FAMILY MEDICINE BOARD REVIEW EXAM / FAMILY
MEDICINE BOARD EXAM STUDY GUIDE AND PRACTICE
EXAM (ALL IN ONE DOCUMENT) COMPLETE ACTUAL
TEST REAL QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (CORRECT VERIFIED
SOLUTIONS) LATEST UPDATED VERSION |ALREADY
GRADED A+
FAMILY MEDICINE BOARD EXAM REVIEW
A 42-year-old Asian male presents for follow-up of elevated
blood pressure. He has no additional chronic medical problems
and is otherwise asymptomatic. An examination is significant
for a blood pressure of 162/95 mm Hg but is otherwise
unremarkable.
Laboratory Findings unremarkable
Urine microalbumin negative
According to the American College of Cardiology/American
Heart Association 2017 guidelines, which one of the following
would be the most appropriate medication to initiate at this
time?
A) Clonidine (Catapres), 0.1 mg twice daily
B) Hydralazine, 25 mg three times daily
C) Lisinopril/hydrochlorothiazide (Zestoretic), 10/12.5 mg daily
,D) Metoprolol tartrate (Lopressor), 25 mg twice daily
E) Triamterene (Dyrenium), 50 mg daily - Answer-C
RATIONALE: This patient has hypertension and according to
both JNC 8 and American College of Cardiology/American Heart
Association 2017 guidelines, antihypertensive treatment should
be initiated. For the general non-African-American population,
monotherapy with an ACE inhibitor, an angiotensin receptor
blocker, a calcium channel blocker, or a thiazide diuretic would
be appropriate for initial management. It is also appropriate to
initiate combination antihypertensive therapy as an initial
management strategy, although patients should not take an
ACE inhibitor and an angiotensin receptor blocker
simultaneously. Studies have shown that blood pressure
control is achieved faster with the initiation of combination
therapy compared to monotherapy, without an increase in
morbidity. Lisinopril/hydrochlorothiazide would be an
appropriate choice in this patient. -Blockers, vasodilators, -
blockers, and potassium-sparing diuretics are not
recommended as initial choices for the treatment of
hypertension.
During rounds at the nursing home, you are informed that
there are two residents on the unit with laboratory-confirmed
influenza. According to CDC guidelines, who should receive
chemoprophylaxis for influenza?
,A) Only symptomatic residents on the same unit
B) Only symptomatic residents in the entire facility
C) All asymptomatic residents on the same unit
D) All residents of the facility regardless of symptoms
E) All staff regardless of symptoms - Answer-C
Rationale: In long-term care facilities, an influenza outbreak is
defined as two laboratory-confirmed cases of influenza
within 72 hours in patients on the same unit. The CDC
recommends chemoprophylaxis for all asymptomatic residents
of the affected unit. Any resident exhibiting symptoms of
influenza should be treated for influenza and not given
chemoprophylaxis dosing. Chemoprophylaxis is not
recommended for residents of other units unless there are two
laboratory-confirmed cases in those units. Facility staff of the
affected unit can be considered for chemoprophylaxis if they
have not been vaccinated or if they had a recent vaccination,
but chemoprophylaxis is not recommended for all staff in the
entire facility.
A 24-year-old female presents with a 2-day history of mild to
moderate pelvic pain. She has had two male sex partners in the
last 6 months and uses oral contraceptives and sometimes
condoms.
, A physical examination reveals a temperature of 36.4°C (97.5°F)
and moderate cervical motion and uterine tenderness. Urine
hCG and a urinalysis are negative. Vaginal microscopy shows
only WBCs.
The initiation of antibiotics for treatment of pelvic
inflammatory disease in this patient
A) is appropriate at this time
B) requires an elevated temperature, WBC count, or C-reactive
protein level
C) should be based on the results of gonorrhea and Chlamydia
testing
D) should be based on the results of pelvic ultrasonography -
Answer-A
Rationale: Pelvic inflammatory disease (PID) is a clinical
diagnosis, and treatment should be administered at the time of
diagnosis and not delayed until the results of the nucleic acid
amplification testing (NAAT) for gonorrhea and Chlamydia are
returned. The clinical diagnosis is based on an at-risk woman
presenting with lower abdominal or pelvic pain, accompanied
by cervical motion, uterine, or adnexal tenderness that can
range from mild to severe. There is often a mucopurulent
discharge or WBCs on saline microscopy. Acute phase
indicators such as fever, leukocytosis, or an elevated C-reactive
protein level may be helpful but are neither sensitive nor
specific. A positive NAAT is not required for diagnosis and
MEDICINE BOARD EXAM STUDY GUIDE AND PRACTICE
EXAM (ALL IN ONE DOCUMENT) COMPLETE ACTUAL
TEST REAL QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (CORRECT VERIFIED
SOLUTIONS) LATEST UPDATED VERSION |ALREADY
GRADED A+
FAMILY MEDICINE BOARD EXAM REVIEW
A 42-year-old Asian male presents for follow-up of elevated
blood pressure. He has no additional chronic medical problems
and is otherwise asymptomatic. An examination is significant
for a blood pressure of 162/95 mm Hg but is otherwise
unremarkable.
