AQUIFER FAMILY MEDICINE END OF CASE EXAM
QUESTIONS 2025-2026 ACTUAL EXAM 170
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (100% VERIFIED ANSWERS)
|ALREADY GRADED A+
A 34-year-old woman who has no past medical problems nor is currently taking
any medications comes into your office because she noticed a tender lump in her
left breast starting approximately one month ago. She is worried because she has
an aunt who had breast cancer that was BRCA positive, though her mother is
BRCA negative. Her periods have been regular since they started at the age of 13
and occur every 32 days. She is currently menstruating. She has three children
aged 12, 9, and 4. On exam, her BMI is 32, up from 28 three years wago wand wher
wother wvital wsigns ware wstable. wOn wbreast wexam, wyou wnote wa wmobile
wrubbery wmass wof wapproximately w1 wx w1cm wand wwith wregular wborders
wthat wis wtender wto wpalpation. wYou wappreciate wno waxillary wadenopathy.
wThe wrest wof wher wphysical wexam wis wunremarkable. wOf wthe winformation
wprovided, wwhich wof wthe wfollowing wplaces wthis wpatient wat wincreased wrisk
wfor wbreast wcancer?
A. Age
B. Weight
C. Parity w- wCorrect wanswer-The wcorrect wanswer wis wB.
,With wa wBMI wof w32, wobesity wis wthe wone wrisk wfactor wfor wthis wpatient
wbased won wthe winformation wgiven. wOther wrisk wfactors wfor wbreast wcancer
winclude wfamily whistory wof wbreast wcancer win wa wfirst wdegree wrelative
w(mother wor wsister w- wnot waunt), wprolonged westrogen wexposure w(menarche
wbefore wage w12, wmenopause wafter w45, wadvanced wage wat wfirst wpregnancy),
wgenetic wpredisposition w(BRCA w1 wor w2 wmutation), wadvanced wage w(breast
wcancer wrisk wincreases wwith wage, wand wthis wpatient wis wrelatively wyoung),
wfemale wsex, wincreased wbreast wdensity wand wcertain wexposures
w(diethylstilbestrol, whormone wor wradiation wtherapy, wheavy wsmoking).
A w64-year-old wwoman wwho wis woverweight wwith wwell-controlled
whypertension wcomes wto wyour woffice wcomplaining wof wa wlump win wher
wbreast wthat wshe wnoticed wwhile wshowering. wShe wdenies wany wpain,
wtenderness, wor wskin wchanges. wA wpertinent wreview wof wsystems wis
wnegative. wMenarche wbegan wat wthe wage wof w10. wHer wfirst wchild wwas wborn
wwhen wshe wwas w31 wand wshe whad wher wsecond wand wlast wchild wat wthe wage
wof w33. wShe wexperienced wmenopause wat wthe wage wof w44. wHer wmother
wdied wof wcolon wcancer wwhen wshe wwas w65 wand wher wfather wpassed waway
wfrom wmetastatic wprostate wcancer wat wthe wage wof w70. wShe whas wno whistory
wof wtobacco wuse wever wand woccasionally wdrinks wa wglass wof wwine wwith
wdinner. wHer wBMI wis w34. wWhich wof wthe winformation wprovided wthus wfar
wputs wthe wpatient wat wdecreased wrisk wfor wbreast wcancer?
A. Age
B. Weight
C. Age wat wfirst wbirth
D. Age wat wmenarche
E. Age wat wmenopause w- wCorrect wanswer-The wcorrect wanswer wis wE.
The wpatient wexperienced wmenopause wat wthe wage wof w44, wwhich wshortens
wher wtime wof
estrogen wexposure, wa wknown wrisk wfactor wfor wthe wdevelopment wof wbreast
wcancer.
