FAMILY MEDICINE BOARD REVIEW QUESTIONS WITH CORRECT ANSWERS GRADED A.pdf

FAMILY MEDICINE BOARD REVIEW
QUESTIONS WITH CORRECT ANSWERS
GRADED A+ FOR 2025-2026 ASSURED
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Ah42-year-oldhAsianhmalehpresentshforhfollow-
uphofhelevatedhbloodhpressure.hHehhashnohadditionalhchronichmedicalhproblemshandhishotherwiseh
asymptomatic.hAnhexaminationhishsignificanthforhahbloodhpressurehofh162/95hmmhHghbuthishotherw
isehunremarkable.

LaboratoryhFindingshunremarkable

Urinehmicroalbuminhnegative

AccordinghtohthehAmericanhCollegehofhCardiology/AmericanhHearthAssociationh2017hguidelines,hw
hichhonehofhthehfollowinghwouldhbehthehmosthappropriatehmedicationhtohinitiatehaththishtime?

A)hClonidineh(Catapres),h0.1hmghtwicehdaily

B)hHydralazine,h25hmghthreehtimeshdaily

C)hLisinopril/hydrochlorothiazideh(Zestoretic),h10/12.5hmghdaily

D)hMetoprololhtartrateh(Lopressor),h25hmghtwicehdaily

E)hTriamtereneh(Dyrenium),h50hmghdailyh-hhCORRECThANSWERSANSWER:hC

ThishpatienthhashhypertensionhandhaccordinghtohbothhJNCh8handhAmericanhCollegehofhCardiology/
AmericanhHearthAssociationh2017hguidelines,hantihypertensivehtreatmenthshouldhbehinitiated.hFor
hthehgeneralhnon-African-


Americanhpopulation,hmonotherapyhwithhanhACEhinhibitor,hanhangiotensinhreceptorhblocker,hahcal
ciumhchannelhblocker,horhahthiazidehdiuretichwouldhbehappropriatehforhinitialhmanagement.hIthishals
ohappropriatehtohinitiatehcombinationhantihypertensivehtherapyhashanhinitialhmanagementhstrateg
y,halthoughhpatientshshouldhnothtakehanhACEhinhibitorhandhanhangiotensinhreceptorhblockerhsimult
aneously.hStudieshhavehshownhthathbloodhpressurehcontrolhishachievedhfasterhwithhthehinitiationhof
hcombinationhtherapyhcomparedhtohmonotherapy,hwithouthanhincreasehinhmorbidity.hLisinopril/hy


drochlorothiazidehwouldhbehanhappropriatehchoicehinhthishpatient.h-Blockers,hvasodilators,h-
blockers,handhpotassium-
sparinghdiureticsharehnothrecommendedhashinitialhchoiceshforhthehtreatmenthofhhypertension.

,Duringhroundshaththehnursinghhome,hyouharehinformedhthaththereharehtwohresidentshonhthehunithwi
thhlaboratory-
confirmedhinfluenza.hAccordinghtohCDChguidelines,hwhohshouldhreceivehchemoprophylaxishforhinfl
uenza?

A)hOnlyhsymptomatichresidentshonhthehsamehunit

B)hOnlyhsymptomatichresidentshinhthehentirehfacility

C)hAllhasymptomatichresidentshonhthehsamehunit

D)hAllhresidentshofhthehfacilityhregardlesshofhsymptoms

E)hAllhstaffhregardlesshofhsymptomsh-hhCORRECThANSWERSANSWER:hC

Inhlong-termhcarehfacilities,hanhinfluenzahoutbreakhishdefinedhashtwohlaboratory-
confirmedhcaseshofhinfluenza

withinh72hhourshinhpatientshonhthehsamehunit.hThehCDChrecommendshchemoprophylaxishforhallhasy
mptomatichresidentshofhthehaffectedhunit.hAnyhresidenthexhibitinghsymptomshofhinfluenzahshouldh
behtreatedhforhinfluenzahandhnothgivenhchemoprophylaxishdosing.hChemoprophylaxishishnothrecom
mendedhforhresidentshofhotherhunitshunlesshthereharehtwohlaboratory-
confirmedhcaseshinhthosehunits.hFacilityhstaffhofhthehaffectedhunithcanhbehconsideredhforhchemopro
phylaxishifhtheyhhavehnothbeenhvaccinatedhorhifhtheyhhadhahrecenthvaccination,hbuthchemoprophyla
xishishnothrecommendedhforhallhstaffhinhthehentirehfacility.



Ah24-year-oldhfemalehpresentshwithhah2-
dayhhistoryhofhmildhtohmoderatehpelvichpain.hShehhashhadhtwohmalehsexhpartnershinhthehlasth6hmon
thshandhuseshoralhcontraceptiveshandhsometimeshcondoms.

Ahphysicalhexaminationhrevealshahtemperaturehofh36.4°Ch(97.5°F)handhmoderatehcervicalhmotionha
ndhuterinehtenderness.hUrinehhCGhandhahurinalysisharehnegative.hVaginalhmicroscopyhshowshonlyh
WBCs.

