FLORIDA BOARD OF MEDICINE FAMILY
MEDICINE CERTIFICATION EXAM WITH
ACTUAL QUESTIONS AND VERIFIED
ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
.
1. A 52-year-old man presents for an annual family medicine
examination. He has hypertension, obesity, and a 30-pack-year
smoking history. His blood pressure is 148/92 mm Hg on two
separate office visits. He has no diabetes, kidney disease,
cardiovascular disease, or secondary cause of hypertension. Which
of the following is the most appropriate next step?
A. Begin hydrochlorothiazide and schedule follow-up in 12 months
B. Confirm persistent hypertension and initiate appropriate lifestyle and
pharmacologic management based on overall cardiovascular risk
C. Obtain a renal artery angiogram before treatment
D. Start aspirin solely because he has hypertension
E. Reassure him because isolated office hypertension is always benign
Answer: B.
Rationale: Persistent hypertension should be confirmed and treated
according to the patient's blood-pressure level and overall
cardiovascular risk. Lifestyle interventions include weight reduction,
dietary sodium reduction, regular aerobic activity, moderation of
alcohol intake, and a heart-healthy diet. In a patient with confirmed
hypertension at this level, pharmacologic therapy is generally
appropriate in addition to lifestyle modification. Extensive testing for
1
,secondary hypertension is not routinely indicated without suggestive
clinical features. Aspirin should not be prescribed solely because
hypertension is present.
2. A 46-year-old woman has a fasting plasma glucose of 132 mg/dL
during routine screening. She feels well and has no symptoms of
hyperglycemia. Which of the following is the best approach?
A. Diagnose diabetes immediately based solely on this result
B. Repeat a diagnostic test to confirm diabetes in the absence of
unequivocal hyperglycemia
C. Diagnose type 1 diabetes
D. Start insulin immediately
E. Repeat the fasting glucose in 5 years
Answer: B.
Rationale: In an asymptomatic patient, a single abnormal diagnostic
test generally requires confirmation with repeat testing or another
accepted diagnostic test. A fasting plasma glucose ≥126 mg/dL is in the
diabetic range, but confirmation is appropriate when classic symptoms
or unequivocal hyperglycemia are absent. Possible confirmatory tests
include repeat fasting plasma glucose or HbA1c.
3. A 58-year-old man with newly diagnosed type 2 diabetes has an
HbA1c of 8.9%. He has no ketoacidosis, no significant weight loss,
and no contraindication to metformin. Which approach is most
appropriate?
A. Lifestyle modification alone for 2 years
B. Initiate glucose-lowering pharmacotherapy together with
comprehensive lifestyle modification
C. Immediately begin lifelong intravenous insulin
2
,D. Treat only if fasting glucose exceeds 300 mg/dL
E. Avoid discussing cardiovascular risk factors until glycemic control
improves
Answer: B.
Rationale: An HbA1c of 8.9% represents significant hyperglycemia
that generally warrants pharmacologic therapy in addition to lifestyle
intervention. Metformin remains a common initial therapy when
appropriate, although modern diabetes management also emphasizes
individualized selection of agents according to cardiovascular disease,
heart failure, kidney disease, obesity, hypoglycemia risk, cost, and
patient preferences. Comprehensive management includes blood
pressure, lipid control, smoking cessation, kidney assessment, and
appropriate preventive care.
4. A 67-year-old woman reports fatigue, constipation, cold
intolerance, dry skin, and gradual weight gain. Laboratory testing
shows elevated TSH and low free T4. Which diagnosis is most
likely?
A. Primary hypothyroidism
B. Secondary hypothyroidism
C. Hyperthyroidism
D. Euthyroid sick syndrome
E. Pheochromocytoma
Answer: A.
Rationale: Elevated TSH with low free T4 is characteristic of primary
hypothyroidism, usually caused by thyroid gland dysfunction. The
symptoms are also classic for hypothyroidism. Secondary or central
hypothyroidism typically produces a low or inappropriately normal
TSH in association with low free T4.
3
, 5. A 35-year-old woman presents with episodic palpitations,
diaphoresis, tremulousness, and unexplained weight loss. Her pulse
is 112/min, and examination reveals a fine tremor and hyperreflexia.
Which laboratory test is the best initial assessment for suspected
hyperthyroidism?
A. Serum TSH
B. Serum cortisol
C. Serum prolactin
D. Serum aldosterone
E. Serum parathyroid hormone
Answer: A.
Rationale: Serum TSH is generally the most sensitive initial screening
test for suspected primary hyperthyroidism. A suppressed TSH should
prompt measurement of free T4 and, when appropriate, T3 to
characterize the degree and type of thyrotoxicosis.
6. A 29-year-old woman presents with dysuria and urinary
frequency for 2 days. She has no fever, flank pain, vomiting, vaginal
discharge, or pregnancy. Examination is otherwise normal. Which
diagnosis is most likely?
A. Acute uncomplicated cystitis
B. Acute pyelonephritis
C. Pelvic inflammatory disease
D. Nephrolithiasis
E. Interstitial cystitis
Answer: A.
