AAFP Board Review Questions
how to differentiate between chlamydial and RSV infections - answer chlamydia: hx of
conjunctivitis, subacute onset, absence of fever, mild wheezing
meds for BPH and lower urinary tract symptoms - answer alpha blocker, 5-a-reductase
inhibitor (if there's evidence of prostatic enlargement or PSA > 1.5 ng/mL),
phosphodiesterase-5 inhibitor, and antimusc therapy
tx for mallet fracture - forced flexion injury of DIP resulting in a small bone fragment at
dorsal surface of proximal distal phalanx - answer splinting the DIP in extension
duration of 8 wks
if fx involves > 30% of intra-articular surface - referral to specialist
tx for acute depression and maintenance therapy of bipolar disorders - answerLi
valproate
lamotrigine
some antipsychotics (including quetiapine)
necrotizing fasciitis - answersevere pain and skin changes outside the realm of cellulitis
- including bullae and deeper discoloration
tx: aggressive surgical debridement w/in 12 hrs
Pt on amiodarone
what hormone should be monitored? - answerTSH
f/u q6 months
radial head subluxation or nursemaid's elbow - answercaused when picking up a toddler
by the arm
partial displacement of radial head when child's arm undergoes axial traction while in a
protonated and fully ext position
tx: reduction of radial head - child's elbow is in 90 deg flexion > hand fully supinated >
elbow brought into full flexion
inhaled corticosteroid use in kids - answerhas not been proven to prematurely close
growth plates
most effective tx for mod persistent asthma w/ least SEs
1st line tx for primary dysmenorrhea - answerNSAIDs
started at onset of menses and cont for first 1-2 days
1 cm nodule in left lobe of thyroid; confirmed by US
,next step in evaluation? - answerTSH level
followed w/ radionuclide thyroid scan if results abnormal
anti-epileptic med that has the SE of SJS - answerlamotrigine
should start at 25 mg qd and titrated q2 wks until goal dosage is reached
CDC guidelines on "outbreaks" - answeroccurence of 2+ lab-confirmed cases of
influenza A = outbreak in long-term care facility
chemoppx w/ appropriate meds for all residents who are asymptomatic and tx those
who are symptomatic regardless of lab confirmation or vaccination status
where to find the strongest evidence for tx, screening, or prevention strategies? -
answersystematic reviews
meta-analyses
RCTs w/ consistent findings or single high-quality RCT
2 day old infant has flesh-colored papules w/ erythematous base
on face and trunk
contain eosinophils
dx? tx? - answererythema toxic neonatorum
happens usually first 2 wks of life
no tx necessary
asymptotic microscopic hematuria measurement? - answer>3 RBCs/hpf
terminally ill pt
new symptom of resp distress
Pox 94% on room air
lungs clear to auscultation
tx? - answeropiates
w/o hypoxia - O2 won't be helpful
abd pain
bloody diarrhea
CV risk factors - hx of vascular dementia, peripheral artery dz, HTN, and HLD
nasogastric aspirate neg for bleeding (r/o PUD)
most likely cause of bleeding? - answerischemic colitis
also associated w/ fever
SEs of inhaled corticosteroids - answerinc risk of brusing
candidiasis infection of oropharynx
PNA
inc bone less and fxs
screening for depression - answerstart w/ PHQ-2 - freq of depressed mood and
anhedonia (lost interest) over past 2 wks
, f/u w/ PHQ-9
"growing pains" - answerbenign nocturnal limb pains of childhood
crampy pains in thigh, calf, or shin
kids 4-6 yo; can occur up to 19 yo
tx: supportive care and OTC analgesics if necessary
initial tx of high BP - answerACEi
ARBs
CCB
thiazides
note that BB are not first line
polymyalgia rheumatica - answerseen in elderly pts (rarely seen before 50 yo)
MSK complaints: pain, stiffness, tenderness, dec ROM
labs: inc CRP and ESR
most pts will also have systemic symptoms - fatigue, weight loss, low-grade fever,
decline in appetite, and depression
tx response to 15 mg prednisone is dramatic - w/in 24-48 hrs
pt wants a procedure that it against your moral principles (ex: abortion)
what do you do? - answerphysicians have the responsibility to provide resources on
how to access a safe and legal procedure
severe diabetic ulcer w/ signs of systemic inflammatory response
which IV antibiotics? - answerpiperacillin/tazobactam (Zosyn) and vanc (Vancocin)
mod to severe diabetic foot ulcers - often polymicrobial and include gram+ cocci, gram-
bacilli, and anaerobes
pt euvolemic but have hyponatremia, dec serum osmolality, inc urine osmolality
what drugs can cause this? - answerSIADH
meds: SSRIs (esp in pts > 65 yo), chlorpropamide, barbs, carbamazepine, opioids,
tolbutamide, vincristine, diuretics, and NSAIDs
MC cause of unintentional deaths in kids? - answerMVA
PFT results: FVC <80% of predicted, FEV1/FVC 90% of predicted, no improvement w/
bronchodilator use
DLCO low
most likely the problem? - answeridiopathic pulmonary fibrosis
PFT results suggest restrictive pattern
acute, sharp chest pain relieved by leaning forward
pericardial friction rub
EKG: diffuse ST elections
echo: small pericardial effusion
