AAFP Board Exam Review questions
with verified answers graded A+
updated
PC
BRAVELRADON
,AAFP Board Exam Review questions
with verified answers graded A+ updated
What screening test has most potential for overdo? - correct answer ✔✔PSA- Overdiagnosis is
the diagnosis of a disease that will not produce symptoms during a
patient's lifetime. It tends to occur with cancers that have very slow rates of growth.
Prostate cancer is most often a slow-growing cancer and is often present without
symptoms in older men. The introduction of prostate-specific antigen (PSA) screening was
accompanied by a marked rise in the rate of diagnosis of prostate cancer while mortality
decreased much less significantly, and this decrease was probably largely attributable to
improved treatment.
What is the treatment for mallet fracture? - correct answer ✔✔The recommended treatment
for a mallet fracture is splinting the distal interphalangeal (DIP) joint in
extension (SOR B). The usual duration of splinting is 8 weeks. It is important that extension be
maintained
throughout the duration of treatment because flexion can affect healing and prolong the time
needed for
treatment. If the finger fracture involves >30% of the intra-articular surface, referral to a hand or
orthopedic surgeon can be considered. However, conservative therapy appears to have
outcomes similar
to those of surgical treatment and therefore is generally preferred.
If subluxed radial head is suspected in a child, is imaging needed? - correct answer ✔✔As long
as there are no outward signs of fracture or abuse it is considered safe and appropriate to
attempt reduction of the radial head before moving on to imaging studies. With the child's
elbow in 90° of flexion, the hand is fully supinated by the examiner and the elbow is then
brought into full flexion. Usually the child will begin to use the affected arm again within a
,couple of minutes. If ecchymosis, significant swelling, or pain away from the joint is present, or
if symptoms do not improve after attempts at reduction, then a plain radiograph is
recommended.
A 17-year-old female sees you for a preparticipation evaluation. She has run 5 miles a day for
the last 6 months, and has lost 6 lb over the past 2 months. Her last menstrual period was 3
months ago. Other than the fact that she appears to be slightly underweight, her examination is
normal.
To fit the criteria for the female athlete triad, she must have which one of the following? -
correct answer ✔✔The initial definition of the female athlete triad was amenorrhea,
osteoporosis, and disordered eating. The American College of Sports Medicine modified this in
2007, emphasizing that the triad components occur on a continuum rather than as individual
pathologic conditions. The definitions have therefore expanded. Disordered eating is no longer
defined as the formal diagnosis of an eating disorder. Energy availability,defined as dietary
energy intake minus exercise energy expenditures, is now considered a risk factor for the triad,
as dietary restrictions and substantial energy expenditures disrupt pituitary and ovarian
function.
Athletes who have amenorrhea for 6 months, disordered eating, and/or a history of a stress
fracture resulting from minimal trauma should have a bone density test. Low bone mineral
density for age is the term used to describe at-risk female athletes with a Z-score of -1 to -2.
Osteoporosis is defined as having clinical risk factors for experiencing a fracture, along with a Z-
score <-2.
what is the work up for secondary amenorrhea? - correct answer ✔✔This patient suffers from
secondary amenorrhea (defined as the cessation of regular menses for 3 months or irregular
menses for 6 months). The most common causes of secondary amenorrhea are polycystic ovary
syndrome, primary ovarian failure, hypothalamic amenorrhea, and hyperprolactinemia. With a
normal physical examination, negative pregnancy test, and no history of chronic disease, a
hormonal
workup is indicated, including TSH, LH, and FSH levels (SOR C).
, A hormonal challenge with medroxyprogesterone to provoke withdrawal bleeding is used to
assess
functional anatomy and estrogen levels (SOR C). However, it has poor specificity and sensitivity
for
ovarian function and a poor correlation with estrogen levels.
Pelvic ultrasonography is indicated in the workup of primary amenorrhea to confirm the
presence of a uterus and detect structural abnormalities of the reproductive organs. Likewise,
karyotyping can be used for patients with primary amenorrhea, as conditions such as Turner's
syndrome and androgen insensitivity syndrome are due to chromosomal abnormalities.
A CBC and metabolic panel would not be initial considerations in the workup of amenorrhea
unless the patient has a known chronic disease which may affect the results.
What's the first line treatment for primary dysmenorrhea? - correct answer ✔✔The first-line
treatment for primary dysmenorrhea should be NSAIDs (SOR A). They should be started
at the onset of menses and continued for the first 1-2 days of the menstrual cycle.
Combined oral contraceptives may be effective for primary dysmenorrhea, but there is a lack of
high-quality randomized, controlled trials demonstrating pain improvement (SOR B). They may
be a good choice if the patient also desires contraception. Although combined oral
contraceptives and intramuscular and subcutaneous progestin-only contraceptives are effective
treatments for dysmenorrhea caused by endometriosis, they are NOT first-line therapy for
primary dysmenorrhea.
A 24-year-old female presents with pelvic pain. She says that the pain is present on most days,
but is worse during her menses. Ibuprofen has helped in the past but is no longer effective. Her
menses are normal and she has only one sexual partner. A physical examination is normal.
