Family Medicine Midterm & Final Exam with Answers Provided

in more than 10 years. Which of the following immunizations would be most appropriate for this individual? A. Tetanus-diphtheria (Td) only B. Tdap, pneumococcal, and influenza C. Pneumococcal and influenza D. Tdap, pneumococcal, influenza, and meningococcal 3 -A 49-year-old sedentary man has made an appointment because his best friend died of an MI at age 50. He asks about an exercise and weight loss program. In counseling him, which of the following statements regarding exercise is most accurate? A. To be beneficial, exercise must be performed every day. B. Walking for exercise has not been shown to improve meaningful clinical outcomes. C. Counseling patients to exercise has not been shown consistently to increase the number of patients who exercise. D. Intense exercise offers no health benefit over mild to moderate amounts of .exercise 4- A 24-year-old woman presents for an initial prenatal visit. She is at 9 weeks' gestation based on her LMP but, on further questioning, she is not certain of the first day of her LMP. Which of the following would be the most accurate estimate of her gestational age? A. Using her LMP if her uterine size is consistent B. A first-trimester ultrasound C. A second-trimester ultrasound D. A quantitative serum hCG level 5- A 38-year-old pregnant woman presents for initial visit at 12 weeks' gestation. She requests a "genetic screen" because she is concerned about her advanced maternal age. She does not want any invasive testing that may cause a potential miscarriage. Which of the following is most appropriate to offer this patient? A. If no prior personal or family history of genetic defects, no screen is needed. B. Draw and send blood for the triple or quad screen, as patient has advanced maternal age. C. Nuchal translucency screening and hCG and PAPP-A testing. D. Offer the patient chorionic villus sampling. 6- A 28-year-old woman with a history of epilepsy presents for a preconception consultation visit. Which of the following is the most important advice to give to this patient? A. Diabetes screening prior to pregnancy. B. EEG reading that is normal prior to conception. C. Preconception folate supplementation. D. Stop epilepsy medication prior to pregnancy and through the first trimester. 7- A 28-year-old GlPO woman at 16 weeks' gestation is noted to be Rh negative. Which of the following is the most appropriate next step for this patient? A. Administer RhoGAM at this time. B. Check the patient's antibody screen (indirect Coombs). C. Schedule the patient for amniocentesis to assess for isoimmunization. D. Counsel the patient to terminate the pregnancy 8- A 30-year-old man has both mild persistent asthma and chronic environmental allergies. Which of the following medications is indicated for the management of this patient's conditions? A. Inhaled albuterol (short-acting -adrenergic agonist) B. Intranasal fluticasone (corticosteroid) C. Oral montelukast (leukotriene modifier) (D. Oral cetirizine (second-generation antihistamine 9-A 12-year-old boy presents with eye itching and redness. He has clear drainage from his eyes but no crusting. Examination today is normal except for mildly injected conjunctiva bilaterally. Which of the following is the most appropriate treatment? A. Antibiotic eye drops B. Ophthalmology consultation C. Anti-inflammatory eye drops D. Oral leukotriene inhibitor 10- A 56-year-old man presents to his physician with symptoms consistent with allergic rhinitis. His past medical history is positive for benign prostatic hyperplasia. He continues to work in a warehouse as a forklift operator. Which of the following medications should be used to treat this patient? A. Diphenhydramine B. Hydroxyzine C. Chlorpheniramine D. Fexofenadine 11-A 21-year-old woman presents for her first Pap smear. She received the full HPV vaccine series at age 19. Assuming that her examination and Pap smear results are normal, when would you recommend that she return for a followup Pap smear? A. 6 months, as the first Pap smear should be followed up soon to reduce the false-negative rate associated with this screening test B. 1 year, as she is higher risk because of her age C. 3 years, as the Pap smear was normal D. 5 years, as she is at low risk because she received the HPV vaccine 12- Which of the following situations is associated with an increased risk of intimate partner violence? A. Pregnancy B. Older age C. Higher income D. Married status 13- Which of the following statements regarding breast cancer screening is true? A. Breast self-examination (BSE) has been shown to decrease mortality rates from breast cancer. B. Clinical breast examination (CBE) in conjunction with routine mammography is shown to improve mortality rates. C. Most abnormalities found on routine mammography are not breast cancer. D. Because breast cancer rates increase in older women, there is no upper age at which breast cancer screening may be discontinued. 14- A 48-year-old woman presents for a well-woman examination. She notes that she had a supracervical hysterectomy in the past. Your records reveal that she had her uterus removed, but the cervix and ovaries were left in place. You also note that she has had Pap smears with HPV cotesting every 5 years since her 20s and that all were normal. She read on the internet that women who have had a hysterectomy no longer need Pap smears. Which of the following would be your advice? A. "You no longer need to get Pap smears since you have had a hysterectomy:' B. "You should continue to have Pap smears every 3 years since your hysterectomy is an indication to shorten the interval for testing:' C. "You should continue to have Pap smears with HPV cotesting every 5 years since your hysterectomy does not exclude you from routine screening recommendation for your age group:' D. "You should continue with annual Pap smears until the age of 50. If they ':are all normal, you can stop having them at that time 15- A third-year medical student is researching various recommendations for the care of the geriatric patient. Which of the following statements is most accurate? A. USPSTF recommends routine screening for colorectal cancer in all adults starting at the age of 50. B. USPSTF recommends stopping screening for cervical cancer with Pap smear in all women past the age of 65. C. The USPSTF recommends that all men should be screened for prostate cancer with prostate-specific antigen (PSA) testing annually starting at the age of 50. D. Herpes zoster vaccination is recommended for all adults over the age of50. 16- A 70-year-old man is having difficulty hearing his family members' conversations. He is diagnosed with presbycusis. Which of the following statements regarding his condition is most accurate? A. Presbycusis does not respond to hearing aid use. B. Presbycusis is usually caused by a conductive disorder. C. Presbycusis usually results in loss of speech discrimination. D. Presbycusis usually results in unilateral hearing loss. E. Presbycusis usually results in low-frequency hearing loss 17- Which one of the following recommendations is accurate regarding the current USPSTF recommendation for osteoporosis screening in the elderly? A. All women with strong risk factors, regardless of age, should be screened for osteoporosis. B. Only women above the age of 65 should be screened for osteoporosis. C. Men and women above the age of 65 should be screened for osteoporosis. D. African-American race is an independent risk factor for osteoporosis and .should warrant screening regardless of other risk factors 18-A 62-year-old man presents for a follow-up visit for severe depression. His symptoms have included crying episodes, insomnia, and decreased appetite. He has suicidal ideations and states that he has a gun in his home that he might use. He has had auditory hallucinations, saying he hears a voice telling him that his wife is the devil. His symptoms have not been relieved by maximum doses of sertraline (Zoloft), venlafaxine (Effexor), or citalopram (Celexa). He is currently taking duloxetine (Cymbalta), which has also failed to improve his symptoms. Which of the following would most likely provide the quickest relief of his symptoms? A. Electroconvulsive therapy (ECT) B. Bupropion (Wellbutrin) C. Stopping duloxetine and starting on an MAO inhibitor D. Behavioral modification 19-A 40-year-old woman sees you in follow-up of treatment for recurrent depression. Her symptoms are improved a little after 2 months of fluoxetine (Prozac) 10 mg a day and weekly counseling sessions with a psychologist. She is having no medication side effects and both she and her husband state that she is taking her medication regularly. Which of the following would be the most appropriate next step? A. Continue with your current plan and give it more time.