AAFP BOARD REVIEW EXAM 100% VERIFIED ANSWERS UPDATE 2024/2025, Study Guides, Projects, Research of Health sciences

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AAFP BOARD REVIEW EXAM 100% VERIFIED ANSWERS UPDATE 2024/2025 Which one of the following statements is TRUE regarding the use of antidepressants for smoking cessation? - Bupropion is contraindicated in a patient with an eating disorder The number 1 cause of preventable morbidity and mortality in the US today is which of the following? - Tobacco Which of the following statements is true regarding alcohol abuse counseling? - The USPSTF recommends screening and counseling adults the risks of alcohol misuse Which immunization would be considered safe to administer during pregnancy? - Tdap Self-help measures recommended for patients with NYHA class 2 HF is on optimal medications include which one of the following? - Avoiding NSAID use How much daily vitamin D supplementation do infants need during the first month of life? - Breastfed infants should have 400 IU of Vitamin D Following a scheduled repeat C-section delivery, a term infant has a respiratory rate >60. What is the most common cause of this presentation? - Transient tachypnea of the newborn Breastfeeding jaundice is characterized by - insufficient feeds What advice would you give parents to reduce the risk of death from sudden infant death syndrome (SIDS) in their infant? - Avoid exposure of the infant to second-hand smoke The majority of failure to thrive cases in infants is due to - inadequate caloric intake What will Medicare cover for an elderly couple asks you how they will pay to live in facility. Which of the following is NOT true? - Medicare will pay once a medical need for services is clearly documented The largest portion of the Medicare budget is spent on - the 20% of Medicare recipients with five or more chronic diseases Patient on meds including risperdone, metoclopramide, and valproate presents with Parkinson's symptoms (trouble standing, walking then freezing, flat affect), so your next step is - stop his risperdone, metoclopramide, and valproate Patient with Parkinson's doing well on carbidopa/levodopa therapy, but worried about dyskinesia. Which would be a good choice to decrease long term effects of this? - Dopamine agonist, such as ropinirole Elderly patient develops C. Diff, so your next step is - begin PO vancomycin 125mg QID 76 yo M with memory not good as it used to be. Difficulty remember discussions from earlier, but still paying bills and doing puzzles. What is your diagnosis? - mild neurocognitive disorder 80 yo M with unsteady gait, 2 falls. Uses walker. Speech diminished in volume, less distinct. Flat affect. Hypertensive, diabetic, smoker. Asymmetric reflexes, 1/5 on Mini- Cog Test, right group weak, muscle tone increased. This patient most likely has which type of dementia? - vascular Which of the following is proven to be protective against Dementia? - educational attainment 81 yo F with advanced dementia who is hoarding food, making sexual inappropriate remarks, walking out of room in underwear only. What can you do to help? - offer to help the staff find ways to manage the behaviors non-pharmacologically A 14-day-old infant is brought to your office for a routine visit. The rectal temperature is 100.8ºF. The infant appears well and parents have zero concerns. What should you do? - admit and do inpatient sepsis workup A 3-year-old girl presents with 4-day history of fever without other symptoms. Ears, throat, lungs and abdominal exams are normal, but she appears lethargic. What should be your next step? - order urinalysis with cultures A 16-year-old female patient is evaluated for a 4-day history of sore throat, nonproductive cough and rhinorrhea. She is afebrile, and exam reveals enlarged erythematous tonsils without exudate, and no lymphadenopathy. What is the next step? - supportive care A 2-year-old child is brought to the emergency department with a barking cough, stridor that worsened tonight, and a temperature of 101º F. What is the treatment? - nebulized epinephrine and dexamethasone A 9-month-old child is admitted in Jan. for cough, wheezing, feeding, and fever of 38ºC. CXR shows mild peribronchial cuffing. Which treatment is indicated? - supplemental O2 and fluids A 2-year-old boy has very red cheeks and a fine rash but does not appear ill. He had a fever a couple of days ago. When can he return to day care? - today A 5-year-old male has 7 days of spiking high fevers and a diffuse erythematous rash. His tongue and lips are red, dry, and cracked, and he has large cervical lymph nodes. In addition to rehydration, what are the next treatment steps? - inpatient immune globulin and high-dose aspirin 3 yo M walking home with mom and cries of pain when elbow is moved and keeping it to left side. Negative x-rays. Using