AQUIFER FAMILY MEDICINE EXAM QUESTIONS AND ANSWERS
NEWEST UPDATED 2024/2025 A COMPLETE SOLUTION WITH
CORRECT VERIFIED/DETAILED ANSWERS BEST GRADED A+ FOR
PASS
A 60-year-old obese woman with history of hypertension and dyslipidemia and family history of
cardiac disease. She has burning chest pain,
three months of intermittent symptoms, association with SOB, variable association with
exertion. Physical exam unremarkable other than hypertension. Which of the following are the
top two diagnoses on your differential at this point?
A. Aortic dissection (AD)
B. Angina
C. Hyperventilation
D. Gastroesophageal reflux disease (GERD)
E. Myocardial infarction (MI)
F. Musculoskeletal pain
G. Pleurisy
H. Pneumothorax
I. Pulmonary embolus (PE)
J. Ventricular tachycardia - CORRECT ANSWERS The correct answers are B, D
Angina
Some patients report pain from angina as 'burning,' although it is not the classic descriptor.
Since women often report atypical symptoms, angina is a reasonable diagnostic consideration
in a woman with atypical symptoms prompted by exertion.
,AQUIFER FAMILY MEDICINE EXAM QUESTIONS AND ANSWERS
NEWEST UPDATED 2024/2025 A COMPLETE SOLUTION WITH
CORRECT VERIFIED/DETAILED ANSWERS BEST GRADED A+ FOR
PASS
In some patients shortness of breath is the only symptom of cardiac ischemia. This is called an
"anginal equivalent."
GERD
Associated chest pain is often described as "burning"
Not usually associated with exertion
Of the following, which are risk factors for coronary artery disease? Select all that apply.
A. Age > 55 in females
B. Male sex
C. Family history of sudden death or premature CAD
D. Smoking
E. Dyslipidemia
F. Diabetes mellitus
G. Moderate alcohol use
H. Excessive caffeine use
I. Hypertension
J. Obesity
K. Mitral valve prolapse - CORRECT ANSWERS The correct answers are A, B, C, D, E, F, I,
J
,AQUIFER FAMILY MEDICINE EXAM QUESTIONS AND ANSWERS
NEWEST UPDATED 2024/2025 A COMPLETE SOLUTION WITH
CORRECT VERIFIED/DETAILED ANSWERS BEST GRADED A+ FOR
PASS
Which of the following drug classes are approved for treating angina? Select all that apply.
A. Beta blockers
B. Calcium channel blockers
C. ACE inhibitors
D. Nitrates - CORRECT ANSWERS > The correct answers are A, B, D
Beta blockers decrease myocardial oxygen consumption by slowing heart rate and decreasing
blood pressure, and thus reduce angina.
Calcium channel blockers dilate coronary arteries and increase coronary blood flow while also
decreasing myocardial oxygen consumption.
Nitrates dilate systemic and coronary arteries but are primarily venodilators. The anti-ischemic
effect of nitrates is due to systemic venodilation that leads to reduced preload and a decrease
in myocardial oxygen demand.
A 58-year-old woman presents to the clinic complaining of chest pain over the past three
months. She describes the pain as sharp and stabbing, in the mid-sternal region, lasting for one
to two minutes, occurring a few times a day. The pain can come on at rest or with exertion and
resolves on its own. It has not become worse since it began. There is no associated diaphoresis,
shortness of breath, nausea, jaw pain, or pain with movement, eating, or laying supine. She has
a 10-year history of obesity and hypertension for which she takes chlorthalidone. She was
recently diagnosed with diabetes, but does not require medication for treatment. Physical
examination shows her pulse is 86 beats/minute, respiration rate is 16 breaths/minute, and
blood pressure is 135/85 mmHg. Her lungs are clear, heart sounds are normal, and there is no
chest wall tenderness to palpation or abdominal tenderness. There is no peripheral edema. Ho -
CORRECT ANSWERS The correct answer is A.
This woman is experiencing atypical angina. She does not meet the criteria for angina which
includes substernal chest discomfort with characteristic duration and features, is exertional in
, AQUIFER FAMILY MEDICINE EXAM QUESTIONS AND ANSWERS
NEWEST UPDATED 2024/2025 A COMPLETE SOLUTION WITH
CORRECT VERIFIED/DETAILED ANSWERS BEST GRADED A+ FOR
PASS
nature and relieved with rest or nitroglycerin. This is considered atypical angina because the
pain does not follow the classic pattern of angina; however, it is still possible that the pain is
cardiac in origin, especially since atypical features are more common in women and patients
with diabetes.
Gastroesophageal reflux typically occurs after meals or while laying flat and is often described
as having a burning quality.
Musculoskeletal pain is typically worse with certain movements and associated with chest wall
tenderness.
Stable angina would meet the criteria and follow a predictable pattern with exertion.
Unstable angina is characterized by chest pain at rest or with progressively less exertion. Angina
with worsening features or new within the past four to six weeks is also considered unstable.
Question
A 42-year-old woman presents to the emergency department complaining of mild chest pain
lasting three to four minutes with vigorous exercise, three times over the past week. She has no
past medical history and is not taking any medications or supplements. She has no family
history of cardiac disease. She follows a vegetarian diet, exercises regularly, and is training for a
half-marathon. Physical examination shows her pulse is 66 beats/minute, respiration rate is 16
breaths/minute, and blood pressure is 110/70 mmHg. Her lungs are clear, heart sounds are
normal, and there is no lower-extremity edema. Which of the following is the most likely
laboratory study in the acute setting to assist with the diagnosis?
