Aquifer FM End of Case Questions
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Aquifer Fm End Of Case Questions With Very Accurate
Answers2024/2025
1. A 34-year-old cisgendered female who has no past medical problems and is not
currently taking any medications comes into your office because she noticed a
tender lump in her left breast starting approximately one month ago. She is worried
because she has a maternal aunt who had breast cancer that was BRCA positive,
though her mother is BRCA negative. Her periods have been regular since they
started at the age of 13 and occur every 32 days. She is currently menstruating. She
has three children, aged 12, 9, and 4. On exam, her BMI is 32, up from 28 three
years ago, and her other vital signs are stable. On breast exam, you note a mobile
rubbery mass approximately 1 x 1cm that has regular borders and is tender to
palpation. You appreciate no axillary adenopathy. The rest of her physical exam is
unremarkable. Of the information provided, which of the following puts this patient
at increased risk for breast cancer?
A. Age
B. Age of menarche
C. Family history of cancer
D. Parity history
E. Weight: The answer is E. From FM 01.
2. A 64-year-old cisgendered female who is overweight with well-controlled
hypertension comes to your office with concerns of a lump in her breast that she
noticed while showering. She reports having no pain, tenderness, or skin changes. A
pertinent review of systems is negative. Menarche began at the age of 10. Her first
child was born when she was 31 and she had her second and last child at the age of
33. She experienced menopause at the age of 44. Her mother died of colon cancer
when she was 65 and her father passed away from metastatic prostate cancer at the
age of 70. She has no history of tobacco use ever and occasionally drinks a glass of
wine with dinner. Her BMI is 34. Which of the information provided thus far puts
the patient at decreased risk for breast cancer?
A. Age
B. Age at first birth
C. Age at menarche
D. Age at menopause
E. Weight: The answer is D. From FM 01.
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3. A 63-year old cisgendered female comes into your office for her annual preventive
exam. She has hypertension and type 2 diabetes. She is not sexually active. Her
blood pressure is 125/80 and her physical exam otherwise is within normal limits.
You recommend influenza and zoster vaccination. Her last colonoscopy was eight
years ago and her last mammogram one year ago; both were normal. She has never
had an abnormal Pap test. At the age of 45 she had a total hysterectomy for fibroids.
Of the details provided about this patient, which is an appropriate reason to explain
why she does not need a Pap test today?
A. She experienced menopause more than 10 years ago
B. She had a total hysterectomy for fibroids
C. She has never had an abnormal Pap test
D. She is 63 years old
E. She is not sexually active: The answer is B. From FM 01.
4. A 47-year-old cisgendered female comes into your office for a health care
maintenance exam. She has hypertension and type 2 diabetes. She is not sexually
active and has not yet experienced menopause. There is no family history of cancer.
Her blood pressure is 118/78, her BMI is 34, and the remainder of her physical exam
is within normal limits. Her vaccinations are up to date, and she has a Pap test today
and will have labs drawn. According to USPSTF, which of the following is the best
recommendation to give her concerning mammography?
A. Should have started at age 40 and every year thereafter
B. Should have started at age 40 and every two years thereafter
C. Should have started at age 45 and every year thereafter
D. Start at age 50 and every year thereafter
E. Start at age 50 and every two years thereafter: The answer is E. From FM 01.
5. A 25-year-old patient presents to the office for follow-up on anxiety and tobacco
dependence. She reports she is doing well on her new medication to help with both
her mood and smoking, though she continues to smoke. She recently started her
first sexual relationship with a new female partner. She received a tetanus vaccine at
the age of 18, and she received her flu vaccine this year. Her blood pressure is
122/70, and her physical exam is within normal limits. You review her recent Pap
test, which was negative. Which of the following indicates the vaccines she should
receive today?
Choose the single best answer.