how to differentiate between chlamydial and RSV infections - answer chlamydia: hx of
conjunctivitis, subacute onset, absence of fever, mild wheezing
meds for BPH and lower urinary tract symptoms - answer alpha blocker, 5-a-reductase
inhibitor (if there's evidence of prostatic enlargement or PSA > 1.5 ng/mL),
phosphodiesterase-5 inhibitor, and antimusc therapy
tx for mallet fracture - forced flexion injury of DIP resulting in a small bone fragment at
dorsal surface of proximal distal phalanx - answer splinting the DIP in extension
duration of 8 wks
if fx involves > 30% of intra-articular surface - referral to specialist
tx for acute depression and maintenance therapy of bipolar disorders - answerLi
valproate
lamotrigine
some antipsychotics (including quetiapine)
necrotizing fasciitis - answersevere pain and skin changes outside the realm of cellulitis
- including bullae and deeper discoloration
tx: aggressive surgical debridement w/in 12 hrs
Pt on amiodarone
what hormone should be monitored? - answerTSH
f/u q6 months
radial head subluxation or nursemaid's elbow - answercaused when picking up a toddler
by the arm
partial displacement of radial head when child's arm undergoes axial traction while in a
protonated and fully ext position
tx: reduction of radial head - child's elbow is in 90 deg flexion > hand fully supinated >
elbow brought into full flexion
inhaled corticosteroid use in kids - answerhas not been proven to prematurely close
growth plates
most effective tx for mod persistent asthma w/ least SEs
1st line tx for primary dysmenorrhea - answerNSAIDs
started at onset of menses and cont for first 1-2 days
1 cm nodule in left lobe of thyroid; confirmed by US
,next step in evaluation? - answerTSH level
followed w/ radionuclide thyroid scan if results abnormal
anti-epileptic med that has the SE of SJS - answerlamotrigine
should start at 25 mg qd and titrated q2 wks until goal dosage is reached
CDC guidelines on "outbreaks" - answeroccurence of 2+ lab-confirmed cases of
influenza A = outbreak in long-term care facility
chemoppx w/ appropriate meds for all residents who are asymptomatic and tx those
who are symptomatic regardless of lab confirmation or vaccination status
where to find the strongest evidence for tx, screening, or prevention strategies? -
answersystematic reviews
meta-analyses
RCTs w/ consistent findings or single high-quality RCT
2 day old infant has flesh-colored papules w/ erythematous base
on face and trunk
contain eosinophils
dx? tx? - answererythema toxic neonatorum
happens usually first 2 wks of life
no tx necessary
asymptotic microscopic hematuria measurement? - answer>3 RBCs/hpf
terminally ill pt
new symptom of resp distress
Pox 94% on room air
lungs clear to auscultation
tx? - answeropiates
w/o hypoxia - O2 won't be helpful
abd pain
bloody diarrhea
CV risk factors - hx of vascular dementia, peripheral artery dz, HTN, and HLD
nasogastric aspirate neg for bleeding (r/o PUD)
most likely cause of bleeding? - answerischemic colitis
also associated w/ fever
SEs of inhaled corticosteroids - answerinc risk of brusing
candidiasis infection of oropharynx
PNA
inc bone less and fxs
screening for depression - answerstart w/ PHQ-2 - freq of depressed mood and
anhedonia (lost interest) over past 2 wks
, f/u w/ PHQ-9
"growing pains" - answerbenign nocturnal limb pains of childhood
crampy pains in thigh, calf, or shin
kids 4-6 yo; can occur up to 19 yo
tx: supportive care and OTC analgesics if necessary
initial tx of high BP - answerACEi
ARBs
CCB
thiazides
note that BB are not first line
polymyalgia rheumatica - answerseen in elderly pts (rarely seen before 50 yo)
MSK complaints: pain, stiffness, tenderness, dec ROM
labs: inc CRP and ESR
most pts will also have systemic symptoms - fatigue, weight loss, low-grade fever,
decline in appetite, and depression
tx response to 15 mg prednisone is dramatic - w/in 24-48 hrs
pt wants a procedure that it against your moral principles (ex: abortion)
what do you do? - answerphysicians have the responsibility to provide resources on
how to access a safe and legal procedure
severe diabetic ulcer w/ signs of systemic inflammatory response
which IV antibiotics? - answerpiperacillin/tazobactam (Zosyn) and vanc (Vancocin)
mod to severe diabetic foot ulcers - often polymicrobial and include gram+ cocci, gram-
bacilli, and anaerobes
pt euvolemic but have hyponatremia, dec serum osmolality, inc urine osmolality
what drugs can cause this? - answerSIADH
meds: SSRIs (esp in pts > 65 yo), chlorpropamide, barbs, carbamazepine, opioids,
tolbutamide, vincristine, diuretics, and NSAIDs
MC cause of unintentional deaths in kids? - answerMVA
PFT results: FVC <80% of predicted, FEV1/FVC 90% of predicted, no improvement w/
bronchodilator use
DLCO low
most likely the problem? - answeridiopathic pulmonary fibrosis
PFT results suggest restrictive pattern
acute, sharp chest pain relieved by leaning forward
pericardial friction rub
EKG: diffuse ST elections
echo: small pericardial effusion