Laboratory Findings unremarkable
Urine microalbumin negative
According to the American College of Cardiology/American
Heart Association 2017 guidelines, which one of the following
would be the most appropriate medication to initiate at this
time?
A) Clonidine (Catapres), 0.1 mg twice daily
B) Hydralazine, 25 mg three times daily
C) Lisinopril/hydrochlorothiazide (Zestoretic), 10/12.5 mg daily
,D) Metoprolol tartrate (Lopressor), 25 mg twice daily
E) Triamterene (Dyrenium), 50 mg daily - Answer-C
RATIONALE: This patient has hypertension and according to
both JNC 8 and American College of Cardiology/American Heart
Association 2017 guidelines, antihypertensive treatment should
be initiated. For the general non-African-American population,
monotherapy with an ACE inhibitor, an angiotensin receptor
blocker, a calcium channel blocker, or a thiazide diuretic would
be appropriate for initial management. It is also appropriate to
initiate combination antihypertensive therapy as an initial
management strategy, although patients should not take an
ACE inhibitor and an angiotensin receptor blocker
simultaneously. Studies have shown that blood pressure
control is achieved faster with the initiation of combination
therapy compared to monotherapy, without an increase in
morbidity. Lisinopril/hydrochlorothiazide would be an
appropriate choice in this patient. -Blockers, vasodilators, -
blockers, and potassium-sparing diuretics are not
recommended as initial choices for the treatment of
hypertension.
During rounds at the nursing home, you are informed that
there are two residents on the unit with laboratory-confirmed
influenza. According to CDC guidelines, who should receive
chemoprophylaxis for influenza?
,A) Only symptomatic residents on the same unit
B) Only symptomatic residents in the entire facility
C) All asymptomatic residents on the same unit
D) All residents of the facility regardless of symptoms
E) All staff regardless of symptoms - Answer-C
Rationale: In long-term care facilities, an influenza outbreak is
defined as two laboratory-confirmed cases of influenza
within 72 hours in patients on the same unit. The CDC
recommends chemoprophylaxis for all asymptomatic residents
of the affected unit. Any resident exhibiting symptoms of
influenza should be treated for influenza and not given
chemoprophylaxis dosing. Chemoprophylaxis is not
recommended for residents of other units unless there are two
laboratory-confirmed cases in those units. Facility staff of the
affected unit can be considered for chemoprophylaxis if they
have not been vaccinated or if they had a recent vaccination,
but chemoprophylaxis is not recommended for all staff in the
entire facility.
A 24-year-old female presents with a 2-day history of mild to
moderate pelvic pain. She has had two male sex partners in the
last 6 months and uses oral contraceptives and sometimes
condoms.
, A physical examination reveals a temperature of 36.4°C (97.5°F)
and moderate cervical motion and uterine tenderness. Urine
hCG and a urinalysis are negative. Vaginal microscopy shows
only WBCs.
The initiation of antibiotics for treatment of pelvic
inflammatory disease in this patient
A) is appropriate at this time
B) requires an elevated temperature, WBC count, or C-reactive
protein level
C) should be based on the results of gonorrhea and Chlamydia
testing
D) should be based on the results of pelvic ultrasonography -
Answer-A
Rationale: Pelvic inflammatory disease (PID) is a clinical
diagnosis, and treatment should be administered at the time of
diagnosis and not delayed until the results of the nucleic acid
amplification testing (NAAT) for gonorrhea and Chlamydia are
returned. The clinical diagnosis is based on an at-risk woman
presenting with lower abdominal or pelvic pain, accompanied
by cervical motion, uterine, or adnexal tenderness that can
range from mild to severe. There is often a mucopurulent
discharge or WBCs on saline microscopy. Acute phase
indicators such as fever, leukocytosis, or an elevated C-reactive
protein level may be helpful but are neither sensitive nor
specific. A positive NAAT is not required for diagnosis and
