AAFP Family Medicine Form 165 Exam
With Actual 120 Questions & Verified
Answers,Plus Rationales/Expert
Verified For Guaranteed Pass Graded
A+/ 2025/2026 /Latest Update/Instant
Download Pdf
1. A 45-year-old man presents for routine screening. He has no significant past medical
history. Which of the following is the most appropriate screening test for colorectal
cancer in this patient?
A. Fecal occult blood test annually
B. Colonoscopy every 10 years
C. Flexible sigmoidoscopy every 5 years
D. CT colonography every 3 years
Answer: B. Colonoscopy every 10 years
Rationale: For average-risk adults aged 45–75, colonoscopy every 10 years is recommended.
Alternative options include annual fecal occult blood test or flexible sigmoidoscopy every 5
years, but colonoscopy is the preferred method for comprehensive evaluation.
2. A 32-year-old woman presents with a 2-day history of dysuria and frequency. Urine
dipstick shows positive nitrites and leukocyte esterase. What is the most appropriate
next step?
A. Urine culture
B. Empiric antibiotics
C. Pelvic ultrasound
D. Cystoscopy
Answer: B. Empiric antibiotics
Rationale: In an otherwise healthy non-pregnant woman with classic symptoms of a urinary
tract infection, empiric antibiotics can be started without urine culture.
3. A 60-year-old man with hypertension presents with new-onset left-sided weakness.
CT scan of the head shows an ischemic stroke. Which medication is indicated for
, secondary prevention?
A. Aspirin
B. Warfarin
C. Clopidogrel
D. Heparin
Answer: A. Aspirin
Rationale: Aspirin is recommended for secondary prevention of ischemic stroke unless there
is a specific indication for anticoagulation (e.g., atrial fibrillation).
4. A 28-year-old woman presents with fatigue, cold intolerance, and constipation. Lab
results show TSH 8.5 mIU/L (high), free T4 low. What is the most likely diagnosis?
A. Hyperthyroidism
B. Hypothyroidism
C. Subclinical hypothyroidism
D. Thyroid cancer
Answer: B. Hypothyroidism
Rationale: Elevated TSH and low free T4 indicate primary hypothyroidism. Subclinical
hypothyroidism usually presents with elevated TSH and normal T4.
5. A 55-year-old man with type 2 diabetes presents for routine follow-up. His HbA1c is
8.2%. What is the first-line treatment adjustment?
A. Add insulin immediately
B. Increase lifestyle modification only
C. Intensify oral hypoglycemic therapy
D. Switch to sulfonylurea monotherapy
Answer: C. Intensify oral hypoglycemic therapy
Rationale: For patients not at goal on current therapy, intensifying treatment (adding
another oral agent or GLP-1 receptor agonist) is appropriate before starting insulin.
6. A 7-year-old boy presents with sore throat, fever, and tender anterior cervical
lymphadenopathy. Rapid strep test is positive. What is the treatment of choice?
A. Azithromycin
B. Penicillin
C. Amoxicillin-clavulanate
D. Ciprofloxacin
Answer: B. Penicillin
Rationale: Penicillin is first-line treatment for group A streptococcal pharyngitis in children.
7. A 68-year-old woman presents with shortness of breath on exertion. Physical exam
reveals bibasilar crackles and an S3 gallop. Echocardiogram shows ejection fraction
35%. Which medication class improves mortality in this patient?
, A. Calcium channel blockers
B. Beta-blockers
C. Loop diuretics
D. Digoxin
Answer: B. Beta-blockers
Rationale: Beta-blockers (e.g., carvedilol, metoprolol succinate) improve survival in patients
with heart failure with reduced ejection fraction.
8. A 25-year-old woman presents with primary dysmenorrhea. First-line treatment
includes:
A. Oral contraceptives or NSAIDs
B. Hormonal IUD only
C. Surgery
D. Acupuncture
Answer: A. Oral contraceptives or NSAIDs
Rationale: NSAIDs and combined oral contraceptives are first-line for managing primary
dysmenorrhea.
9. A 50-year-old man presents for routine health maintenance. He has a 30-pack-year
smoking history. Which screening test is recommended?
A. Chest X-ray
B. Low-dose CT scan
C. Sputum cytology
D. PET scan
Answer: B. Low-dose CT scan
Rationale: Annual low-dose CT is recommended for adults aged 50–80 with ≥20-pack-year
smoking history.
10. A 38-year-old woman presents with fatigue and pallor. Labs show microcytic anemia
with low ferritin. What is the most likely cause?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Anemia of chronic disease
D. Thalassemia
Answer: B. Iron deficiency anemia
Rationale: Microcytic anemia with low ferritin is most consistent with iron deficiency anemia.
11. A 65-year-old man presents for routine screening. He has a history of hypertension
but is otherwise healthy. Which vaccine is recommended at this age?
