Fitzgerald Practice Exam Questions And
100% Correct Answers Rated A+
2025\2026.
During a well child evaluation of a 13-year-old girl, you note the presence of breast buds and
sparse growth of long, straight pigmented hair along the labia. Since her last visit one year ago,
you find that she has grown 3 inches (7.7 cm), gained 6 lbs (2.7 kg), and is within the 50th
percentile for height and weight. The mother asks if these findings are normal for her age. You
respond:
This is normal as onset of puberty typically occurs between ages 8 and 13 for girls.
A referral to endocrinology is likely warranted.
A bone age determination is recommended.
A follow-up visit in 6 months is needed to note any additional changes. - Answer **This is
normal as onset of puberty typically occurs between ages 8 and 13 for girls.
The presence of breast buds and sparse pubic hair signifies Tanner Stage 2 development, which
is normal for a 13-year-old girl. During pre-adolescence (6-10 years of age), children gain
approximately 2-3 kg (5-7 lbs) and 5-8 cm (2-3 inches) per year. Growth spurt in girls typically
begins around 9-10 years of age, with maximum growth at 12 years of age.
You see a 17-year-old female with suspected bacterial pharyngitis caused by group A beta-
hemolytic streptococci. Anticipated findings would include all of the following except:
QID:3740186
Mark For Review
Palatial petechiae.
"Strawberry tongue."
Exudative pharyngitis.
Anterior cervical lymphadenopathy. - Answer "Strawberry tongue."
Physical examination of the patient with acute pharyngitis by S. pyogenes will typically find
exudative pharyngitis (C), palatial petechiae (A), and anterior cervical lymphadenopathy (D).
A 37-year-old man presents with a many-month history of well-demarcated plaques with silvery
,Testing for presence of rheumatoid factor and checking ESR.
A tissue biopsy is needed.
Referral. - Answer This is largely a clinical diagnosis.
A diagnosis of psoriasis vulgaris can be made with a review of patient history, patient risk factors
including family history, and physical examination (A). Additional testing can be considered to
differentiate the condition from another possible cause but is not usually required.
A 27-year-old male presents with a 2-day history of purulent nasal discharge and a 4-day history
of upper respiratory tract infection symptoms but is without fever. He asks for an antimicrobial
to treat his "sinus infection." He is otherwise healthy, has not received antimicrobial therapy in
the past 3 months, and has no drug allergies. You consider:
QID:3740188
Mark For Review
Oral amoxicillin 1000 mg BID for 7 days.
Oral amoxicillin-clavulanate 875/125 mg BID for 5 days.
Oral azithromycin 500 mg QD for 5 days.
Antimicrobial therapy is not warranted. - Answer Antimicrobial therapy is not warranted.
Given that this is likely a viral infection, antimicrobial therapy is not warranted (A, B, C). If the
illness progresses to suggest a bacterial infection (e.g., "double sickening," where URI-like
symptoms initially improve then worsen, or illness persisting beyond 7?10 days), then an
antimicrobial can be considered.
Appropriate treatment for an otherwise well 15-year-old with presumed bacterial community-
acquired pneumonia who has not received any recent antimicrobial therapy and has no known
drug allergies is:
Oral amoxicillin 90 mg/kg/day for 5 days.
Oral amoxicillin-clavulanate 90/6.4 mg/kg/day for 14 days.
Oral clarithromycin 15 mg/kg/day for 10 days.
Oral levofloxacin 750 mg for 5 days. - Answer Oral amoxicillin 90 mg/kg/day for 5 days.
Though viral pathogens also often implicated, the primary treatment target for presumed
bacterial community-acquired pneumonia in children is Streptococcus pneumoniae. PIDS/IDSA
guidelines recommend amoxicillin as a first-line agent (A). Cephalosporins can be considered in
,antimicrobials in the past 6 months, and has no history of drug allergies. Appropriate therapy
can include:
Amoxicillin/clavulanate 875 mg/125 mg PO BID for 10 days.
Amoxicillin 1000 mg PO TID for 5 days.
Trimethoprim-sulfamethoxazole 80 mg/400 mg PO BID for 14 days.
Levofloxacin 750 mg PO QD for 5 days. - Answer Amoxicillin 1000 mg PO TID for 5 days.
For patients with risk factors for drug-resistant infections, high-dose amoxicillin-clavulanate or
certain cephalosporins are appropriate (A). Fluoroquinolones are not recommended as first-line
therapy (D) and TMP-SMX is not recommended for treatment of AOM (C).
Which of the following is indicative of subclinical hypothyroidism?