an evidence-based approach to your patient, what would be the best treatment? - hyperpronation of the forearm A 44 yo female tripped and fell on the ice on an outstretched left hand [FOOSH]. She presents with this radiograph showing distal radial fracture. What is the most commonly injured nerve in this injury? - median nerve A 36 yo female presents to your office and reports that she fell on an outstretched left hand [FOOSH] 3 days ago and presents with left wrist pain, minor swelling, and this radiograph showing a scaphoid fracture. What is the best treatment option? - thumb spica cast for 8 weeks Football player injured ring finger after grabbing the jersey of another place and feeling pain in the distal aspect of the affected finger. Can't flex DIP joint and small bony fragment seen at solar surface of the proximal distal phalanx. Which one of the following would be the most appropriate management? - referral to hand surgeon Volleyball player who jammed his left 5th finger with full passive ROM but not active extension of the distal phalanx. Normal hand x-ray. Which of the following is the most appropriate treatment? - immobilization of the DIPJ in extension for 6-8 weeks 74 yo F with HTN, osteoporosis, and arthritis has had increased back pain over 2 months. Radiograph shows vertebral compression fracture. Which statement is correct? - she has an increased mortality rate of 15% over those without this condition 72 yo M with left hip pain has pain with ambulation after fall. Wants to be non- weightbearing. What is your diagnosis? - left hip fracture Which of the following is NOT a factor in the Ottawa Ankle Rules? - discrete bony tenderness at the anterior distal fibula Examination findings of a 17 yo male athlete with near syncope and suspicion for hypertrophic cardiomyopathy would include the following finding: - a crescendo- decrescendo systolic murmur at the left sternal border that increases with valsalva The defining characteristic distinguishing between heat exhaustion and heat stroke is which of the following? - mental status changes Which of the following statements is true regarding sports related concussion? - physical rest is recommended during the first 24-48 hours post-concussion You have been invited to present a grand rounds lecture on "Sports Injuries in High School Athletes." Which of the following statements would you include in your talk? - football has the highest injury rate Which physical exam test is the most sensitive maneuver for the corresponding knee injury? - Thessaly test- meniscal tear Which one of the following statements is true regarding ACL injuries? - in high school sports, football has the highest rate of ACL injury A 26 yo male suffers an inversion ankle injury and ambulates to the ED for evaluation. You find lateral ankle swelling and tenderness over the anterior distal fibula. The next best course of action includes - recommendation for early range of motion for the ankle Which of the following pharmacokinetic factors changes least with age? - absorption An 80 yo hypertensive woman is switched from atenolol to propranolol to treat tremor. A week later she seems more bradycardic, confused, and despondent. The most likely cause is: - lipophila of propranolol An 84 yo man has been less alert and his balance is deteriorating. He was taking 5 mg of diazepam twice a day and agrees to stop. One week later, he's no better. Three weeks later he's improved. The most likely explanation is: - active drug metabolites Which pharmacokinetic factor changes the most with age? - elimination An 80 yo on warfarin has an INR of 2.5. The best explanation for increased bleeding risk compared with a younger patient is - pharmacodynamic differences 75 yo female is following up for recent L femur fracture. Which long term medicine most likely contributed to her osteoporosis? - pantoprazole 92 yo has T2DM with A1c of 7.1 and taking metformin, jardiance, and glimiperide. Regarding his A1C, you counsel that - he should discontinue his glimiperide Which medicine is best to stop to improve cognition and falls? - amitriptyline 25mg PO qHS Which of the following statements is true regarding congenital pediatric musculoskeletal conditions? - Duchenne's muscular dystrophy is more common in males Which of the following statements is true regarding bone tumors in the pediatric & adolescent population? - non-ossifying fibromas resolve with skeletal maturity 6 yo F has been more clumsy and falling more. Patellae and toes point inward. Normal neuro exam. What is the most likely diagnosis? - femoral anteversion 12 yo M with limp for the past 3 days. Antalgic gait, overweight, and painful right hip with ROM. No trauma. Radiographs are normal. What is your presumptive diagnosis? - slipped capital femoral epiphysis 3 yo M with Hb SS disease and taking penicillin daily. Parents