history of dull, aching pain in the epigastric region.
He mentions that the pain is relieved by eating. What is the most likely diagnosis for his
symptoms? What medication would you prescribe for this patient? Correct Ans-Peptic
ulcer disease. Proton pump inhibitor (PPI).
, CCFP Exam with Complete Solutions
A 20-year-old woman presents with a 3-day history of lower abdominal pain and vaginal
discharge. She is sexually active and does not use any form of contraception. What are two
differential diagnoses for her symptoms? What investigation would you order to confirm the
diagnosis? Correct Ans-Pelvic inflammatory disease (PID), Ectopic pregnancy. Pelvic
ultrasound and/or pregnancy test.
A 65-year-old man presents with a 1-day history of severe, sharp pain in the right lower
quadrant of his abdomen. On examination, you note rebound tenderness in the same area.
What is the most likely diagnosis for his symptoms? What is the next step in managing this
patient? Correct Ans-Appendicitis. Surgical consultation for possible appendectomy.
A 7-year-old girl presents with a 2-day history of abdominal pain and vomiting. Her mother
mentions that she has not passed stools for the past 3 days. What is the most likely diagnosis
for her symptoms? What investigation would you order to confirm the diagnosis? Correct
Ans-Intussusception. Abdominal ultrasound.
A 50-year-old woman presents with a 6-month history of recurrent, crampy abdominal pain.
She also reports having diarrhea and occasional blood in her stools. What is the most likely
diagnosis for her symptoms? List two medications that can help manage her symptoms.
Correct Ans-Mesalamine and corticosteroids
A 30-year-old woman presents with a 1-day history of sharp, localized pain in the right lower
quadrant of her abdomen. She mentions that she is currently menstruating. What gynecologic
etiology should be considered for her abdominal pain? What investigation would you order to
, CCFP Exam with Complete Solutions
confirm the diagnosis? Correct Ans-Mittelschmerz (ovulation pain). Clinical diagnosis, no
further investigation needed
A 60-year-old man presents with a 3-day history of diffuse abdominal pain and distension. He
also reports having constipation for the past week. What is the most likely diagnosis for his
symptoms? What imaging study would you order to confirm the diagnosis? Correct Ans-
Bowel obstruction. Abdominal CT scan.
A 25-year-old woman presents with a 2-day history of lower abdominal pain and spotting. She
mentions that her last menstrual period was 6 weeks ago and she is sexually active. What life-
threatening condition should be considered in this patient? What is the first step in managing
this patient? Correct Ans-Ruptured ectopic pregnancy. Immediate surgical consultation.
A 45-year-old presents to your clinic with abdominal pain. They describe the pain as sharp
and sudden, localized to the right lower quadrant, and started 6 hours ago.
Questions:
List five potential differential diagnoses for this patient's pain.
What investigations would you order for this patient? Correct Ans-Appendicitis, ectopic
pregnancy, nephrolithiasis, IBD, bowel obstruction.
Labs (CBC, ALT/AST, lipase, sodium, potassium), Ultrasound (especially if RUQ pain), CT with IV
contrast for RLQ pain.
A 52-year-old female has been diagnosed with gastroesophageal reflux disease (GERD). She
complains of frequent heartburn, especially after eating spicy foods.
, CCFP Exam with Complete Solutions
Questions:
What lifestyle modifications would you recommend?
Name two medications suitable for managing her condition.
What complications can arise if GERD is left untreated? Correct Ans-Avoid spicy foods,
elevate head of bed, avoid lying down immediately after meals, reduce alcohol and caffeine
intake.
Proton pump inhibitors (e.g., omeprazole), H2 blockers (e.g., ranitidine).
Esophagitis, Barrett's esophagus, esophageal stricture.
A 3-year-old boy is brought in by his mother with complaints of abdominal pain and vomiting
for the past day. The mother reports no fever but mentions the child has been crying a lot.
Questions:
List three urgent differential diagnoses for this age group.
What are two red flags in children with abdominal pain?
Which imaging modality would you consider first? Correct Ans-Acute gastroenteritis, HSP (
Henoch-Schönlein purpura), pneumonia.
Bilious vomiting, rebound tenderness.
Ultrasound.
A 55-year-old male collapses at a gym. Bystanders start CPR and you arrive with an AED. The
AED shows a shockable rhythm.
What is the most likely rhythm?
What is the immediate action to be taken?