Thehinitiationhofhantibioticshforhtreatmenthofhpelvichinflammatoryhdiseasehinhthishpatient

A)hishappropriatehaththishtime

B)hrequireshanhelevatedhtemperature,hWBChcount,horhC-reactivehproteinhlevel

C)hshouldhbehbasedhonhthehresultshofhgonorrheahandhChlamydiahtesting

D)hshouldhbehbasedhonhthehresultshofhpelvichultrasonographyh-hhCORRECThANSWERSANSWER:hA

,Pelvichinflammatoryhdiseaseh(PID)hishahclinicalhdiagnosis,handhtreatmenthshouldhbehadministeredha
ththehtimehofhdiagnosishandhnothdelayedhuntilhthehresultshofhthehnucleichacidhamplificationhtestingh(
NAAT)hforhgonorrheahandhChlamydiaharehreturned.hThehclinicalhdiagnosishishbasedhonhanhat-
riskhwomanhpresentinghwithhlowerhabdominalhorhpelvichpain,haccompaniedhbyhcervicalhmotion,hut
erine,horhadnexalhtendernesshthathcanhrangehfromhmildhtohsevere.hTherehishoftenhahmucopurulenth
dischargehorhWBCshonhsalinehmicroscopy.hAcutehphasehindicatorshsuchhashfever,hleukocytosis,horha
nhelevatedhC-
reactivehproteinhlevelhmayhbehhelpfulhbutharehneitherhsensitivehnorhspecific.hAhpositivehNAAThishnot
hrequiredhforhdiagnosishandhtreatmenthbecausehanhupperhtracthinfectionhmayhbehpresent,horhthehca


usativehagenthmayhnothbehgonorrheahorhChlamydia.hPIDhshouldhbehconsideredhahpolymicrobialhinf
ection.hPelvichultrasonographyhmayhbehusedhifhtherehishahconcernhabouthotherhpathologyhsuchhasha
htubo-ovarianhabscess.




Ah24-year-
oldhpatienthwantshtohstarththehprocesshofhtransitioninghfromhfemalehtohmale.hHehhashbeenhworking
hwithhahpsychiatristhwhohhashconfirmedhthehdiagnosishofhgenderhdysphoria.hWhichhonehofhthehfollo


winghwouldhbehthehbesthinitialhtreatmenthforhthishpatient?

A)hClomiphene

B)hLetrozoleh(Femara)

C)hLeuprolideh(Eligard)

D)hSpironolactoneh(Aldactone)

E)hTestosteroneh-hhCORRECThANSWERSANSWER:hE

Forhpatientshwithhgenderhdysphoriahorhgenderhincongruencehwhohdesirehhormonehtreatment,hthe
htreatmenthgoalhishtohsuppresshendogenoushsexhhormonehproductionhandhmaintainhsexhhormonehl


evelshinhthehnormalhrangehforhtheirhaffirmedhgender.hForhahfemale-to-
malehtransgenderhpatienththishishmostheasilyhaccomplishedhwithhtestosterone.hWhenhtestosterone
hlevelsharehmaintainedhinhthehnormalhgenetichmalehrange,hgonadotropinshandhovarianhhormonehpr


oductionhishsuppressed,hwhichhaccomplisheshbothhgoalshforhhormonalhtreatmenthwithouththehnee
dhforhadditionalhgonadotropinhsuppressionhfromhmedicationshsuchhashleuprolide.hClomiphenehcan
hincreasehserumhtestosteronehlevels,hbuthonlyhinhthehpresencehofhahfunctioninghtesticle.hLetrozolehi


shanhestrogenhreceptorhantagonist,hbuthithwouldhnothincreasehserumhtestosteronehlevels.hSpironol
actonehhashandrogenhreceptorhblockingheffectshandhwouldhnothaccomplishheitherhofhthehhormone
htreatmenthgoals.

, BasedhonhAmericanhCancerhSocietyhguidelineshforhcervicalhcancerhscreening,hwhenhshouldhHPVhD
NAhco-testinghfirsthbehperformedhalonghwithhPapanicolaouhtesting?

A)hAththehonsethofhsexualhactivity

B)hAthageh21

C)hAthageh25

D)hAthageh30

E)hAthageh35h-hhCORRECThANSWERSANSWER:hD

AccordinghtohAmericanhCancerhSocietyhguidelineshforhcervicalhcancerhscreening,hPapanicolaouh(Pa
p)htesting

shouldhbeginhathageh21hirrespectivehofhsexualhactivityhandhshouldhbehcontinuedheveryh3hyearshuntil
hageh29.hThehpreferredhscreeninghstrategyhbeginninghathageh30hishPaphtestinghwithhHPVhco-


testing,hwhichhshouldhbehcontinuedheveryh5hyearshuntilhageh65.hCervicalhscreeninghmayhbehdisconti
nuedhaththathtimehifhthehpatient'shlasthtwohtestshhavehbeenhnegativehandhthehpatienthwashtestedhwi
thinhthehprevioush5hyears.



Long-termhprotonhpumphinhibitorhusehishassociatedhwithhanhincreasedhriskhfor

A)hBarrett'shesophagus

B)hgout

C)hhypertension

D)hpneumonia

E)htypeh2hdiabetesh-hhCORRECThANSWERSANSWER:hD

Acidhsuppressionhtherapyhishassociatedhwithhanhincreasedhriskhofhcommunity-
acquiredhandhhealthhcare-associatedhpneumonia,hwhichhishrelatedhtohgastrichovergrowthhbyhgram-
negativehbacteria.hLong-
termhtreatmenthofhBarrett'shesophagushishanhindicationhforhchronichprotonhpumphinhibitorh(PPI)hus
e.hPPIhtherapyhdoeshnothincreasehthehriskhofhgout,hhypertension,horhtypeh2hdiabetes.



Anh87-year-
oldhfemalehcomeshtohyourhofficehforhanhannualhhealthhmaintenancehvisit.hShehappearshcachecticha
ndhtellshyouhthathforhthehpasth6hmonthshshehhashhadhahdecreasedhappetitehandhgeneralizedhmuscle