want to know if he should continue. You should recommend: - Take penicillin V 250mg PO BID until age 5 at least 65 yo M with seizure that included stiffness and taking all over, urine incontinence, and had post ictal symptoms. His seizure would be classified as - generalized tonic clonic The most likely cause of a new seizure in a patient >65 years old would be - cerebrovascular disease/stroke A patient with a new onset seizure has a complete workup that is unremarkable for any provoked causes, signs of infection, drug toxicities, or neurological disease. The next step in the workup for this patient would be: - neuroimaging (CT/MRI) A patient presents to you having had a single new unprovoked seizure with negative workup. Your first step in treatment would be - start no medications at this time 46 yo M with fever, arthralgia, and erythoderma with fever, elevated WBC, eosinophils and abnormal LFTS. The most likely diagnosis is - DRESS syndrome 46 yo M smoker with unilateral, cyclical, nocturnal headaches for 30min. The best prophylactic medication for his headaches would be - verapamil Because of the prevalence and its lethality, the USPSTF recommends that ultrasound screening be performed in which patients? - one time screening for men ages 65-75 who have ever smoked You identified an abdominal aortic aneurysm (AAA) in your patient. At what size (in centimeters) should you refer your patient for surgical intervention? - 5-5.5cm A 68 yo male presents with complaints of an aching pain in both thighs when he walks about one block. The pain subsides within about 1-2 minutes after he stops ambulating. The best initial test in this case is to see if there is decreased blood flow - perform an ankle-brachial index (ABI) When obtaining an ABI, AHA/ACC recommends obtaining the brachial (arm) systolic BP in both arms and using the higher of the 2 readings. However, if a difference in systolic BP > 20 mm between the arms, the most likely diagnosis is? - subclavian artery stenosis 72 yo F with sudden severe R leg pain in the setting of tachycardia and irregular heart rhythm. Leg is cool to touch, pale in color, and no pulses. At this point, you should - start heparin and immediately consult vascular surgeon 76 yo M with Hx of HTN, HLD, and smoking presents with with blue painful toes in the setting of intact pulses. The most likely diagnosis is - Blue toe syndrome 34 yo F with SLE has acute pain, rubber, calor, and swelling of the left knee. No trauma and is on hydroxychloroquine and prednisone. SLE symptoms are well controlled . The most likely cause of this patient's knee pain is - infectious arthritis 59 yo F with fatigue, weight loss, and morning stiffness in bilateral hands that lasts more than 1 hour. Increased tenderness in bilateral MCPs and DIPs bilaterally. Which of the following is the most specific to the diagnosis of this inflammatory process? - rheumatoid joint erosion When using the Joint Score Classification, which of the following does not contribute toward a diagnosis of RA? - duration of symptoms less than 6 weeks After diagnosing RA, when should disease modulating anti-rheumatic drugs (DMARDs) be initiated? - promptly upon making the diagnosis 35 yo M with 3 month history of asymmetric poly arthritis noted in 6 separate joints and pitting of fingernails along with scaly, silver rash noted on both elbows. Which tx has been shown to delay further progression of this patient's joint erosion? - etanercept 80 yo right handed man who previously pained with chronic, right, dull hand pain, DIP and PIP are tender and swollen but not MCPs. Which of the following is NOT consistent with this diagnosis? - MCP inflammation 53 yo M with hx of renal stones and now very painful left great toe and heel that started last night. No systemic symptoms. Which diagnostic feature is most specific to this inflammatory disorder? - negatively birefringent crystals in tissues Acute stroke events are most often the result of which of the following pathological process? - acute thrombosis An 82 yo male developed sudden dysarthria and RUE weakness. Onset at 8am. He arrives at the ED at 11 am. IV is inserted, labs sent. Which of the following imaging studies should be ordered STAT? - non-contrast head CT An 82 yo male developed sudden dysarthria and RUE weakness. Onset at 8am. He arrives at the ED at 11 am. BP= 200/100; At 12 noon, the labs and head CT are reported as "normal." Your management will include ... ? - Do NOT start IV tPA or IV nicardipine, but do start aspirin 325mg TIA (Transient Ischemic Attack) is defined as - transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infection A 52 yo male presents with evolving symptoms of noctururia. He notes increase in dribbling following urination and less force of stream. Which of the following is the most appropriate first line agent of