A. HPV vaccine alone
, Aquifer FM End of Case Questions
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B. HPV vaccine and pneumococcal conjugate vaccine (PCV13)
C. HPV vaccine and pneumococcal polysaccharide vaccine (PPSV23)
D. HPV vaccine and Zoster vaccine
E. No vaccines are needed: The answer is C. From FM 01.
6. A 55-year-old male with no significant past medical history presents for a routine
physical exam. He last saw a doctor five years ago. Social history is remarkable for a
35-pack-year tobacco history since the age of 20. He indicates that his wife and
children have urged him to quit smoking for the last few months. When you ask him
if he has considered quitting, he replies, "I just don't see what the big deal is!"
Which stage of change best describes this patient at this time? A. Action
B. Contemplation
C. Maintenance
D. Precontemplation
E. Preparation: The answer is D. From FM 02.
7. A 48-year-old male with a past medical history that includes hypertension,
chronic obstructive pulmonary disease (COPD), and hyperlipidemia presents to
clinic as a new patient in October for a general physical exam. History reveals that
he has been smoking a pack of cigarettes daily since age 20. He drinks two beers
daily. He is intermittently nonadherent with his medications. Review of the state
immunization database reveals that the only immunization he has received as an
adult was a tetanus diphtheria shot administered 12 years ago. Which of the
following vaccine combinations would be most appropriate for this patient?
A. Influenza, meningococcal, and zoster
B. Influenza, pneumococcal, and Tdap
C. Influenza, zoster, and Tdap
D. Meningococcal, pneumococcal, and Tdap
Meningococcal, pneumococcal, and zoster: The answer is B. From FM 02.
8. A 55-year-old male comes to the clinic for a visit. He has read about the dangers
of being overweight and inquires about which category he fits into. He is 5' 10'' (1.78
m) and weighs 220 lbs (100 kg), BMI = 31.6. Which of the following categories most
accurately describes the patient based on his BMI?
A. Ideal
B. Morbidly (very severely) obese
C. Obese
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D. Overweight
E. Underweight: The answer is C. From FM 02.
9. A 55-year-old male with a family history of melanoma presents to the clinic for
evaluation of a skin lesion on his back which appeared three months ago. His wife
first alerted him to it, hasn't noticed it change and he has not noticed any symptoms
associated with it. Physical examination reveals a 7 mm uniformly black macule that
is symmetrically round with sharply demarcated borders on his upper back near the
right shoulder. Which of the following characteristics would most justify it being
biopsied today?
A. Borders
B. Color
C. Diameter
D. Location
E. Symmetry: The answer is C. From FM 02.
10. A 55-year-old male with no significant past medical history and generally
healthy behaviors presents to clinic for a health care maintenance exam. He says,
"I'd like to get tested for all types of cancer." He does not have any family history of
cancer. Review of systems is negative for any symptoms of prostate cancer, such as
urinary frequency, urgency, retention, hematuria, weight loss, or back pain. He is a
lifelong non-smoker, and he doesn't drink alcohol or use recreational drugs. Which
of the following screening tests is given either a USPSTF A or B recommendation in
favor of its routine use for patients such as this one?
A. Colon cancer screening
B. ECG screening for coronary artery disease
C. Lung cancer screening
D. Pancreatic cancer screening
E. Prostate specific antigen (PSA) testing: The answer is A. From FM 02.
11. A 65-year-old truck driver presents to your office complaining of right calf pain
and swelling. He has recently returned from a four-day cross-country trip after
which he had onset of his current symptoms. The patient reports that the week prior
to his four-day trip, he was mostly in bed recovering from a bout of the flu. His
PMH is significant for DM type 2 and COPD. He has a 25-pack-year smoking
history. He denies having any chest pain or SOB. His physical exam shows 2+ pitting
edema of his right leg. When measuring the circumference of his right leg, you note
that it is 34 cm compared to the left, which has a circumference of 30 cm. What is
the most appropriate next step in diagnosis?