Which one of the following should be the next step in the workup of this patient? - correct
answer ✔✔The initial evaluation for chronic pelvic pain should include a urinalysis and culture,
with verified answers graded A+
updated
PC
BRAVELRADON
,AAFP Board Exam Review questions
with verified answers graded A+ updated
What screening test has most potential for overdo? - correct answer ✔✔PSA- Overdiagnosis is
the diagnosis of a disease that will not produce symptoms during a
patient's lifetime. It tends to occur with cancers that have very slow rates of growth.
Prostate cancer is most often a slow-growing cancer and is often present without
symptoms in older men. The introduction of prostate-specific antigen (PSA) screening was
accompanied by a marked rise in the rate of diagnosis of prostate cancer while mortality
decreased much less significantly, and this decrease was probably largely attributable to
improved treatment.
What is the treatment for mallet fracture? - correct answer ✔✔The recommended treatment
for a mallet fracture is splinting the distal interphalangeal (DIP) joint in
extension (SOR B). The usual duration of splinting is 8 weeks. It is important that extension be
maintained
throughout the duration of treatment because flexion can affect healing and prolong the time
needed for
treatment. If the finger fracture involves >30% of the intra-articular surface, referral to a hand or
orthopedic surgeon can be considered. However, conservative therapy appears to have
outcomes similar
to those of surgical treatment and therefore is generally preferred.
If subluxed radial head is suspected in a child, is imaging needed? - correct answer ✔✔As long
as there are no outward signs of fracture or abuse it is considered safe and appropriate to
attempt reduction of the radial head before moving on to imaging studies. With the child's
elbow in 90° of flexion, the hand is fully supinated by the examiner and the elbow is then
brought into full flexion. Usually the child will begin to use the affected arm again within a
,couple of minutes. If ecchymosis, significant swelling, or pain away from the joint is present, or
if symptoms do not improve after attempts at reduction, then a plain radiograph is
recommended.
A 17-year-old female sees you for a preparticipation evaluation. She has run 5 miles a day for
the last 6 months, and has lost 6 lb over the past 2 months. Her last menstrual period was 3
months ago. Other than the fact that she appears to be slightly underweight, her examination is
normal.
To fit the criteria for the female athlete triad, she must have which one of the following? -
correct answer ✔✔The initial definition of the female athlete triad was amenorrhea,
osteoporosis, and disordered eating. The American College of Sports Medicine modified this in
2007, emphasizing that the triad components occur on a continuum rather than as individual
pathologic conditions. The definitions have therefore expanded. Disordered eating is no longer
defined as the formal diagnosis of an eating disorder. Energy availability,defined as dietary
energy intake minus exercise energy expenditures, is now considered a risk factor for the triad,
as dietary restrictions and substantial energy expenditures disrupt pituitary and ovarian
function.
Athletes who have amenorrhea for 6 months, disordered eating, and/or a history of a stress
fracture resulting from minimal trauma should have a bone density test. Low bone mineral
density for age is the term used to describe at-risk female athletes with a Z-score of -1 to -2.
Osteoporosis is defined as having clinical risk factors for experiencing a fracture, along with a Z-
score <-2.
what is the work up for secondary amenorrhea? - correct answer ✔✔This patient suffers from
secondary amenorrhea (defined as the cessation of regular menses for 3 months or irregular
menses for 6 months). The most common causes of secondary amenorrhea are polycystic ovary
syndrome, primary ovarian failure, hypothalamic amenorrhea, and hyperprolactinemia. With a
normal physical examination, negative pregnancy test, and no history of chronic disease, a
hormonal
workup is indicated, including TSH, LH, and FSH levels (SOR C).
, A hormonal challenge with medroxyprogesterone to provoke withdrawal bleeding is used to
assess
functional anatomy and estrogen levels (SOR C). However, it has poor specificity and sensitivity
for
ovarian function and a poor correlation with estrogen levels.
Pelvic ultrasonography is indicated in the workup of primary amenorrhea to confirm the
presence of a uterus and detect structural abnormalities of the reproductive organs. Likewise,
karyotyping can be used for patients with primary amenorrhea, as conditions such as Turner's
syndrome and androgen insensitivity syndrome are due to chromosomal abnormalities.
A CBC and metabolic panel would not be initial considerations in the workup of amenorrhea
unless the patient has a known chronic disease which may affect the results.
What's the first line treatment for primary dysmenorrhea? - correct answer ✔✔The first-line
treatment for primary dysmenorrhea should be NSAIDs (SOR A). They should be started
at the onset of menses and continued for the first 1-2 days of the menstrual cycle.
Combined oral contraceptives may be effective for primary dysmenorrhea, but there is a lack of
high-quality randomized, controlled trials demonstrating pain improvement (SOR B). They may
be a good choice if the patient also desires contraception. Although combined oral
contraceptives and intramuscular and subcutaneous progestin-only contraceptives are effective
treatments for dysmenorrhea caused by endometriosis, they are NOT first-line therapy for
primary dysmenorrhea.
A 24-year-old female presents with pelvic pain. She says that the pain is present on most days,
but is worse during her menses. Ibuprofen has helped in the past but is no longer effective. Her
menses are normal and she has only one sexual partner. A physical examination is normal.
Which one of the following should be the next step in the workup of this patient? - correct
answer ✔✔The initial evaluation for chronic pelvic pain should include a urinalysis and culture,