A. Brain natriuretic peptide (BNP)
B. Complete blood count (CBC)
NEWEST UPDATED 2024/2025 A COMPLETE SOLUTION WITH
CORRECT VERIFIED/DETAILED ANSWERS BEST GRADED A+ FOR
PASS
A 60-year-old obese woman with history of hypertension and dyslipidemia and family history of
cardiac disease. She has burning chest pain,
three months of intermittent symptoms, association with SOB, variable association with
exertion. Physical exam unremarkable other than hypertension. Which of the following are the
top two diagnoses on your differential at this point?
A. Aortic dissection (AD)
B. Angina
C. Hyperventilation
D. Gastroesophageal reflux disease (GERD)
E. Myocardial infarction (MI)
F. Musculoskeletal pain
G. Pleurisy
H. Pneumothorax
I. Pulmonary embolus (PE)
J. Ventricular tachycardia - CORRECT ANSWERS The correct answers are B, D
Angina
Some patients report pain from angina as 'burning,' although it is not the classic descriptor.
Since women often report atypical symptoms, angina is a reasonable diagnostic consideration
in a woman with atypical symptoms prompted by exertion.
,AQUIFER FAMILY MEDICINE EXAM QUESTIONS AND ANSWERS
NEWEST UPDATED 2024/2025 A COMPLETE SOLUTION WITH
CORRECT VERIFIED/DETAILED ANSWERS BEST GRADED A+ FOR
PASS
In some patients shortness of breath is the only symptom of cardiac ischemia. This is called an
"anginal equivalent."
GERD
Associated chest pain is often described as "burning"
Not usually associated with exertion
Of the following, which are risk factors for coronary artery disease? Select all that apply.
A. Age > 55 in females
B. Male sex
C. Family history of sudden death or premature CAD
D. Smoking
E. Dyslipidemia
F. Diabetes mellitus
G. Moderate alcohol use
H. Excessive caffeine use
I. Hypertension
J. Obesity
K. Mitral valve prolapse - CORRECT ANSWERS The correct answers are A, B, C, D, E, F, I,
J
,AQUIFER FAMILY MEDICINE EXAM QUESTIONS AND ANSWERS
NEWEST UPDATED 2024/2025 A COMPLETE SOLUTION WITH
CORRECT VERIFIED/DETAILED ANSWERS BEST GRADED A+ FOR
PASS
Which of the following drug classes are approved for treating angina? Select all that apply.
A. Beta blockers
B. Calcium channel blockers
C. ACE inhibitors
D. Nitrates - CORRECT ANSWERS > The correct answers are A, B, D
Beta blockers decrease myocardial oxygen consumption by slowing heart rate and decreasing
blood pressure, and thus reduce angina.
Calcium channel blockers dilate coronary arteries and increase coronary blood flow while also
decreasing myocardial oxygen consumption.
Nitrates dilate systemic and coronary arteries but are primarily venodilators. The anti-ischemic
effect of nitrates is due to systemic venodilation that leads to reduced preload and a decrease
in myocardial oxygen demand.
A 58-year-old woman presents to the clinic complaining of chest pain over the past three
months. She describes the pain as sharp and stabbing, in the mid-sternal region, lasting for one
to two minutes, occurring a few times a day. The pain can come on at rest or with exertion and
resolves on its own. It has not become worse since it began. There is no associated diaphoresis,
shortness of breath, nausea, jaw pain, or pain with movement, eating, or laying supine. She has
a 10-year history of obesity and hypertension for which she takes chlorthalidone. She was
recently diagnosed with diabetes, but does not require medication for treatment. Physical
examination shows her pulse is 86 beats/minute, respiration rate is 16 breaths/minute, and
blood pressure is 135/85 mmHg. Her lungs are clear, heart sounds are normal, and there is no
chest wall tenderness to palpation or abdominal tenderness. There is no peripheral edema. Ho -
CORRECT ANSWERS The correct answer is A.
This woman is experiencing atypical angina. She does not meet the criteria for angina which
includes substernal chest discomfort with characteristic duration and features, is exertional in
, AQUIFER FAMILY MEDICINE EXAM QUESTIONS AND ANSWERS
NEWEST UPDATED 2024/2025 A COMPLETE SOLUTION WITH
CORRECT VERIFIED/DETAILED ANSWERS BEST GRADED A+ FOR
PASS
nature and relieved with rest or nitroglycerin. This is considered atypical angina because the
pain does not follow the classic pattern of angina; however, it is still possible that the pain is
cardiac in origin, especially since atypical features are more common in women and patients
with diabetes.
Gastroesophageal reflux typically occurs after meals or while laying flat and is often described
as having a burning quality.
Musculoskeletal pain is typically worse with certain movements and associated with chest wall
tenderness.
Stable angina would meet the criteria and follow a predictable pattern with exertion.
Unstable angina is characterized by chest pain at rest or with progressively less exertion. Angina
with worsening features or new within the past four to six weeks is also considered unstable.
Question
A 42-year-old woman presents to the emergency department complaining of mild chest pain
lasting three to four minutes with vigorous exercise, three times over the past week. She has no
past medical history and is not taking any medications or supplements. She has no family
history of cardiac disease. She follows a vegetarian diet, exercises regularly, and is training for a
half-marathon. Physical examination shows her pulse is 66 beats/minute, respiration rate is 16
breaths/minute, and blood pressure is 110/70 mmHg. Her lungs are clear, heart sounds are
normal, and there is no lower-extremity edema. Which of the following is the most likely
laboratory study in the acute setting to assist with the diagnosis?
A. Brain natriuretic peptide (BNP)
B. Complete blood count (CBC)
