FAMILY MEDICINE BOARD UPDATED
ACTUAL QUESTIONS AND CORRECT
ANSWERS COMPREHENSIVE STUDY GUIDE
●● Weakness of the thumb and index finger pincer mechanism is
indicative
of an _________ nerve injury.
Answer: Weakness of the thumb and index finger pincer mechanism is
indicative
of an *ulnar* nerve injury.
●● Symptoms related to the __________ nerve generally include
paresthesia of the thumb, index finger, and long finger.
Answer: Symptoms related to the *median* nerve generally include
paresthesia of the thumb, index finger,
and long finger.
●● Weakness of supination of the forearm would indicate a potential
________ nerve
injury.
Answer: Weakness of supination of the forearm would indicate a
potential * musculocutaneous* nerve
injury.
,●● Weakness of active wrist extension would indicate a potential
________ nerve injury.
Answer: Weakness of active wrist extension would indicate a potential
*radial* nerve injury.
●● A 30-year-old male is diagnosed with hereditary hemochromatosis.
Periodic therapeutic phlebotomy may be appropriate to prevent
A) chronic liver disease B) chronic renal disease C) encephalopathy D)
myelofibrosis E) Wilson disease
Answer: A) chronic liver disease
Hereditary hemochromatosis is a common inherited disorder of iron
metabolism. Iron deposits in the liver
may lead to chronic liver disease and hepatocellular cancer. Screening
for hereditary hemochromatosis
includes serum ferritin levels, a family history, and genetic testing.
Chronic renal disease, encephalopathy,
myelofibrosis, and Wilson disease (disorder of copper transport) do not
result from iron overload.
●● A 70-year-old female sees you for a Medicare annual wellness visit.
Her past medical history includes hypertension treated with enalapril
(Vasotec). She states that she "couldn't be better" and says that she has
,no new symptoms or health concerns. She has a blood pressure of
159/90 mm Hg, a temperature of 36.7°C (98.1°F), a heart rate of 76
beats/min, a respiratory rate of 17/min, and an oxygen saturation of 98%
on room air. On examination you note a new harsh systolic murmur that
is heard best at the second right intercostal space and can also be heard
over the right carotid artery. A transthoracic echocardiogram reveals
severe aortic stenosis. Which one of the following should you
recommend for this patient? A) Antibiotic prophylaxis for dental
procedures B) Transesophageal echocardiography C) Repeat
echocardiography in 6 months D) Referral for aortic valve replacement
Answer: ANSWER: C
This patient has severe aortic stenosis that is asymptomatic. Watchful
waiting is recommended for most
asymptomatic patients. In asymptomatic patients with severe aortic
stenosis, monitoring with serial
echocardiography is recommended every 6-12 months. Antibiotic
prophylaxis is not indicated unless the
patient has undergone aortic valve replacement or has a history of
endocarditis. Transesophageal
echocardiography is not indicated in this situation. Aortic valve
replacement is indicated to decrease
mortality in patients with symptomatic aortic stenosis.
●● After a thorough history and examination you determine that a 30-
year-old male has an upper respiratory infection with a persistent cough.
He is afebrile and is otherwise healthy. The best treatment for
symptomatic relief of his persistent cough would be intranasal A)
, antibiotics B) antihistamines C) corticosteroids D) ipratropium
(Atrovent) E) saline
Answer: ANSWER: D - ipratropium (Atrovent)
Upper respiratory tract infections are the most common acute illness in
the United States. Symptoms are
self-limited and can include nasal congestion, rhinorrhea, sore throat,
cough, general malaise, and a
low-grade fever. According to a Cochrane review of 10 trials without a
meta-analysis, antitussives and
expectorants are no more effective than placebo for cough.
Intranasal ipratropium is the only medication
that improves persistent cough related to upper respiratory infection in
adults.
Intranasal antibiotics,
antihistamines, corticosteroids, and saline would not improve this
patient's cough.
●● A 30-year-old female presents for evaluation of chronic abdominal
bloating, cramping, diarrhea, and recent weight loss. An abdominal
examination is unremarkable, and stool guaiac testing is negative. She
requests testing for celiac disease. Which one of the following would be
most likely to cause a false-negative result on serologic testing for celiac
disease? A) A recent increase in dietary wheat consumption B) Recent
ACTUAL QUESTIONS AND CORRECT
ANSWERS COMPREHENSIVE STUDY GUIDE
●● Weakness of the thumb and index finger pincer mechanism is
indicative
of an _________ nerve injury.