treatment? - terazosin 70 yo M with acute bacterial prostatitis. All of the following risk factors (history of BPH, Temp >100.4F, urinary retention, transurethral catheterization) increases the risk of a poor prognosis with ABP in his age group EXCEPT? - BMI>25 62 yo M with PMHx of HTN, OSA, BPH and erectile dysfunction has increased fatigue for 6 months. On physical exam has decreased muscle mass and thinning hair. What is the most appropriate next diagnostic step? - obtain an early morning testosterone 46 yo M with worsening erectile dysfunction. Normal AM testosterone level. BMI 32. Which of the following is the most appropriate therapy? - a phosphodiesterase inhibitor 49 yo F has hematuria and flank pain and found to have kidney stone on CT of abdomen/pelvis that she passes and was found to be calcium oxalate. Dietary recommendations would include - normal calcium diet A 55 yo M is noted to have incidental urolithiasis on plain films of the abdomen. He denies abdominal pain, nausea, vomiting and bowel changes. Abdominal examination is unremarkable. The most appropriate next step is? - watchful waiting A 10 yo male has a BMI of 21, which places him at the 92nd percentile. He would be considered - overweight A 23 yo M comes in for work physical. Labs significant for LDL 138, HDL 35, Trig 237 with BP 140/85 and waist is 47 inches .When you call with his lab results, you recommend - starting monthly visits for weight loss counseling A 27 yo female with a BMI of 39 requests help with a diet. You tell her - there is now weight loss diet that is better than the others 57 yo F with BMI 37 and lost 7 lbs over 6 months with intensive behavioral program. BP is 135/85 and A1c is 8. She is on sertraline for depression. Requesting weight loss medication. What would be the best choice? - liraglutide (saxenda) Which is the most common complication of bariatric surgery listed below? - cholelithiasis The USPSTF recommends screening for diabetes in which of the following groups? - all persons age 40-70 who are overweight 17 yo with neck swelling for 2-3 weeks, 5lb weight gain, and feeling more tired. Exam shows diffusely enlarged, smooth, and non-tender thyroid. What initial test would you order for this patient? - TSH 6 weeks after initiating therapy with levothyroxine, you check a steady-state TSH level. The TSH decreased from 9.3 to 7.21. All of the following factors are barriers to reaching How do you calculate the number needed to treat? - 1/absolute risk reduction Specificity is best described as the proportion of persons - without the condition who test negative SNOUT - SeNsitive test with a Negative result rules OUT the disease SPIN - Specific test with a Positive result rules IN the disease Which of the following is an indicated treatment for achalasia? - calcium channel blockers Which of the following diagnostic tests is recommended in the patient with GERD refractory to maximum PPI therapy? - 24 hour pH monitoring In discussing the initiation of a patient on a proton pump inhibitor (PPI), which of the following is a potential risk of therapy that should be reviewed with the patient? - increased his of Vitamin B12 deficiency Risk factors for esophageal intestinal metaplasia (Barrett's Esophagus) include which one of the following characteristics? - hiatal hernia 49 yo F with 4 weeks of epigastric pain that is worse within an hour of eating. No alarm symptoms or signs. She only uses tylenol periodically for headaches. Which of the following diagnostic tests would you recommend in your evaluation? - urea breath test In considering NSAID-induced ulcers, which of the following statements is true? - eradicating H. pylori in NSAID users reduces the likelihood of peptic ulcer by about one- half A 65-yo male smoker complains of dyspepsia, weight loss, early satiety, and occasional nausea and vomiting. Which one of the following would be the initial diagnostic method of choice? - upper GI endoscopy 42 yo F with PMHx of HTN that is refractory to 3 agents. Na 144, K 3.3, Cr 0.68. Which one of the following tests is most likely to reveal the cause of her refractory hypertension? - plasma aldosterone/renin ratio 54 yo hispanic woman with elevated BP and follows low salt diet and exercises. Which one of the following medications would be most appropriate for this patient? - chlorthalidone 54 yo M with PMHx of HTN that is resistant to medications (chlorthalidone, carvedilol, amlodipine, and lisinopril), normal labs. Which one of the following medication adjustments would be most appropriate to bring his blood pressure to goal? - add spironolactone 54 yo M with PMHx of type 2DM and HTN who has an increase in Cr after starting lisinopril after 1 week. What is the best approach in this situation? - continue lisinopril at the same dosage A 68-year-old man recently had a myocardial infarction. Which