Exam (elaborations)
Fam Med NBME Form 2 Exam Questions and Answers
Fam Med NBME Form 2 Exam Questions and Answers
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Fam Med NBME Form 2 Exam Questions
and Answers
42 iiyo ii- iirecent iihigh iiBP iireadings
past iimonth: iiBP ii- ii150/94 iimmHg iion ii2 iioccasions iiat iihealth iifairs
PMHx: iimigraines ii2x/wk iifor iilast ii6 iimonths ii- iitx iiibuprofen ii4-6x/wk
BP: ii152/92 iimmHg
pt iishould iidiscontinue iiibuprofen iiand iitake iiwhat iiapp iipharmacotherapy? ii- iiAnswers ii-
B-adrenergic iiblocking iiagent
pt iishould iistop iitaking iiibuprofen iibc iithe iihigh iiBP iimight iibe iiwhat iiis iicausing iiher
iimigraines ii
BBs iiand iiACEi ii- iidec iimortality iiand iimorbidity ii
propranolol, iitimolol, iinadolol, iiand iimetoprolol ii- iican iibe iiused iifor iimigraine iiprevention
iias iiwell
62 iiyo ii- ii9 iimonths iiof iipain/swelling iiof iifinger iijoints
pain iiinc iiw/ iiactivity ii
prog iistiffness iiin iifingers iifor iilast ii2 iiyrs
PMHx: iimild iiHTN ii- iitx iiw/ iidiet
no iimeds
BP: ii138/90 iimmHg
PE: iiasymmetric iidistribution iiof iienlarged iibony iiPIP iiand iiDIP iijoints; iisome iitender;
iipassive iiROM iilimited iiby iipain; iigrip iistrength iinormal
most iiapp iiinitial iistep iiin iimgnt iiis iiadministration iiof? ii- iiAnswers ii-acetaminophen
1st iiline iifor iiacute iidz: iianti-inf iimeds ii(NSAIDs ii> iiacetaminophen iitho)
to iireduce iijoint iidamage/disability ii- iiDMARDs iiadded iiearly ii(no iilater iithan ii6 iimonths
iifrom iionset iiof iisymptoms)
> iimethotrexate ii- ii1st iiline
> iisulfasalazine iior iihydroxychloroquine ii- iipts iiw/ iimilder iiforms iiof iiRA
> iiothers: iigold iisalts, iiD-penicillamine, iiand iiazathioprine ii
- iicorticosteroids ii
- iinewer iioption: iilefunomide ii(inhibits iipyrimidine iisynthesis) ii
- iiTNF iireceptor iiblockers
42 iiyo ii- ii2 iiyrs iiof iimild iiHTN iitx iiw/ iiNa iirestriction iiand iireduced-cal iidiet ii
4.4 iilb iiweight iiloss ii
FHx: iidad ii- iicerebral iiinfarction iiat ii55 iiyo
SHx: iino iicigs; iidrinks ii2 iiglasses iiof iiwine iiqNight; iiaccountant; iidoesn't iiexercise
iiregularly
BMI: ii39
BP: ii160/98 iimmHg ii
,lipids: iitotal iichol ii228, iiHDL ii45, iiLDL ii148 ii
strongest iipredisposing iifactor iifor iicerebral iiinfarction iiin iithis iipt? ii- iiAnswers ii-
hypertension
*HYPERTENSION iiIS iiTHE iiSINGLE iiMOST iiIMPORTANT iiRISK iiFACTOR iiFOR
iiSTROKE*
other iirisk iifactors: iiDM, iimale, iiolder iiage, iiFHx, iidyslipidemia, iismoking
42 iiyo ii- iipersistent iiR.heel iipain ii
began ii3 iiwks iiago ii- iitook ii5 iimile iiwalk ii
tx iiw/ iinaproxen, iiheel iicushion, iiand iiexercises ii- iididn't iirelieve iipain
4 iidays iiago: iifoot iiswelling
PMHx: iiT1DM iiand iiHTN
meds: iiinsulin iiand iibenazepril
PE: ii1+ iiedema iiBL iito iimid-calf ii
most iilikely iicause iiof iiedema? ii- iiAnswers ii-impaired iirenal iiexcretion iiof iisodium ii
even iithough iiher iiDM iiis iiwell-controlled ii- iishe iiprob iihas iisome iirenal iidamage
taking iinaproxen iiconsistently iifor ii3 iiwks iileads iito iifurther iirenal iidamage
37 iiyo ii- ii3 iimonths iiof iigen iifatigue
dec iienergy iilevel ii- iiesp iiat iiend iiof iiday
3 iiyrs iiof iiabd iibloating iiand iiint iidiarrhea ii(esp iiafter iieating iipasta) ii
no iichange iiin iiappetite/weight iiloss
menses iireg iiw/ iilight iiflow iifor ii2 iidays
BMI: ii25
PE: iimod iipale iioral iimucosa; iiabd iidistended/tympanitic iibut iino
iitenderness/organomegaly; iirectal iiexam iigucci ii
stool iifor iioccult iiblood: iineg
labs: iidec iiHct, iiMCV; iiinc iiplt
what iitest iiwould iiconfirm iithe iiunderlying iicause iiof iiher iisymptoms? ii- iiAnswers ii-assay
iifor iianti-transglutaminase iiantibodies ii
gluten iihypersensitivity ii
