Family Med Aquifer Questions
"Now that you have a diagnosis of disc herniation with radiculopathy for Mr.
Payne, let's discuss what would you like to do for him."
Which of the following are indicated at this time?
Select all that apply.
A. Moist heat
B. Order an MRI
C. Prescribe NSAID
D. Referral to a back surgeon
✅✅
E. Referral to physical therapy
F. Strict bed rest - -A, C, E.
Mr. Payne has no red flags and has had pain for only two weeks, so conservative
therapy is appropriate for him.
"What if he presented with one week of upper respiratory symptoms including
nasal congestion and drainage? On the day the symptoms began, he had a
low-grade fever that has now resolved. His nasal congestion persisted and he
has now had yellow nasal drainage for five days with associated mild headaches.
On exam, he has a small amount of yellowish-clear drainage. There is
tenderness when you lightly percuss his maxillary sinuses."
What would your treatment plan be for the patient in this situation?
Choose the single best answer.
A. Observation and reassurance
✅✅-A
B. Treatment with an antibiotic such as amoxicillin
C. Treatment with an antibiotic such as a fluoroquinolone -
The patient in the example above is presenting with symptoms consistent with
acute viral rhinosinusitis (the common cold). In the setting of a viral infection,
prescribing antibiotics (B or C) would be inappropriate.
,"Which lifestyle modification will decrease blood pressure the most?"
Choose the single best answer.
A. DASH eating plan
B. Dietary potassium
C. Dietary sodium reduction
D. Moderation of alcohol consumption
✅✅
E. Physical activity
F. Weight loss of 10 kg or less - -A. DASH eating plan
"Which of the following findings would support the diagnosis of disc herniation?"
Select all that apply.
A. Drop foot
B. Pain worse with cough and sneezing
C. Pain worse with sitting
✅✅
D. Pain worse with standing
E. Urinary retention - -A, B, C.
Urinary retention (E) is a symptom consistent with cauda equina syndrome.
Standing typically relieves the symptoms of disc herniation (D), so it is incorrect
here.
14-year-old Jennifer is brought to the 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 - ✅✅-C. A teacher's report of
inattentive behavior
A 12-year-old patient is brought to the clinic with a pruritic, red, scaly rash in the
creases of his elbows. He reports no 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. Ask the patient to return to the clinic after three days
B. Biopsy the skin lesion
C. Prescribe oral antibiotics
✅✅
D. Prescribe oral corticosteroids
E. Prescribe topical corticosteroids - -E. Prescribe topical corticosteroids
(sounds like eczema)
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
reports no 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. Her vitals are: temperature is 36.8 C
(98.2 F), pulse is 96 beats/minute, respiratory rate is 20 breaths/minute, oxygen
saturation is 98%, blood pressure is 110/72 mmHg. She is in no acute distress
and is breathing comfortably. On auscultation, there are some mild wheezes on
expiration but air movement is good. What is the best next step?
A. Prescribe a daily corticosteroid and long-acting beta agonist inhaler
✅✅
B. Prescribe a daily corticosteroid inhaler
C. Prescribe a long-acting be - -E. Prescribe a short-acting beta agonist
inhaler with a short course of oral steroids
Because the patient is symptomatic and wheezing, she needs to be treated with
a medication to control her symptoms and treat her exacerbation. A short-acting
beta-agonist does just that. Oral corticosteroids could be considered if her
symptoms were more severe, or if she does not improve with the short-acting
beta-agonist. After controlling her symptoms and treating her exacerbation, a
more in-depth interview needs to be performed around the asthma symptoms
and other ancillary tests need to be ordered and interpreted including pulmonary
function test. Then a decision can be made regarding daily controller inhalers.
, Finally, antibiotic therapy is not indicated in the treatment of an asthma
exacerbation.
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 - -A. AC joint sprain
A 21-year-old G1P0 patient presents to the clinic as a new patient to establish
prenatal care. Which statement represents something that would not be expected
to be a benefit of group prenatal care for this patient?
A. Decreases the likelihood of preterm delivery
B. Increases adherence to techniques for pain management during labor
C. Increases physician contact
✅✅
D. Increases support network
E. Shared education between patients - -B. Increases adherence to
techniques for pain management during labor
A 21-year-old G1P0 patient presents to the clinic as a new patient to establish
prenatal care. Which statement represents something that would not be expected
to be a benefit of group prenatal care for this patient?
A. Decreases the likelihood of preterm delivery
B. Increases adherence to techniques for pain management during labor
C. Increases physician contact
✅✅
D. Increases support network
E. Shared education between patients - -B. Increases adherence to
techniques for pain management during labor
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