Study online at https://quizlet.com/_8mzrh9
Aquifer Fm End Of Case Questions With Very Accurate
Answers2024/2025
1. A 34-year-old cisgendered female who has no past medical problems and is not
currently taking any medications comes into your office because she noticed a
tender lump in her left breast starting approximately one month ago. She is worried
because she has a maternal aunt who had breast cancer that was BRCA positive,
though her mother is BRCA negative. Her periods have been regular since they
started at the age of 13 and occur every 32 days. She is currently menstruating. She
has three children, aged 12, 9, and 4. On exam, her BMI is 32, up from 28 three
years ago, and her other vital signs are stable. On breast exam, you note a mobile
rubbery mass approximately 1 x 1cm that has regular borders and is tender to
palpation. You appreciate no axillary adenopathy. The rest of her physical exam is
unremarkable. Of the information provided, which of the following puts this patient
at increased risk for breast cancer?
A. Age
B. Age of menarche
C. Family history of cancer
D. Parity history
E. Weight: The answer is E. From FM 01.
2. A 64-year-old cisgendered female who is overweight with well-controlled
hypertension comes to your office with concerns of a lump in her breast that she
noticed while showering. She reports having no pain, tenderness, or skin changes. A
pertinent review of systems is negative. Menarche began at the age of 10. Her first
child was born when she was 31 and she had her second and last child at the age of
33. She experienced menopause at the age of 44. Her mother died of colon cancer
when she was 65 and her father passed away from metastatic prostate cancer at the
age of 70. She has no history of tobacco use ever and occasionally drinks a glass of
wine with dinner. Her BMI is 34. Which of the information provided thus far puts
the patient at decreased risk for breast cancer?
A. Age
B. Age at first birth
C. Age at menarche
D. Age at menopause
E. Weight: The answer is D. From FM 01.
, Aquifer FM End of Case Questions
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3. A 63-year old cisgendered female comes into your office for her annual preventive
exam. She has hypertension and type 2 diabetes. She is not sexually active. Her
blood pressure is 125/80 and her physical exam otherwise is within normal limits.
You recommend influenza and zoster vaccination. Her last colonoscopy was eight
years ago and her last mammogram one year ago; both were normal. She has never
had an abnormal Pap test. At the age of 45 she had a total hysterectomy for fibroids.
Of the details provided about this patient, which is an appropriate reason to explain
why she does not need a Pap test today?
A. She experienced menopause more than 10 years ago
B. She had a total hysterectomy for fibroids
C. She has never had an abnormal Pap test
D. She is 63 years old
E. She is not sexually active: The answer is B. From FM 01.
4. A 47-year-old cisgendered female comes into your office for a health care
maintenance exam. She has hypertension and type 2 diabetes. She is not sexually
active and has not yet experienced menopause. There is no family history of cancer.
Her blood pressure is 118/78, her BMI is 34, and the remainder of her physical exam
is within normal limits. Her vaccinations are up to date, and she has a Pap test today
and will have labs drawn. According to USPSTF, which of the following is the best
recommendation to give her concerning mammography?
A. Should have started at age 40 and every year thereafter
B. Should have started at age 40 and every two years thereafter
C. Should have started at age 45 and every year thereafter
D. Start at age 50 and every year thereafter
E. Start at age 50 and every two years thereafter: The answer is E. From FM 01.
5. A 25-year-old patient presents to the office for follow-up on anxiety and tobacco
dependence. She reports she is doing well on her new medication to help with both
her mood and smoking, though she continues to smoke. She recently started her
first sexual relationship with a new female partner. She received a tetanus vaccine at
the age of 18, and she received her flu vaccine this year. Her blood pressure is
122/70, and her physical exam is within normal limits. You review her recent Pap
test, which was negative. Which of the following indicates the vaccines she should
receive today?
Choose the single best answer.