Total T4=43 mcg/dL (4.5-12.0 mcg/dL); free T3=6.5 pmol/L (3.5-7.7 pmol/L)
Total T4=1.3 mcg/dL (4.5-12.0 mcg/dL); free T3=42 pmol/L (3.5-7.7 pmol/L)
TSH <0.2 mIU/L (0.4-4.0 mIU/L); free T4=64 pmol/L (10-27 pmol/L)
TSH=18 mIU/L (0.4-4.0 mIU/L); free T4=13.2 pmol/L (10-27 pmol/L) - Answer TSH=18 mIU/L
(0.4-4.0 mIU/L); free T4=13.2 pmol/L (10-27 pmol/L)
TSH levels below normal is an indication of hyperthyroidism (C). Total T4 is rarely an indicated
test for thyroid conditions as the level can be increased or decreased in the absence of thyroid
disease (A, B). Free T3 is also a rarely indicated test for thyroid disorders.
Anticipated findings in a 25-year-old man with epididymo-orchitis would include all of the
following except:
Irritative voiding symptoms.
Fever.
Blood-tinged penile discharge.
Painful scrotal swelling. - Answer Blood-tinged penile discharge.
Clinical presentation typically includes irritative voiding symptoms (A), fever (B), and painful
swelling of epididymis and the scrotum (D).
, Advanced age (>80 years).
Impaired renal function.
Obesity.
Hypovolemia. - Answer Obesity
Risk factors include impaired renal function (B), hypovolemia (D), low perfusion state, and/or
advanced age (>80 years) (A).
Common signs of depression in a 16-year-old girl can include all of the following except:
Irritable mood.
Physical complaints, such as stomach aches.
Poor school performance.
Seeking out a new group of friends. - Answer Seeking out a new group of friends.
A 22-year-old presents after being bitten by a brown recluse spider on the foot two days earlier.
Examination reveals a single lesion surrounded by an erythematous halo with edema in the
surrounding tissue. Treatment can include all of the following except:
Local debridement.
Elevation and immobilization.
Oral trimethoprim-sulfamethoxazole for 7 days.
Cool compresses to the affected area. - Answer Oral trimethoprim-sulfamethoxazole for 7
days.
General wound management can include local debridement (A), elevation, and loose
immobilization of the affected area (B). Cool compresses should be used until progression of the
necrotic process has stopped (D).
Which of the following is the strongest indicator for a diagnosis of asthma?
Recurrent cough and shortness of breath
Increase in FEV1 by at least 12% post-short-acting beta2-agonist
100% Correct Answers Rated A+
2025\2026.
During a well child evaluation of a 13-year-old girl, you note the presence of breast buds and
sparse growth of long, straight pigmented hair along the labia. Since her last visit one year ago,
you find that she has grown 3 inches (7.7 cm), gained 6 lbs (2.7 kg), and is within the 50th
percentile for height and weight. The mother asks if these findings are normal for her age. You
respond:
This is normal as onset of puberty typically occurs between ages 8 and 13 for girls.
A referral to endocrinology is likely warranted.
A bone age determination is recommended.
A follow-up visit in 6 months is needed to note any additional changes. - Answer **This is
normal as onset of puberty typically occurs between ages 8 and 13 for girls.
The presence of breast buds and sparse pubic hair signifies Tanner Stage 2 development, which
is normal for a 13-year-old girl. During pre-adolescence (6-10 years of age), children gain
approximately 2-3 kg (5-7 lbs) and 5-8 cm (2-3 inches) per year. Growth spurt in girls typically
begins around 9-10 years of age, with maximum growth at 12 years of age.
You see a 17-year-old female with suspected bacterial pharyngitis caused by group A beta-
hemolytic streptococci. Anticipated findings would include all of the following except:
QID:3740186
Mark For Review
Palatial petechiae.
"Strawberry tongue."
Exudative pharyngitis.
Anterior cervical lymphadenopathy. - Answer "Strawberry tongue."
Physical examination of the patient with acute pharyngitis by S. pyogenes will typically find
exudative pharyngitis (C), palatial petechiae (A), and anterior cervical lymphadenopathy (D).
A 37-year-old man presents with a many-month history of well-demarcated plaques with silvery
,Testing for presence of rheumatoid factor and checking ESR.
A tissue biopsy is needed.
Referral. - Answer This is largely a clinical diagnosis.
A diagnosis of psoriasis vulgaris can be made with a review of patient history, patient risk factors
including family history, and physical examination (A). Additional testing can be considered to
differentiate the condition from another possible cause but is not usually required.
A 27-year-old male presents with a 2-day history of purulent nasal discharge and a 4-day history
of upper respiratory tract infection symptoms but is without fever. He asks for an antimicrobial
to treat his "sinus infection." He is otherwise healthy, has not received antimicrobial therapy in
the past 3 months, and has no drug allergies. You consider:
QID:3740188
Mark For Review
Oral amoxicillin 1000 mg BID for 7 days.