one of the following is recommended by the American Heart Association as a first-line agent for managing hypertension in patients with stable ischemic heart disease? - a beta blocker 20 yo college student with 3 year history of cramping, bloating abdominal pain and better with defecation. Bowel movements are firm and difficult to pass. Denies risk factors of alarm. Uses soluble fiber daily. Negative family history. Normal physical exam. Diagnose IBS. Which ONE of the following would be most appropriate at this time? - therapeutic trial of lubiprostone 19 yo F with intermittent abdominal cramping and bloating, diarrhea, fatigue, and weight loss. Initially diagnosed with IBS, but now concern for celiac disease. Which one of the following should be used to establish the diagnosis? - serologic testing initially, followed by endoscopy if test results are positive 32 yo M wants refill of sulfasalazine for ulcerative colitis that has been well controlled, and he hasn't seen an GI for years. Which one of the following is an appropriate management plan for this patient? - continue sulfasalazine and arrange for colonoscopy to screen for colorectal cancer Which of the following is the most common cause of infectious diarrhea in children both in developed and developing countries? - rotavirus 52 yo F with HTN has 2 day history of profuse bloody diarrhea, moderate to severe abdominal cramping, and fever. Recently came back from Singapore. Stool culture is positive for Campylobacter. Which one of the following is the treatment of choice? - azithromycin Of the following antibiotics, which is the agent recommended for treatment of pseudomembranous enterocolitis in an individual over the age of 60 with a temp of 38.7C and a wbc count of 19.8K? - vancomycin 54 yo M for health maintenance visit. For colon cancer screening, he wants to use fecal occult blood testing. You recommend he repeat this test at which one of the following intervals? - yearly One week after colonoscopy, a 51 yo F with no medical history comes to review pathology results. Solitary 8mm hyper plastic polyp was found. No family history of colon cancer. Which one of the following is the most appropriate interval for follow-up colonoscopy in this patient? - 10 years 86 yo F with SOB and productive cough, slightly tachypnic, and tachycardic but afebrile. Bilateral crackles on lung exam and bilateral fluffy infiltrates on CXR. Labs normal. EKG shows tachycardia. Which of the following tests would be best to determine whether she should be treated for pneumonia, heart failure, or both? - BNP and procalcitonin levels A 72 yo male has a new diagnosis of hypertensive cardiomyopathy with left ventricular ejection fraction of 30%. He has dyspnea at rest and with minimal exertion. Which one of the following drugs will reduce his mortality risk? - lisinopril 69 yo F with PMHx of HTN, previous MI, and EF 32%. She is breathless when walking upstairs. On atorvastatin, lisinopril, metoprolol succinate, furosemide, and aspirin. BP is well controlled. has bibasilar rales, trace pretibial edema. Adding which one of the following would help to decrease both mortality and risk of hospitalization? - spironolactone 62 yo man with HTN and HF has dyspnea on exertion on enalapril, carvedilol, spironolactone, and furosemide with normal BP and HR. EF 35% and BNP 250. Current American Heart Association guidelines recommend which of the following to further reduce morbidity and mortality? - stop enalapril and start sacubitril/valsartan (entresto) 40/51mg BID A 70-year-old man has a history of a myocardial infarction and now has heart failure with an EF of 30%. EKG: normal sinus rhythm. Which one of the following medications that he is currently taking is potentially harmful and should be discontinued? - diltiazem Given the rhythm strip of sinus brady with first degree AV block, which of the following drugs would be inappropriate to use in this patient? - cyanide 24 yo F has SVT. You try valsalva, and it doesn't work. Which of the following is the next best step in treatment? - IV adenosine 76 yo M with new atrial fibrillation but stable BP. History of COPD and uses albuterol and steroids. Scattered wheezes and rhonci on lung exam . Which one of the following would be the best choice to control his heart rate? - diltiazem A 32-year-old woman presents with dyspnea, palpitations and near-syncope. Her EKG shows rapid atrial fibrillation (150 bpm) with delta waves. Which of the following treatments is a Class I recommendation for acute treatment? - IV procainamide Nausea and vomiting in early pregnancy is very common. Although often called "morning sickness," it can any time of the day. Which one of the following is considered first-line pharmacotherapy? - Vitamin B6, 10-25mg PO in combination with Doxylamine, 12.5mg PO q6-8 hours You are reviewing the