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Aquifer FM End of Case Questions with 100% Actual correct answers | verified | latest update | Graded A+ | Already Passed | Complete Solution £6.29
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Aquifer FM End of Case Questions
13-year-old female patient comes to your office for a physical. Her mother is concerned
because she complains of menstrual cramps during her period each month. You
determine that menarche was earlier that year and her periods have been mostly
regular since that time. The pain is in her lower abdomen and is relieved with Ibuprofen
and a heat pack. She has no other medical problems and her physical exam is normal.
What is the most appropriate treatment for this patient?
A. Continue ibuprofen and heat packs; return if worsening
B. Copper IUD
C. Start an SSRI
✅✅
D. Start danazol
E. Start oral contraceptive pills (OCPs) - -The answer is A. From FM 32.
14-year-old Jennifer is brought to clinic by her mother who is concerned about ADHD.
She states Jennifer lacks motivation, regularly does not clean her room, and has to be
reminded to do chores around the house. She also is concerned Jennifer does not listen
to her and avoids doing homework.
Which of the following would most strongly support additional evaluation to assess for
ADHD?
A. A diagnosis of major depression
B. A report card with good grades
C. A teacher's report of inattentive behavior
✅✅
D. Fidgety behavior in the car when driving long distances
E. Symptom onset with entry to high school - -The answer is C. From FM 23.
56-year old male with a past medical history of hypertension and type 2 diabetes
mellitus presents with progressive dyspnea on exertion, orthopnea, paroxysmal
nocturnal dyspnea, and dependent edema over the prior 4 days. His social history is
notable for a 30 pack-year tobacco history and occasional marijuana use. His family
history is positive for bypass surgery in his mother at the age of 62. On exam, his vitals
include a blood pressure of 166/86 mmHg, pulse of 98 beats/minute, respirations of
21/minute and a BMI of 32 kg/m^2. He appears mildly dyspneic. His neck reveals an
elevated jugular venous pulse, his chest exam reveals bilateral crackles in the lower
lung fields, and his cardiovascular exam reveals mild tachycardia, a regular rhythm, and
no murmurs. His abdominal exam is unremarkable, and he has 2+ edema in his legs
✅✅
midway to his knees. An EKG reveals sinus tachycardia with a left axis deviation and Q
waves - -The answer is E. From FM 31.
,A 12-year-old male is brought to the clinic with a pruritic, red, scaly rash in the creases
of his elbows. He denies new topical exposures and generally feels well. He has a
history of seasonal allergies. Which of the following is the most appropriate course of
action?
A. Biopsy the skin lesion
B. Ask the patient to return to the clinic after three days
C. Prescribe topical corticosteroids
✅✅
D. Prescribe oral antibiotics
E. Prescribe oral corticosteroids - -The answer is C. From FM 16.
A 13-year-old female comes to your clinic stating she has been having fever and chills
for three days, and aching muscles for the last two days. She states she has also had a
mild cough, but is not having any difficulty with breathing. She is up to date on vaccines
and her only other medical history is having her tonsils and adenoids removed last year.
On physical exam, you find her temperature is 39.2 C (102.6 F), pulse is 96
beats/minute, and her blood pressure is 108/62 mmHg. She has clear rhinorrhea and
her oropharynx is mildly erythematous. The rest of her physical exam is normal, and a
rapid strep test in the office is negative.
What is the next best step in management?
A. Albuterol
B. Amantadine
C. Aspirin
✅✅-The answer is D. From FM 21.
D. Ibuprofen
E. Zanamivir -
A 13-year-old female patient comes to your office for a physical. Her mother is
concerned because she complains of menstrual cramps during her period each month.
You determine that menarche was earlier that year and her periods have been mostly
regular since that time. The pain is in her lower abdomen and is relieved with Ibuprofen
and a heat pack. She has no other medical problems and her physical exam is normal.
What best describes this patient's condition?
A. Menorrhagia
B. Premenstrual dysphoric disorder
C. Premenstrual syndrome
✅✅
D. Primary dysmenorrhea
E. Secondary dysmenorrhea - -The answer is D. From FM 32.
A 15-year-old female with a history of allergic rhinitis presents to the clinic with a five
day history of productive cough and wheezing that is worse at night. She denies any
,shortness of breath, chest pain, or fever. The patient states that she has had similar
symptoms in the past, especially when seasons change. The only reported past medical
history is atopic dermatitis which is well-controlled with an over-the-counter steroid
cream. What is the best next step?