A. Tdap once
B. Zoster recombinant vaccine
With Actual 120 Questions & Verified
Answers,Plus Rationales/Expert
Verified For Guaranteed Pass Graded
A+/ 2025/2026 /Latest Update/Instant
Download Pdf
1. A 45-year-old man presents for routine screening. He has no significant past medical
history. Which of the following is the most appropriate screening test for colorectal
cancer in this patient?
A. Fecal occult blood test annually
B. Colonoscopy every 10 years
C. Flexible sigmoidoscopy every 5 years
D. CT colonography every 3 years
Answer: B. Colonoscopy every 10 years
Rationale: For average-risk adults aged 45–75, colonoscopy every 10 years is recommended.
Alternative options include annual fecal occult blood test or flexible sigmoidoscopy every 5
years, but colonoscopy is the preferred method for comprehensive evaluation.
2. A 32-year-old woman presents with a 2-day history of dysuria and frequency. Urine
dipstick shows positive nitrites and leukocyte esterase. What is the most appropriate
next step?
A. Urine culture
B. Empiric antibiotics
C. Pelvic ultrasound
D. Cystoscopy
Answer: B. Empiric antibiotics
Rationale: In an otherwise healthy non-pregnant woman with classic symptoms of a urinary
tract infection, empiric antibiotics can be started without urine culture.
3. A 60-year-old man with hypertension presents with new-onset left-sided weakness.
CT scan of the head shows an ischemic stroke. Which medication is indicated for
, secondary prevention?
A. Aspirin
B. Warfarin
C. Clopidogrel
D. Heparin
Answer: A. Aspirin
Rationale: Aspirin is recommended for secondary prevention of ischemic stroke unless there
is a specific indication for anticoagulation (e.g., atrial fibrillation).
4. A 28-year-old woman presents with fatigue, cold intolerance, and constipation. Lab
results show TSH 8.5 mIU/L (high), free T4 low. What is the most likely diagnosis?
A. Hyperthyroidism
B. Hypothyroidism
C. Subclinical hypothyroidism
D. Thyroid cancer
Answer: B. Hypothyroidism
Rationale: Elevated TSH and low free T4 indicate primary hypothyroidism. Subclinical
hypothyroidism usually presents with elevated TSH and normal T4.
5. A 55-year-old man with type 2 diabetes presents for routine follow-up. His HbA1c is
8.2%. What is the first-line treatment adjustment?
A. Add insulin immediately
B. Increase lifestyle modification only
C. Intensify oral hypoglycemic therapy
D. Switch to sulfonylurea monotherapy
Answer: C. Intensify oral hypoglycemic therapy
Rationale: For patients not at goal on current therapy, intensifying treatment (adding
another oral agent or GLP-1 receptor agonist) is appropriate before starting insulin.
6. A 7-year-old boy presents with sore throat, fever, and tender anterior cervical
lymphadenopathy. Rapid strep test is positive. What is the treatment of choice?
A. Azithromycin
B. Penicillin
C. Amoxicillin-clavulanate
D. Ciprofloxacin
Answer: B. Penicillin
Rationale: Penicillin is first-line treatment for group A streptococcal pharyngitis in children.
7. A 68-year-old woman presents with shortness of breath on exertion. Physical exam
reveals bibasilar crackles and an S3 gallop. Echocardiogram shows ejection fraction
35%. Which medication class improves mortality in this patient?
, A. Calcium channel blockers
B. Beta-blockers
C. Loop diuretics
D. Digoxin
Answer: B. Beta-blockers
Rationale: Beta-blockers (e.g., carvedilol, metoprolol succinate) improve survival in patients
with heart failure with reduced ejection fraction.
8. A 25-year-old woman presents with primary dysmenorrhea. First-line treatment
includes:
A. Oral contraceptives or NSAIDs
B. Hormonal IUD only
C. Surgery
D. Acupuncture
Answer: A. Oral contraceptives or NSAIDs
Rationale: NSAIDs and combined oral contraceptives are first-line for managing primary
dysmenorrhea.
9. A 50-year-old man presents for routine health maintenance. He has a 30-pack-year
smoking history. Which screening test is recommended?
A. Chest X-ray
B. Low-dose CT scan
C. Sputum cytology
D. PET scan
Answer: B. Low-dose CT scan
Rationale: Annual low-dose CT is recommended for adults aged 50–80 with ≥20-pack-year
smoking history.
10. A 38-year-old woman presents with fatigue and pallor. Labs show microcytic anemia
with low ferritin. What is the most likely cause?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Anemia of chronic disease
D. Thalassemia
Answer: B. Iron deficiency anemia
Rationale: Microcytic anemia with low ferritin is most consistent with iron deficiency anemia.
11. A 65-year-old man presents for routine screening. He has a history of hypertension
but is otherwise healthy. Which vaccine is recommended at this age?
A. Tdap once
B. Zoster recombinant vaccine
