FAMILY MEDICINE BOARD CERTIFICATION
EXAM| COMPREHENSIVE EXAM WITH
CORRECT VERIFIED ANSWERS
A 52-year-old man with hypertension presents for routine
follow-up. BP is 152/94 on two visits. No comorbidities. Best
next step?
A. Lifestyle modification only
B. Start ACE inhibitor
C. Start beta blocker
D. Repeat BP in 1 year
Correct Answer: B
Rationale: Stage 2 hypertension requires pharmacologic
therapy plus lifestyle changes.
2. First-line treatment for acute uncomplicated cystitis in a
nonpregnant woman:
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Ceftriaxone
,Correct Answer: B
Rationale: Nitrofurantoin is guideline-recommended first-
line therapy.
3. Screening recommendation for colorectal cancer in
average-risk adults:
A. Start age 40
B. Start age 45
C. Start age 50
D. Only if symptomatic
Correct Answer: B
Rationale: Screening begins at age 45 for average-risk
individuals.
4. A patient with diabetes has A1C 9.2% despite metformin.
Next step?
A. Stop metformin
B. Add second agent
C. Diet only
D. Insulin only
Correct Answer: B
,Rationale: Poor glycemic control requires combination
therapy.
5. Which vaccine is recommended annually for all adults?
A. Hepatitis B
B. Influenza
C. HPV
D. Pneumococcal
Correct Answer: B
Rationale: Annual influenza vaccination is universal
recommendation.
6. Most common cause of hypothyroidism in adults:
A. Iodine deficiency
B. Hashimoto thyroiditis
C. Thyroid cancer
D. Pituitary disease
Correct Answer: B
Rationale: Autoimmune thyroid destruction is most common
in developed settings.
, 7. First-line therapy for GERD without alarm symptoms:
A. Endoscopy
B. PPI trial
C. H2 blocker only
D. Surgery
Correct Answer: B
Rationale: Empiric proton pump inhibitor therapy is
standard initial approach.
8. Which condition requires urgent referral in back pain?
A. Pain after lifting
B. Radiculopathy
C. Saddle anesthesia
D. Muscle spasm
Correct Answer: C
Rationale: Saddle anesthesia suggests cauda equina
syndrome.
9. First-line treatment for mild persistent asthma:
EXAM| COMPREHENSIVE EXAM WITH
CORRECT VERIFIED ANSWERS
A 52-year-old man with hypertension presents for routine
follow-up. BP is 152/94 on two visits. No comorbidities. Best
next step?
A. Lifestyle modification only
B. Start ACE inhibitor
C. Start beta blocker
D. Repeat BP in 1 year
Correct Answer: B
Rationale: Stage 2 hypertension requires pharmacologic
therapy plus lifestyle changes.
2. First-line treatment for acute uncomplicated cystitis in a
nonpregnant woman:
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Ceftriaxone
,Correct Answer: B
Rationale: Nitrofurantoin is guideline-recommended first-
line therapy.
3. Screening recommendation for colorectal cancer in
average-risk adults:
A. Start age 40
B. Start age 45
C. Start age 50
D. Only if symptomatic
Correct Answer: B
Rationale: Screening begins at age 45 for average-risk
individuals.
4. A patient with diabetes has A1C 9.2% despite metformin.
Next step?
A. Stop metformin
B. Add second agent
C. Diet only
D. Insulin only
Correct Answer: B
,Rationale: Poor glycemic control requires combination
therapy.
5. Which vaccine is recommended annually for all adults?
A. Hepatitis B
B. Influenza
C. HPV
D. Pneumococcal
Correct Answer: B
Rationale: Annual influenza vaccination is universal
recommendation.
6. Most common cause of hypothyroidism in adults:
A. Iodine deficiency
B. Hashimoto thyroiditis
C. Thyroid cancer
D. Pituitary disease
Correct Answer: B
Rationale: Autoimmune thyroid destruction is most common
in developed settings.
, 7. First-line therapy for GERD without alarm symptoms:
A. Endoscopy
B. PPI trial
C. H2 blocker only
D. Surgery
Correct Answer: B
Rationale: Empiric proton pump inhibitor therapy is
standard initial approach.
8. Which condition requires urgent referral in back pain?
A. Pain after lifting
B. Radiculopathy
C. Saddle anesthesia
D. Muscle spasm
Correct Answer: C
Rationale: Saddle anesthesia suggests cauda equina
syndrome.
9. First-line treatment for mild persistent asthma:
