AAFP BOARD EXAM NEWEST 2026 ACTUAL EXAM
TEST BANK| AAFP BOARD REVIEW WITH COMPLETE
950 REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) GRADED A+
1. A 54-year-old male with cervical disc disease, generalized
anxiety disorder, and opioid use disorder on maintenance
therapy presents with a 5-day history of pain and numbness in
both hands and feet. He reports increased urinary frequency and
feeling less steady on his feet. Neurologic examination shows
wide-based gait, decreased sensation in upper extremities to
forearms and lower extremities to calves, brisk Achilles reflexes
with clonus, and normal strength. What is the most likely
diagnosis?
A) Cervical myelopathy
B) Epidural abscess
1
,C) Guillain-Barré syndrome
D) Multiple sclerosis
Answer: A
Rationale: The findings suggest cord compression. Cervical
myelopathy presents with loss of sensation in all four extremities,
hyperreflexia, gait instability, and can lead to bladder/bowel
dysfunction. Epidural abscess typically presents with localized
tenderness and fever. Guillain-Barré presents with ascending
numbness and weakness with associated loss of reflexes, not
hyperreflexia .
2. An otherwise healthy 70-year-old male presents with a 6-
month history of hives recurring every week. No causative factor
identified on history and physical. What is the recommended
first-line treatment?
A) First-generation H1-antihistamine
2
,B) Second-generation H1-antihistamine
C) H2-antihistamine
D) Omalizumab
E) Prednisone
Answer: B
Rationale: For chronic urticaria of unknown cause, first-line
treatment is a second-generation H1-antihistamine (e.g.,
loratadine, cetirizine), which can be increased up to four times
the approved dosage. If not controlled, add H2-antihistamines or
antileukotrienes. Systemic corticosteroids should be avoided long-
term. First-generation antihistamines cause sedation, especially in
the elderly .
3. A 23-year-old G1P0 at 38 weeks gestation presents with
severe headaches and epigastric pain. BP is 140/100 mm Hg.
Urinalysis shows 2+ protein, 5 lb weight gain in last week, and
3
, 2+ pitting edema. What is the most appropriate management?
A) Strict bed rest at home with reexamination in 48 hours
B) Admission for bed rest and monitoring of BP, weight, and
proteinuria
C) Admission and begin hydralazine to maintain BP below 140
D) Admission, parenteral magnesium sulfate, and prompt
delivery
Answer: D
Rationale: This patient has severe preeclampsia at term,
indicated by epigastric pain and headache. These symptoms
suggest the process is advanced with convulsions imminent.
Treatment requires rapid control of symptoms and delivery of
the infant. Magnesium sulfate prevents seizures, and delivery is
the definitive treatment .
4
TEST BANK| AAFP BOARD REVIEW WITH COMPLETE
950 REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) GRADED A+
1. A 54-year-old male with cervical disc disease, generalized
anxiety disorder, and opioid use disorder on maintenance
therapy presents with a 5-day history of pain and numbness in
both hands and feet. He reports increased urinary frequency and
feeling less steady on his feet. Neurologic examination shows
wide-based gait, decreased sensation in upper extremities to
forearms and lower extremities to calves, brisk Achilles reflexes
with clonus, and normal strength. What is the most likely
diagnosis?
A) Cervical myelopathy
B) Epidural abscess
1
,C) Guillain-Barré syndrome
D) Multiple sclerosis
Answer: A
Rationale: The findings suggest cord compression. Cervical
myelopathy presents with loss of sensation in all four extremities,
hyperreflexia, gait instability, and can lead to bladder/bowel
dysfunction. Epidural abscess typically presents with localized
tenderness and fever. Guillain-Barré presents with ascending
numbness and weakness with associated loss of reflexes, not
hyperreflexia .
2. An otherwise healthy 70-year-old male presents with a 6-
month history of hives recurring every week. No causative factor
identified on history and physical. What is the recommended
first-line treatment?
A) First-generation H1-antihistamine
2
,B) Second-generation H1-antihistamine
C) H2-antihistamine
D) Omalizumab
E) Prednisone
Answer: B
Rationale: For chronic urticaria of unknown cause, first-line
treatment is a second-generation H1-antihistamine (e.g.,
loratadine, cetirizine), which can be increased up to four times
the approved dosage. If not controlled, add H2-antihistamines or
antileukotrienes. Systemic corticosteroids should be avoided long-
term. First-generation antihistamines cause sedation, especially in
the elderly .
3. A 23-year-old G1P0 at 38 weeks gestation presents with
severe headaches and epigastric pain. BP is 140/100 mm Hg.
Urinalysis shows 2+ protein, 5 lb weight gain in last week, and
3
, 2+ pitting edema. What is the most appropriate management?
A) Strict bed rest at home with reexamination in 48 hours
B) Admission for bed rest and monitoring of BP, weight, and
proteinuria
C) Admission and begin hydralazine to maintain BP below 140
D) Admission, parenteral magnesium sulfate, and prompt
delivery
Answer: D
Rationale: This patient has severe preeclampsia at term,
indicated by epigastric pain and headache. These symptoms
suggest the process is advanced with convulsions imminent.
Treatment requires rapid control of symptoms and delivery of
the infant. Magnesium sulfate prevents seizures, and delivery is
the definitive treatment .
4