Factors wassociated wwith wdecreased wbreast wcancer wrisk winclude
,wpregnancy wat wan
early wage, wlate wmenarche, wearly wmenopause, whigh wparity wand wmedications
wsuch was
, selective westrogen wreceptor wmodulators walong wwith wNSAIDs wand waspirin.
wRisk wfactors wfor wbreast wcancer winclude wfamily whistory wof wbreast wcancer
win wa wfirst wdegree wrelative w(mother wor wsister), wprolonged westrogen
wexposure w(menarche wbefore wage w12, wmenopause wafter w55, wadvanced
wage wat wpregnancy, wobesity wafter wmenopause), wfemale wsex, wgenetic
wpredisposition w(BRCA w1 wor w2 wmutation), wadvanced wage w(breast wcancer
wrisk wincreases wwith wage), wincreased wbreast wdensity wand wexposures
w(diethylstilbestrol, whormone wor wradiation wtherapy, wsmoking).
A w63-year wold wwoman wcomes winto wyour woffice wfor wher wannual wpreventive
wexam. wShe whas whypertension wand wtype w2 wdiabetes. wShe wis wnot wsexually
wactive. wHer wblood wpressure wis w125/80 wand wher wphysical wexam wotherwise
wis wwithin wnormal wlimits. wYou wrecommend winfluenza wand wzoster
wvaccination. wHer wlast wcolonoscopy wwas weight wyears wago wand wher wlast
wmammogram wone wyear wago wwas wnormal. wShe whas wnever whad wan
wabnormal wPap wsmear. wAt wthe wage wof w45 wshe whad wa wtotal whysterectomy
wfor wfibroids. wYou wtell wher wshe wdoes wnot wrequire wa wPap wsmear wtoday
wbecause:
A. She whas wnever whad wan wabnormal wPap wsmear
B. She wis wnot wsexually wactive
C. She whad wa wtotal whysterectomy wfor wfibroids
D. She wis w63 wyears wold
E. She wexperienced wmenopause wmore wthan w10 wyears wago w- wCorrect
wanswer-The wcorrect wanswer wis wC.
The wpatient wdescribed wabove wunderwent wa wtotal whysterectomy w(total
wremoval wof
the wuterus wand wcervix wwith wor wwithout woophorectomy) wfor
wbenign wreasons
QUESTIONS 2025-2026 ACTUAL EXAM 170
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (100% VERIFIED ANSWERS)
|ALREADY GRADED A+
A 34-year-old woman who has no past medical problems nor is currently taking
any medications comes into your office because she noticed a tender lump in her
left breast starting approximately one month ago. She is worried because she has
an aunt who had breast cancer that was BRCA positive, though her mother is
BRCA negative. Her periods have been regular since they started at the age of 13
and occur every 32 days. She is currently menstruating. She has three children
aged 12, 9, and 4. On exam, her BMI is 32, up from 28 three years wago wand wher
wother wvital wsigns ware wstable. wOn wbreast wexam, wyou wnote wa wmobile
wrubbery wmass wof wapproximately w1 wx w1cm wand wwith wregular wborders
wthat wis wtender wto wpalpation. wYou wappreciate wno waxillary wadenopathy.
wThe wrest wof wher wphysical wexam wis wunremarkable. wOf wthe winformation
wprovided, wwhich wof wthe wfollowing wplaces wthis wpatient wat wincreased wrisk
wfor wbreast wcancer?
A. Age
B. Weight
C. Parity w- wCorrect wanswer-The wcorrect wanswer wis wB.
,With wa wBMI wof w32, wobesity wis wthe wone wrisk wfactor wfor wthis wpatient
wbased won wthe winformation wgiven. wOther wrisk wfactors wfor wbreast wcancer
winclude wfamily whistory wof wbreast wcancer win wa wfirst wdegree wrelative
w(mother wor wsister w- wnot waunt), wprolonged westrogen wexposure w(menarche
wbefore wage w12, wmenopause wafter w45, wadvanced wage wat wfirst wpregnancy),
wgenetic wpredisposition w(BRCA w1 wor w2 wmutation), wadvanced wage w(breast
wcancer wrisk wincreases wwith wage, wand wthis wpatient wis wrelatively wyoung),
wfemale wsex, wincreased wbreast wdensity wand wcertain wexposures
w(diethylstilbestrol, whormone wor wradiation wtherapy, wheavy wsmoking).