Answer: Weakness of the thumb and index finger pincer mechanism is
indicative
of an *ulnar* nerve injury.
●● Symptoms related to the __________ nerve generally include
paresthesia of the thumb, index finger, and long finger.
Answer: Symptoms related to the *median* nerve generally include
paresthesia of the thumb, index finger,
and long finger.
●● Weakness of supination of the forearm would indicate a potential
________ nerve
injury.
Answer: Weakness of supination of the forearm would indicate a
potential * musculocutaneous* nerve
injury.
,●● Weakness of active wrist extension would indicate a potential
________ nerve injury.
Answer: Weakness of active wrist extension would indicate a potential
*radial* nerve injury.
●● A 30-year-old male is diagnosed with hereditary hemochromatosis.
Periodic therapeutic phlebotomy may be appropriate to prevent
A) chronic liver disease B) chronic renal disease C) encephalopathy D)
myelofibrosis E) Wilson disease
Answer: A) chronic liver disease
Hereditary hemochromatosis is a common inherited disorder of iron
metabolism. Iron deposits in the liver
may lead to chronic liver disease and hepatocellular cancer. Screening
for hereditary hemochromatosis
includes serum ferritin levels, a family history, and genetic testing.
Chronic renal disease, encephalopathy,
myelofibrosis, and Wilson disease (disorder of copper transport) do not
result from iron overload.
●● A 70-year-old female sees you for a Medicare annual wellness visit.
Her past medical history includes hypertension treated with enalapril
(Vasotec). She states that she "couldn't be better" and says that she has
,no new symptoms or health concerns. She has a blood pressure of
159/90 mm Hg, a temperature of 36.7°C (98.1°F), a heart rate of 76
beats/min, a respiratory rate of 17/min, and an oxygen saturation of 98%
on room air. On examination you note a new harsh systolic murmur that
is heard best at the second right intercostal space and can also be heard
over the right carotid artery. A transthoracic echocardiogram reveals
severe aortic stenosis. Which one of the following should you
recommend for this patient? A) Antibiotic prophylaxis for dental
procedures B) Transesophageal echocardiography C) Repeat
echocardiography in 6 months D) Referral for aortic valve replacement
Answer: ANSWER: C
This patient has severe aortic stenosis that is asymptomatic. Watchful
waiting is recommended for most
asymptomatic patients. In asymptomatic patients with severe aortic
stenosis, monitoring with serial
echocardiography is recommended every 6-12 months. Antibiotic
prophylaxis is not indicated unless the
patient has undergone aortic valve replacement or has a history of
endocarditis. Transesophageal
echocardiography is not indicated in this situation. Aortic valve
replacement is indicated to decrease
mortality in patients with symptomatic aortic stenosis.
●● After a thorough history and examination you determine that a 30-
year-old male has an upper respiratory infection with a persistent cough.
He is afebrile and is otherwise healthy. The best treatment for
symptomatic relief of his persistent cough would be intranasal A)
, antibiotics B) antihistamines C) corticosteroids D) ipratropium
(Atrovent) E) saline
Answer: ANSWER: D - ipratropium (Atrovent)
Upper respiratory tract infections are the most common acute illness in
the United States. Symptoms are
self-limited and can include nasal congestion, rhinorrhea, sore throat,
cough, general malaise, and a
low-grade fever. According to a Cochrane review of 10 trials without a
meta-analysis, antitussives and
expectorants are no more effective than placebo for cough.
Intranasal ipratropium is the only medication
that improves persistent cough related to upper respiratory infection in
adults.
Intranasal antibiotics,
antihistamines, corticosteroids, and saline would not improve this
patient's cough.
●● A 30-year-old female presents for evaluation of chronic abdominal
bloating, cramping, diarrhea, and recent weight loss. An abdominal
examination is unremarkable, and stool guaiac testing is negative. She
requests testing for celiac disease. Which one of the following would be
most likely to cause a false-negative result on serologic testing for celiac
disease? A) A recent increase in dietary wheat consumption B) Recent
