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AAFP Board Review, Set #1

Total questions: 10

Worksheet time: 8mins

Name
Class
Date
1.

A 4-week old white M is brought to your office with a 2-week hx of increasing dyspnea, cough, and poor feeding. The child appears nontoxic and is afebrile. On exam, you note conjunctivitis, and a chest exam reveals tachypnea and crackles. A chest film shows hyperinflation and diffuse interstitial infiltrates and a WBC count reveals eosinophilia. What is the most likely etiologic agent?

a)

Staphylococcus species

b)

Chlamydia trachomatis

c)

RSV

d)

Parainfluenza virus

2.

A 52 y/o M presents with moderate sx of prostatism. A prostate exam is normal. His PVR is 90mL. His PSA level is 0.75ng/mL (nml 0.0-4.0). He says his nocturia has become troublesome and you decide to initiate therapy. This pt does NOT meet the criteria for use of which one of the following?

a)

Doxazosin (Cardura)

b)

Finasteride (Proscar)

c)

Tadalafil (Cialis)

d)

Tamsulosin (Flomax)

e)

Silodosin (Rapaflo)

3.

A factory worker sustains a forced flexion injury of the distal interphalangeal (DIP) joint, resulting in a small bone fragment at the dorsal surface of the proximal distal phalanx (mallet fracture). Which one of the following is the most appropriate management strategy?

a)

Buddy taping and early range of motion

b)

Splinting the DIP joint in extension

c)

Splinting the DIP joint in flexion

d)

Referral for surgical repair

4.

Which one of the following drugs is NOT effective for maintenance therapy in bipolar disorders?

a)

Haloperidol (Haldol)

b)

Lamotrigine (Lamictal)

c)

Lithium

d)

Quetiapine (Seroquel)

e)

Valproate sodium (Depacon)

5.

A 30 y/o ill-appearing M presents with Rt hand and arm pain and a rapidly expanding area of redness. On exam, he has T 38.9C (102F), HR 120, BP 116/74. He also has erythema from the dorsal hand to the elbow, violaceous bullae on the dorsal hand and wrist, and severe pain with dorsiflexion of the wrist or fingers. Which one of the following is the most appropriate initial step in the management of this pt?

a)

Oral dicloxacillin and OP f/u within the next 24 hours

b)

IV metronidazole

c)

Consultation with ID for abx management

d)

Immediate surgical consultation for operative debridement

e)

Incision and drainage with wound cx in the ED

6.

Patients being treated with amiodarone (Cardone) should be monitored periodically with serum levels of:

a)

Cortisol

b)

Creatine phosphokinase

c)

Creatine

d)

LDH

e)

TSH

7.

A mother brings her 2 y/o daughter to your office because the child is not using her Lt arm. Earlier in the day, the mother left the toddler under the supervision of her 12y/o sister while she went to the store. When she returned, the toddler was playing with toys using only her Rt arm, and was holding the Lt arm slightly pronated, flexed, and close to her body. The older daughter was unaware of any injury to the girl's arm, and the child does not seem distressed or traumatized. PE of the child's clavicle, shoulder, wrist, and hand do not elicit any signs of pain or change in function. She does seem to have some tenderness near the lateral elbow and resists your attempts to examine the area. There is no ecchymosis, swelling, or deformity of the elbow. Which one of the following would be most appropriate at this point?

a)

Plain radiographs of the affected elbow

b)

Ultrasonography of the affected elbow

c)

Evaluation by an orthopedic surgeon within 24 hours

d)

Attempted reduction of the subluxed radial head

e)

Placement in a splint and f/u in the office if there is no improvement in the next 1-2 weeks

8.

A 12y/o M uses a short-acting bronchodilator 3x per week to control his asthma. Lately he has been waking up about 2x per week because of his sx. Which one of the following medications would be most appropriate?

a)

Inhaled medium-dose corticosteroids

b)

A scheduled short-acting bronchodilator

c)

A scheduled long-acting bronchodilator

d)

A leukotriene inhibitor

e)

Ordering a free T4

9.

Which one of the following is the most appropriate first-line therapy for primary dysmenorrhea?

a)

Combined monophasic OCPs

b)

Combined multiphasic OCPs

c)

Subdermal etonogestrel (Nexplanon)

d)

Intramuscular medroxyprogesterone (Depo-Provera)

e)

NSAIDs

10.

While performing a routine PE on a 42y/o F you discover an apparent nodule in the Lt lobe of the thyroid measuring approximately 1cm in diameter, which is confirmed on ultrasonography. The most appropriate next step in the evaluation of this finding is a...

a)

Serum calcitonin level

b)

Serum free T3 level

c)

Serum TSH level

d)

Serum thyroglobulin level

e)

Radionuclide thyroid scan