FAMILY MEDICINE (FM EOR) PAEA
NEWEST ACTUAL EXAM QUESTIONS
AND DETAILED CORRECT ANSWERS
WITH RATIONALE | 2025 FM END OF
ROTATION
51 year-old patient presents for follow-up after a recent
stroke. Cardiac examination reveals a moderately loud
systolic ejection murmur in the 2nd and 3rd interspaces
parasternally. The second heart sound is fixed and widely
split. Which of the following is the most likely diagnosis in
this patient?
A. Aortic stenosis
B. Mitral valve regurgitation
C. Patent foramen ovale
D. Ventricular septal defect Correct Answer
C. A patent foramen ovale is present in 25% of the
population and can lead to paradoxic emboli and
cerebrovascular events. Suspicion should be highest
in patients who have cryptogenic stroke before age 55
years.
A 5 year-old male is brought to the office by his father who
reports a 2 day history of low grade fever and coryza. The
child awoke this morning with bright red cheeks. Physical
examination reveals edematous, confluent plaques over
the
,malar region of the face and reticular rash over the child's
extensor surfaces. Which of the following is the most likely
diagnosis?
A. Rubeola
B. Parvovirus B19
C. Respiratory syncytial virus
D. Epstein-Barr virus Correct Answer
B. This is a classic presentation of Fifth Disease, a
childhood exantham associated with human
parvovirus B19
In a patient with a low probability of pulmonary embolism
(PE) based on the Wells criteria, which of the following lab
studies is most helpful in ruling out a PE?
A. D dimer assay
B. PT with INR
C. Factor V assay
D. Clotting time Correct Answer A. Even though useful
in ruling in a pulmonary
Which subset of the asymptomatic general population
should undergo one-time screening for abdominal aortic
aneurysm?
A. 65 year-old female with chronic kidney disease
B. 65 year-old healthy male who has smoked since age 20
C. 74 year-old male who has diabetes mellitus
D. 74 year-old female who has smoked since age 15
Correct Answer B. . Data support the use of abdominal
ultrasound to screen 65- to 74-year old men, but not
women, who have a
,history of smoking. Repeated screening does not
appear to be needed if the aorta shows no
enlargement.
Which of the following is the pharmacologic therapy of
choice in male patients suffering from mild-moderate
gynecomastia?
A. Selective serum reuptake inhibitor (SSRIs)
B. Selective estrogen receptor modulator (SERMs)
C. Testosterone
D. Progesterone Correct Answer B. SERM therapy is
particularly effective in glandular ("lumpy") gynecomastia.
Examples of SERMS are tamoxifen
and raloxifene.
A 4 week-old female is seen for a well child visit. Birth
history is significant for breech presentation and weighing
9
pounds 8 ounces at delivery. Which of the following is
indicated to rule out developmental dysplasia of the hip?
A. Ultrasound
B. Physical examination
C. Anterior/posterior radiograph
D. Computed tomography Correct Answer B. A careful
physical examination at birth and repeated evaluation
at each well visit until the child walks is
indicated to identify DDH. A high degree of suspicion
is necessary in children with risk factors for DDH,
such as
, positive family history, ligamentous laxity, breech
presentation, female gender, large fetal size, and first-
born
status.
A 9 year-old presents with increasing shortness of breath
while playing basketball recently. On examination, radial
pulses are exaggerated while femoral pulsations are
weak. Chest radiograph shows rib notching and a mildly
enlarged heart. Which of the following is the most likely
diagnosis for this patient?
A. Atrial septal defect
B. Coarctation of the aorta
C. Patent ductus arteriosus
D. Tetralogy of Fallot Correct Answer B. In older
children, the ECG and chest x-ray usually show left
ventricular hypertrophy and a mildly enlarged
heart. Rib notching may also be seen in older children
(>8 years old) with large collaterals.
A 74 year-old male presents with sudden onset of
unilateral eye pain. He reports severe bulbar pain,
decreased
vision of the left eye and nausea. Examination is
significant for decreased visual acuity, marked ciliary
injection and
mid-dilated pupil. Which of the following is the most
appropriate initial treatment for this disorder?
A. Topical pilocarpine
B. Trabeculectomy
C. Topical atropine
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