lab findings of a 64 yo male hospitalized with AKI, who has no h/o any long-term medication use. Renal function had been normal, but now the Cr = 2.8 mg/dL, BUN = 60 mg/dL. Urine sp gr = 1.025, and urine sediment shows only hyaline casts. His FENa = 0.75%. Based on these findings, which one of the following conditions is most likely? - hypovolemia due to vomiting Systemic manifestations of acute kidney injury include which of the following abnormalities? - metabolic acidosis In patients with AKI, urgent dialysis is not indicated in which of the following situations? - metabolic acidosis with pH=7.25 Which one of the following statements is true in ACEi? - ACE inhibitors dilate efferent arterioles 59 yo F postmenopausal and has painless vaginal bleeding. Paps have been normal and most recent was 1 year ago. Pelvis exam was normal. Which one of the following management options is the preferred next diagnostic step? - transvaginal ultrasound 33 yo F had pap that is negative for intraepithelial neoplasia, positive for HPV but negative for serotypes 16 and 18. Which one of the following is the most appropriate management for this patient? - repeat Pap and HPV testing in 12 months A 52 yo patient currently takes no prescribed or over-the-counter medications and declines estrogen replacement therapy. Which one of the following would be most effective for relieving this patient's menopausal symptoms? - venlafaxine 51 yo F with left breast mass. Had auto accident 5 years ago and first noticed it then. 1cm had mass in the upper outer quadrant of left breast that is mobile and contender. No overlying change in the skin, nipple discharge, or nipple retraction. Had negative screening mammogram 6 months ago. Which of the following is the first diagnostic imaging study that should be performed in evaluating this new palpable breast mass? - mammogram 32 yo breastfeeding F with redness over right breast and fever of 101F. Redness started 3 days ago and fever within the past 12 hours. Had c-section 14 days ago and was in hospital for 7 days after for endomyometritis. Has hard, red, tender, swollen area over right breast measuring 4 x 6cm with no axillary adenopathy . Which one of the following would be the most appropriate management option? - clindamycin According to ACOG, use of emergency contraception is recommended no longer than how many hours after inadequately protected or unprotected intercourse in women who do not desire pregnancy? - 120 hours Infertility is defined as an inability to conceive in what time period of attempted conception? - 12 months A couple with 12 months of infertility presents to the office for evaluation. A semen analysis is completed and found to be normal. What is the first step in evaluating the female? - progesterone level Stage 4 chronic kidney disease is defined as an estimated GFR of? - 15-29mL/min Nephrogenic systemic fibrosis most often occurs as the result of which of the following? - MRI with gadolinium contrast Which of the following statements are true about CKD and hypertension? - most patients with hypertension and elevated creatinine levels can be treated safely with ACEi or ARB Which of the following is true regarding anemia in CKD? - therapy with erythropoiesis- stimulating agents is associated with an increased risk of MI and thromboembolic events The most common acid base abnormality seen in patients with CKD is: - metabolic acidosis Which of the following patterns is commonly found in patients with CKD? - low Ca2+, high PO4, and high PTH Indications for nephrology referral in patients with CKD include which of the following? - GFR <30 mL/min 39 yo G2P2 who was seen 2 weeks ago with 13 months of infrequent periods (q 2-3 months). Non smoker. No meds. Breastfed children. Normal pelvic exam and pap with HPV testing. Urine pregnancy is negative. Serum TSH and prolactin are normal. Which one of the following is the best initial approach in this patient? - prescribe a 35 ug ethinyl estradiol combination oral contraceptive pill daily The onset of heavy menses at menarche is often the first sign of what disorder? - von Willebrand disease 36 yo G3P2A1 presents with 14 month history of amenorrhea, hot flashes, and vaginal dryness. Used to have normal menses. Negative urine pregnancy with normal TSH, prolactin levels but elevated LH and FSH levels. The most likely diagnosis is: - primary ovarian insufficiency A 22-year-old female presents with the complaints of irregular menses, increased facial hair, and acne. Your evaluation leads to the diagnosis of polycystic ovary syndrome. Which one of the following is the first-line treatment for her constellation of symptoms? - hormonal contraceptives A 55 yo postmenopausal woman presents with 2 days of vaginal bleeding (spotting). She initiated HT 10 months ago because of significant nocturnal hot flashes. Which