A. HPV vaccine alone
, Aquifer FM End of Case Questions
Study online at https://quizlet.com/_8mzrh9
B. HPV vaccine and pneumococcal conjugate vaccine (PCV13)
C. HPV vaccine and pneumococcal polysaccharide vaccine (PPSV23)
D. HPV vaccine and Zoster vaccine
E. No vaccines are needed: The answer is C. From FM 01.
6. A 55-year-old male with no significant past medical history presents for a routine
physical exam. He last saw a doctor five years ago. Social history is remarkable for a
35-pack-year tobacco history since the age of 20. He indicates that his wife and
children have urged him to quit smoking for the last few months. When you ask him
if he has considered quitting, he replies, "I just don't see what the big deal is!"
Which stage of change best describes this patient at this time? A. Action
B. Contemplation
C. Maintenance
D. Precontemplation
E. Preparation: The answer is D. From FM 02.
7. A 48-year-old male with a past medical history that includes hypertension,
chronic obstructive pulmonary disease (COPD), and hyperlipidemia presents to
clinic as a new patient in October for a general physical exam. History reveals that
he has been smoking a pack of cigarettes daily since age 20. He drinks two beers
daily. He is intermittently nonadherent with his medications. Review of the state
immunization database reveals that the only immunization he has received as an
adult was a tetanus diphtheria shot administered 12 years ago. Which of the
following vaccine combinations would be most appropriate for this patient?
A. Influenza, meningococcal, and zoster
B. Influenza, pneumococcal, and Tdap
C. Influenza, zoster, and Tdap
D. Meningococcal, pneumococcal, and Tdap
Meningococcal, pneumococcal, and zoster: The answer is B. From FM 02.
8. A 55-year-old male comes to the clinic for a visit. He has read about the dangers
of being overweight and inquires about which category he fits into. He is 5' 10'' (1.78
m) and weighs 220 lbs (100 kg), BMI = 31.6. Which of the following categories most
accurately describes the patient based on his BMI?
A. Ideal
B. Morbidly (very severely) obese
C. Obese
, Aquifer FM End of Case Questions
Study online at https://quizlet.com/_8mzrh9
D. Overweight
E. Underweight: The answer is C. From FM 02.
9. A 55-year-old male with a family history of melanoma presents to the clinic for
evaluation of a skin lesion on his back which appeared three months ago. His wife
first alerted him to it, hasn't noticed it change and he has not noticed any symptoms
associated with it. Physical examination reveals a 7 mm uniformly black macule that
is symmetrically round with sharply demarcated borders on his upper back near the
right shoulder. Which of the following characteristics would most justify it being
biopsied today?
A. Borders
B. Color
C. Diameter
D. Location
E. Symmetry: The answer is C. From FM 02.
10. A 55-year-old male with no significant past medical history and generally
healthy behaviors presents to clinic for a health care maintenance exam. He says,
"I'd like to get tested for all types of cancer." He does not have any family history of
cancer. Review of systems is negative for any symptoms of prostate cancer, such as
urinary frequency, urgency, retention, hematuria, weight loss, or back pain. He is a
lifelong non-smoker, and he doesn't drink alcohol or use recreational drugs. Which
of the following screening tests is given either a USPSTF A or B recommendation in
favor of its routine use for patients such as this one?
A. Colon cancer screening
B. ECG screening for coronary artery disease
C. Lung cancer screening
D. Pancreatic cancer screening
E. Prostate specific antigen (PSA) testing: The answer is A. From FM 02.
11. A 65-year-old truck driver presents to your office complaining of right calf pain
and swelling. He has recently returned from a four-day cross-country trip after
which he had onset of his current symptoms. The patient reports that the week prior
to his four-day trip, he was mostly in bed recovering from a bout of the flu. His
PMH is significant for DM type 2 and COPD. He has a 25-pack-year smoking
history. He denies having any chest pain or SOB. His physical exam shows 2+ pitting
edema of his right leg. When measuring the circumference of his right leg, you note
that it is 34 cm compared to the left, which has a circumference of 30 cm. What is
the most appropriate next step in diagnosis?