Rationale: Dysuria and urinary frequency in a reproductive-age
woman without vaginal symptoms or systemic illness strongly suggest
4
MEDICINE CERTIFICATION EXAM WITH
ACTUAL QUESTIONS AND VERIFIED
ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
.
1. A 52-year-old man presents for an annual family medicine
examination. He has hypertension, obesity, and a 30-pack-year
smoking history. His blood pressure is 148/92 mm Hg on two
separate office visits. He has no diabetes, kidney disease,
cardiovascular disease, or secondary cause of hypertension. Which
of the following is the most appropriate next step?
A. Begin hydrochlorothiazide and schedule follow-up in 12 months
B. Confirm persistent hypertension and initiate appropriate lifestyle and
pharmacologic management based on overall cardiovascular risk
C. Obtain a renal artery angiogram before treatment
D. Start aspirin solely because he has hypertension
E. Reassure him because isolated office hypertension is always benign
Answer: B.
Rationale: Persistent hypertension should be confirmed and treated
according to the patient's blood-pressure level and overall
cardiovascular risk. Lifestyle interventions include weight reduction,
dietary sodium reduction, regular aerobic activity, moderation of
alcohol intake, and a heart-healthy diet. In a patient with confirmed
hypertension at this level, pharmacologic therapy is generally
appropriate in addition to lifestyle modification. Extensive testing for
1
,secondary hypertension is not routinely indicated without suggestive
clinical features. Aspirin should not be prescribed solely because
hypertension is present.
2. A 46-year-old woman has a fasting plasma glucose of 132 mg/dL
during routine screening. She feels well and has no symptoms of
hyperglycemia. Which of the following is the best approach?
A. Diagnose diabetes immediately based solely on this result
B. Repeat a diagnostic test to confirm diabetes in the absence of
unequivocal hyperglycemia
C. Diagnose type 1 diabetes
D. Start insulin immediately
E. Repeat the fasting glucose in 5 years
Answer: B.
Rationale: In an asymptomatic patient, a single abnormal diagnostic
test generally requires confirmation with repeat testing or another
accepted diagnostic test. A fasting plasma glucose ≥126 mg/dL is in the
diabetic range, but confirmation is appropriate when classic symptoms
or unequivocal hyperglycemia are absent. Possible confirmatory tests
include repeat fasting plasma glucose or HbA1c.
3. A 58-year-old man with newly diagnosed type 2 diabetes has an
HbA1c of 8.9%. He has no ketoacidosis, no significant weight loss,
and no contraindication to metformin. Which approach is most
appropriate?
A. Lifestyle modification alone for 2 years
B. Initiate glucose-lowering pharmacotherapy together with
comprehensive lifestyle modification
C. Immediately begin lifelong intravenous insulin
2
,D. Treat only if fasting glucose exceeds 300 mg/dL
E. Avoid discussing cardiovascular risk factors until glycemic control
improves
Answer: B.
Rationale: An HbA1c of 8.9% represents significant hyperglycemia
that generally warrants pharmacologic therapy in addition to lifestyle
intervention. Metformin remains a common initial therapy when
appropriate, although modern diabetes management also emphasizes
individualized selection of agents according to cardiovascular disease,
heart failure, kidney disease, obesity, hypoglycemia risk, cost, and
patient preferences. Comprehensive management includes blood
pressure, lipid control, smoking cessation, kidney assessment, and
appropriate preventive care.
4. A 67-year-old woman reports fatigue, constipation, cold
intolerance, dry skin, and gradual weight gain. Laboratory testing
shows elevated TSH and low free T4. Which diagnosis is most
likely?
A. Primary hypothyroidism
B. Secondary hypothyroidism
C. Hyperthyroidism
D. Euthyroid sick syndrome
E. Pheochromocytoma
Answer: A.
Rationale: Elevated TSH with low free T4 is characteristic of primary
hypothyroidism, usually caused by thyroid gland dysfunction. The
symptoms are also classic for hypothyroidism. Secondary or central
hypothyroidism typically produces a low or inappropriately normal
TSH in association with low free T4.
3
, 5. A 35-year-old woman presents with episodic palpitations,
diaphoresis, tremulousness, and unexplained weight loss. Her pulse
is 112/min, and examination reveals a fine tremor and hyperreflexia.
Which laboratory test is the best initial assessment for suspected
hyperthyroidism?
A. Serum TSH
B. Serum cortisol
C. Serum prolactin
D. Serum aldosterone
E. Serum parathyroid hormone
Answer: A.
Rationale: Serum TSH is generally the most sensitive initial screening
test for suspected primary hyperthyroidism. A suppressed TSH should
prompt measurement of free T4 and, when appropriate, T3 to
characterize the degree and type of thyrotoxicosis.
6. A 29-year-old woman presents with dysuria and urinary
frequency for 2 days. She has no fever, flank pain, vomiting, vaginal
discharge, or pregnancy. Examination is otherwise normal. Which
diagnosis is most likely?
A. Acute uncomplicated cystitis
B. Acute pyelonephritis
C. Pelvic inflammatory disease
D. Nephrolithiasis
E. Interstitial cystitis
Answer: A.
Rationale: Dysuria and urinary frequency in a reproductive-age
woman without vaginal symptoms or systemic illness strongly suggest
4