A w64-year-old wwoman wwho wis woverweight wwith wwell-controlled
whypertension wcomes wto wyour woffice wcomplaining wof wa wlump win wher
wbreast wthat wshe wnoticed wwhile wshowering. wShe wdenies wany wpain,
wtenderness, wor wskin wchanges. wA wpertinent wreview wof wsystems wis
wnegative. wMenarche wbegan wat wthe wage wof w10. wHer wfirst wchild wwas wborn
wwhen wshe wwas w31 wand wshe whad wher wsecond wand wlast wchild wat wthe wage
wof w33. wShe wexperienced wmenopause wat wthe wage wof w44. wHer wmother
wdied wof wcolon wcancer wwhen wshe wwas w65 wand wher wfather wpassed waway
wfrom wmetastatic wprostate wcancer wat wthe wage wof w70. wShe whas wno whistory
wof wtobacco wuse wever wand woccasionally wdrinks wa wglass wof wwine wwith
wdinner. wHer wBMI wis w34. wWhich wof wthe winformation wprovided wthus wfar
wputs wthe wpatient wat wdecreased wrisk wfor wbreast wcancer?
A. Age
B. Weight
C. Age wat wfirst wbirth
D. Age wat wmenarche
E. Age wat wmenopause w- wCorrect wanswer-The wcorrect wanswer wis wE.
The wpatient wexperienced wmenopause wat wthe wage wof w44, wwhich wshortens
wher wtime wof
estrogen wexposure, wa wknown wrisk wfactor wfor wthe wdevelopment wof wbreast
wcancer.
Factors wassociated wwith wdecreased wbreast wcancer wrisk winclude
,wpregnancy wat wan
early wage, wlate wmenarche, wearly wmenopause, whigh wparity wand wmedications
wsuch was
, selective westrogen wreceptor wmodulators walong wwith wNSAIDs wand waspirin.
wRisk wfactors wfor wbreast wcancer winclude wfamily whistory wof wbreast wcancer
win wa wfirst wdegree wrelative w(mother wor wsister), wprolonged westrogen
wexposure w(menarche wbefore wage w12, wmenopause wafter w55, wadvanced
wage wat wpregnancy, wobesity wafter wmenopause), wfemale wsex, wgenetic
wpredisposition w(BRCA w1 wor w2 wmutation), wadvanced wage w(breast wcancer
wrisk wincreases wwith wage), wincreased wbreast wdensity wand wexposures
w(diethylstilbestrol, whormone wor wradiation wtherapy, wsmoking).
A w63-year wold wwoman wcomes winto wyour woffice wfor wher wannual wpreventive
wexam. wShe whas whypertension wand wtype w2 wdiabetes. wShe wis wnot wsexually
wactive. wHer wblood wpressure wis w125/80 wand wher wphysical wexam wotherwise
wis wwithin wnormal wlimits. wYou wrecommend winfluenza wand wzoster
wvaccination. wHer wlast wcolonoscopy wwas weight wyears wago wand wher wlast
wmammogram wone wyear wago wwas wnormal. wShe whas wnever whad wan
wabnormal wPap wsmear. wAt wthe wage wof w45 wshe whad wa wtotal whysterectomy
wfor wfibroids. wYou wtell wher wshe wdoes wnot wrequire wa wPap wsmear wtoday
wbecause:
A. She whas wnever whad wan wabnormal wPap wsmear
B. She wis wnot wsexually wactive
C. She whad wa wtotal whysterectomy wfor wfibroids
D. She wis w63 wyears wold
E. She wexperienced wmenopause wmore wthan w10 wyears wago w- wCorrect
wanswer-The wcorrect wanswer wis wC.
The wpatient wdescribed wabove wunderwent wa wtotal whysterectomy w(total
wremoval wof
the wuterus wand wcervix wwith wor wwithout woophorectomy) wfor
wbenign wreasons