presents iiw/ iichronic ii(fatty) iidiarrhea, iiFTT, iianemia, iiand iinutritional iidef ii
can iicause iielevation iiof iiliver iienzymes ii
also iiassociated iiw/ iidermatitis iiherpetiformis ii(rash) iiand iiosteoporosis ii
dx: iiserum iitissue iitransglutaminase iiAb iiand/or iiantiendomysial iiAb; iiduodenal iibiopsy ii
tx: iigluten-free iidiet
42 iiyo ii- iiPKD ii
PMHx: iiHTN ii- iitx iiw/ iiHCTZ
BP: ii156/94 iimmHg iion iiprevious ii2 iivisits; ii160/96 iimmHg iitoday
PE: iilungs iiclear; iicardiac iigucci
labs: iiserum iiCr ii1; iiUA ii- ii2+ iiprotein, ii5-10 iiRBCs
next iistep iiin iimgnt? ii- iiAnswers ii-lisinopril iitherapy
homeboy's iikidneys iiare iiclearly iinot iiworking iitoo iigood ii- iiproteinuria iiand iiRBCs
iipresent iiin iiurine ii
sig iimicroscopic iihematuria iiif ii> ii3 iiRBCs
, glomerular iicause ii- iisig iiproteinuria, iiRBC iicasts, iiand iidysmorphic iiRBCs
nonglomerular iicause ii- ii2/2 iitubulointerstitial, iirenovascular iiand iimetabolic iidisorders;
iisig iiproteinuria iibut iino iiRBC iicasts iior iidysmorphic iiRBCs
ACEi ii- iishown iito iiimprove iikidney iifunction iialong iiw/ iilowering iiBP
no iichange iiin iiBP iiafter ii3 iivisits ii- iiadd iianother iiagent
52 iiyo ii- ii14 iimonths iiof iigen iimuscle iipain iiand iidifficulty iisleeping ii
pain iimost iisevere iiduring iiperiods iiof iistress
exhausted iiafter iiwaking iiup ii- ii8-9 iihrs iiof iisleep iiqNight
vitals iistable
PE: ii12 iiareas iiof iimuscle iipoint iitendnerness
along iiw/ iian iiaerobic iiexercise iiprogram, iiwhat iiis iithe iimost iiapp iitx iifor iithis iipt? ii-
iiAnswers ii-antidepressant iitherapy ii
homegirl iiprob iihas iifibromyalgia ii
widespread iimusculoskeletal iipain iialong iiw/ iifatigue, iisleep, iimemory iiand iimood iiissues
"fibro iifog" ii- iiproblems iiw/ iimemory/thinking iiclearly
tx: iiSSRIs; iiPT ii(trigger iipoint iirelease iitechniques; iigentle iistretching/exercises;
iimyofascial iirelease)
27 iiyo ii- iiG2P1 ii- ii26 iiwks iigest
vitals iistable
PE: iiecchymoses iiin iivarious iistages iiof iihealing iion iiforearms/lower iiabd; iifundal iiheight
ii27 iicm; iicervix iilong/closed; iiuterus iinontender/firm
fetal iiheart iitones iigucci
labs: iiHcb ii12; iiplt ii280,000; iibleeding iitime ii6 iiminutes
most iilikely iidx? ii- iiAnswers ii-domestic iiabuse
bruises iiin iidifferent iistages iiof iihealing iiis iia iiclassic iisign iiof iiphysical iiabuse ii
pregnant iipt iiis iialso iia iitypical iivictim ii
check iiCBC iiand iicoag iitest iito iir/o iimedical iicauses iiof iibruising ii
HELLP: iivariant iiof iipreeclampsia ii(requires iinew iionset iiHTN iiand iiproteinuria ii+/- iialarm
iisymptoms) iiw/ iiHemolytic iianemia, iiElevated iiLiver iienzymes, iiLow iiPlatelets
DIC: iipt iisick iifrom iisomething iielse ii> iidec iiplts iiand iibleeds; iifibrin iiclots iiconsume iiplts
iiand iifactors; iiblood iishears iiagainst iithese iiclots ii> iihemolytic iianemia iiand
iischistocytes; iilow iifibrinogen, iiinc iiPT/PTT, iiand iiinc iiD-dimer; iitx ii- iiplts ii+ iiblood ii
TTP: iiAI iidz; iihylaine iiclots iiform; iivWF iimultimers iipersist iiand iiswallow iiplts; iipentad
ii(FAT iiRN) ii- iiFever, iiAnemia, iiThrombocytopenia, iiRenal iiFailure, iiNeurologic
iisymptoms; iitx ii- iiplasma iiexchange/transfusion
ITP: iiAI iidz; iidx iiof iiexclusion; iitx ii- iisteroids; iiIVIg iito iiinc iiplts; iisplenectomy; iirituximab
vonW: iiplt iitype iibleeding iibut iinormal iiplt iicount; iivWF iistabilizes iifactor iiVIII; iimesses iiw/
iiplt iiadherence; iitx ii- iidesmopressin, iiif iisevere iicryoprecipitate iior iifactor iiVIII
32 iiyo ii- ii4 iimonths iiof iiconstant iipain iion iioutside iiof iiR.elbow iiat iirest ii
NSAIDs iiand iiwrist iisplint ii- iinot iihelpful ii
recently iibegun iibuilding iian iiaddition iito iihis iihouse ii- iilifting iiheavy iisupplies ii
BMI: ii24