Oral amoxicillin-clavulanate 875/125 mg BID for 5 days.
Oral azithromycin 500 mg QD for 5 days.
Antimicrobial therapy is not warranted. - Answer Antimicrobial therapy is not warranted.
Given that this is likely a viral infection, antimicrobial therapy is not warranted (A, B, C). If the
illness progresses to suggest a bacterial infection (e.g., "double sickening," where URI-like
symptoms initially improve then worsen, or illness persisting beyond 7?10 days), then an
antimicrobial can be considered.
Appropriate treatment for an otherwise well 15-year-old with presumed bacterial community-
acquired pneumonia who has not received any recent antimicrobial therapy and has no known
drug allergies is:
Oral amoxicillin 90 mg/kg/day for 5 days.
Oral amoxicillin-clavulanate 90/6.4 mg/kg/day for 14 days.
Oral clarithromycin 15 mg/kg/day for 10 days.
Oral levofloxacin 750 mg for 5 days. - Answer Oral amoxicillin 90 mg/kg/day for 5 days.
Though viral pathogens also often implicated, the primary treatment target for presumed
bacterial community-acquired pneumonia in children is Streptococcus pneumoniae. PIDS/IDSA
guidelines recommend amoxicillin as a first-line agent (A). Cephalosporins can be considered in
,antimicrobials in the past 6 months, and has no history of drug allergies. Appropriate therapy
can include:
Amoxicillin/clavulanate 875 mg/125 mg PO BID for 10 days.
Amoxicillin 1000 mg PO TID for 5 days.
Trimethoprim-sulfamethoxazole 80 mg/400 mg PO BID for 14 days.
Levofloxacin 750 mg PO QD for 5 days. - Answer Amoxicillin 1000 mg PO TID for 5 days.
For patients with risk factors for drug-resistant infections, high-dose amoxicillin-clavulanate or
certain cephalosporins are appropriate (A). Fluoroquinolones are not recommended as first-line
therapy (D) and TMP-SMX is not recommended for treatment of AOM (C).
Which of the following is indicative of subclinical hypothyroidism?
Total T4=43 mcg/dL (4.5-12.0 mcg/dL); free T3=6.5 pmol/L (3.5-7.7 pmol/L)
Total T4=1.3 mcg/dL (4.5-12.0 mcg/dL); free T3=42 pmol/L (3.5-7.7 pmol/L)
TSH <0.2 mIU/L (0.4-4.0 mIU/L); free T4=64 pmol/L (10-27 pmol/L)
TSH=18 mIU/L (0.4-4.0 mIU/L); free T4=13.2 pmol/L (10-27 pmol/L) - Answer TSH=18 mIU/L
(0.4-4.0 mIU/L); free T4=13.2 pmol/L (10-27 pmol/L)
TSH levels below normal is an indication of hyperthyroidism (C). Total T4 is rarely an indicated
test for thyroid conditions as the level can be increased or decreased in the absence of thyroid
disease (A, B). Free T3 is also a rarely indicated test for thyroid disorders.
Anticipated findings in a 25-year-old man with epididymo-orchitis would include all of the
following except:
Irritative voiding symptoms.
Fever.
Blood-tinged penile discharge.
Painful scrotal swelling. - Answer Blood-tinged penile discharge.
Clinical presentation typically includes irritative voiding symptoms (A), fever (B), and painful
swelling of epididymis and the scrotum (D).
, Advanced age (>80 years).
Impaired renal function.
Obesity.
Hypovolemia. - Answer Obesity
Risk factors include impaired renal function (B), hypovolemia (D), low perfusion state, and/or
advanced age (>80 years) (A).
Common signs of depression in a 16-year-old girl can include all of the following except:
Irritable mood.
Physical complaints, such as stomach aches.
Poor school performance.
Seeking out a new group of friends. - Answer Seeking out a new group of friends.
A 22-year-old presents after being bitten by a brown recluse spider on the foot two days earlier.
Examination reveals a single lesion surrounded by an erythematous halo with edema in the
surrounding tissue. Treatment can include all of the following except:
Local debridement.
Elevation and immobilization.
Oral trimethoprim-sulfamethoxazole for 7 days.
Cool compresses to the affected area. - Answer Oral trimethoprim-sulfamethoxazole for 7
days.
General wound management can include local debridement (A), elevation, and loose
immobilization of the affected area (B). Cool compresses should be used until progression of the
necrotic process has stopped (D).
Which of the following is the strongest indicator for a diagnosis of asthma?
Recurrent cough and shortness of breath
Increase in FEV1 by at least 12% post-short-acting beta2-agonist