of the following statements is most accurate? - postmenopausal women on hormone therapy for <12 months who experience bleeding may be observed for one year before diagnosing abnormal uterine bleeding Which of the following statements regarding pharmacotherapy in chronic pain is true? - non-pharmacologic therapy and non-opioid pharmacologic therapy are preferred for chronic pain Which of the following statements is true regarding topical analgesics? - topical analgesics are not typically associated with systemic side effect and drug interactions Which of the following statements regarding opioids is true? - treatment should begin with short-acting agents then titrated to optimal effect Which of the following statements regarding opioid prescribing is true? - when prescribing opioids for acute pain, more than 7 days supply will rarely be needed Which of the following is correct in pain management? - one should avoid prescribing opioids and benzodiazepines concurrently Which of the following is true with regard to screening for depression? - brief, 2-question screens for depression are equivalent to longer instruments Which of the following is true about depression and Persistent Depressive Disorder (dysthymia)? - depression is more common in medically ill patients Which of the following is true about treatments for depression? - memory loss caused by ECT is often short term and reversible Which class of antidepressant medication is generally avoided due to a potentially life- threatening side effect? - monoamine oxidase inhibitors (MAOIs) Which of the following is true of postpartum depression? - patients are predisposed by prior history of depression A 12 yo male is brought into the office for a well visit. His parents report he has nighttime cough and wheezing for the past several months. He is otherwise healthy and up-to-date on immunizations. Which one of the following would be most appropriate at this time? - perform spirometry When performing spirometry after the administration of a bronchodilator (adults), what percentage of airway reversibility and change in FEV1 is consistent with the diagnosis of asthma? - 12% and 200mL Which of the following would be consistent with a diagnosis of ADHD? - hyperactive- impulsive or inattentive symptoms causing impairment before 12 year of age A 27 yo male is diagnosed with ADHD. Which of the following will be most likely true in his case? - he is more likely to be inattentive than hyperactive Research has shown that the optimal treatment approach for children with ADHD is: - medication plus behavior modification A 13 yo female with a history of anorexia nervosa is diagnosed with ADHD, inattentive type. What is the most reasonable FDA-approved treatment option? - atomoxetine What are the current recommendations regarding adverse cardiac outcomes with ADHD medications? - laboratory testing prior to starting mediation is at the physician's discretion 22 yo G0 woman with 2 days of vaginal discharge. Cervix appears reddened almost strawberry texture. Generous amount of yellowish, malodorous leukorrhea, but not pus at the os. Of the following, which is the most likely diagnosis? - trichomonas vaginalis infection Trichomonas vaginal infection is best treated with which of the following agents? - metronidazole 2g PO in a single dose 39 yo F with uncontrolled diabetes with 8 day history of thick white vaginal discharge and vulvar itching. Had tried 7 day OTC for yeast infection, but only did 5 days of it. Has extensive vulvar erythema, excoriations, and edema with thick, curd-like white discharge at the introits with the vagina being erythematous. KOH prep shows budding yeast and hyphae. Which of the following medications would be the most appropriate treatment for this condition? - Fluconazole 150mg PO in two doses that are 72 hours apart A 22 yo sexually active female comes to your office for a Pap test and STI screening. Her Pap test is normal, but she tests positive for gonorrhea. Chlamydia testing is negative. Which one of the following is the recommended treatment? - ceftriaxone 500mg IM as a single dose A 21 yo female had a pelvic examination and a normal Pap test 1 week ago. Her screening test for Chlamydia returned positive. She is now being treated for chlamydia cervicitis with Doxycycline 100 mg BID for seven days. When should she have a test of cure for Chlamydia? - no test of cure is required According to the CDC 2015, screening for syphilis should be undertaken by which one of the following tests? - nontreponemal serology (RPR) 35 yo M with parents born in southeast asia, but he was born in the US. No vaccine records. Has a relative that is positive for Hep B. According to the USPSTF, which one of the following screening recommendations is appropriate for this patient? - screen for HBV infection because he is at high risk