A. Prescribe a short acting beta agonist inhaler with a short course of oral steroids
B. Prescribe a long acting beta agonist inhaler
C. Prescribe a daily corticosteroid inhaler
✅✅
D. Prescribe a daily corticosteroid and long acting beta agonist inhaler
E. Prescribe antibiotic therapy - -The answer is A. From FM 13.
A 16-year-old male patient presents with dull, aching pain in his left scrotum. He says
that the dull aching pain is more prominent upon standing.
Which of the following the most likely diagnosis?
A. Epididymitis
B. Henoch-Schönlein purpura (HSP)
C. Hydrocele
✅✅
D. Testicular torsion
E. Varicocele - -The answer is E. From FM 27.
A 17-year-old male football player presents to the emergency department with acute
onset of right-shoulder pain. The pain started approximately two hours ago when he
was tackled during a game while carrying the football. Shoulder swelling and pain were
present after injury. He is holding ice to a swollen shoulder, and on exam you notice
severe bruising, pain on palpation over the lateral edge of the shoulder, and a raised
bump over that same area. There is also severe tenderness over the coracoclavicular
ligaments.
What is the most likely diagnosis?
A. AC joint sprain
B. Rotator cuff tear
C. Rotator cuff tendonitis
✅✅
D. Subacromial bursitis
E. Subacromial impingement - -The answer is A. From FM 25.
A 19-year-old female with no significant past medical history is the driver in a motor
vehicle accident and is brought to the Emergency Department by EMS. She is
complaining of severe pain in her right lower extremity that has worsened since the
accident. In addition, she has started to notice what she describes as "burning and
tingling" in her right foot. On physical exam, her right calf is edematous and tender with
tense overlying skin. There is no swelling or tenderness of the right foot or ankle but the
right dorsalis pedis and posterior tibial artery pulses are barely palpable. She cannot
, confirm light touch of the foot and cannot wiggle her toes on command. What is the next
best step in the management of this patient?
A. Emergent surgical consultation
B. Diagnostic imaging of right foot and ankle
C. Immobilize leg and ankle with a cast
✅✅
D. Reassurance and icepacks q 2 hours
E. Urgent EMG of the right lower extre - -The answer is A. From FM 04.
A 20-year-old healthy female with no significant past history presents to your clinic with
dysuria, lower abdominal discomfort, frequency, and urgency for one day. She notes an
odor to her urine but denies any change in its appearance. She reports no vaginal
discharge or fever. Review of systems is otherwise negative. The patient denies sexual
activity and reports normal menses. There are no known allergies. Her examination is
remarkable for mild suprapubic tenderness. Urinalysis: negative; urine HCG: negative.
Which of the following would be the next best step in her clinical management?
A. Await urine culture results before any treatment
B. Initiate antibiotic treatment while awaiting urine culture results
C. Insist that a pelvic exam and cervical DNA probe be performed today
✅✅
D. Reassure that this is not a urinary tract infection
E. Urine DNA probe - -The answer is B. From FM 04.
A 21-year-old female comes into your family medicine office complaining of an
abnormal discharge with a foul odor. She has been sexually active with four to five
partners over the past year, and uses condoms inconsistently.
Which of the following can be seen on a wet prep?
A. Chlamydia
B. Gonorrhea
C. Herpes
✅✅
D. Syphilis
E. Trichomonas - -The answer is E. From FM 27.
A 21-year-old female with no significant past medical history experienced an
inversion-type injury to her right ankle while playing soccer a day prior to presentation to
the family medicine ambulatory practice. She remembers immediate pain and swelling
but was able to weight bear and limp off the field. She has noticed some significant
swelling which is mostly still present. She has been icing the ankle since the injury as
her coach recommended. Pain is still present near the lateral malleolus. Physical
examination reveals an edematous lateral right ankle with purplish hue and intact
bilateral pulses. Sensation of the bilateral lower extremities is intact and symmetric
motor function is preserved. Palpation of the posterior edge of the lateral malleolus
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