2022 AAFP Board Review Course Questions – COMPLETE SOLUTION, 100% pass rate.

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2022 AAFP Board Review Course Questions – COMPLETE SOLUTION Which one of the following statements is TRUE regarding the use of antidepressants for smoking cessation? - ✔✔Bupropion is contrain... dicated in a patient with an eating disorder The number 1 cause of preventable morbidity and mortality in the US today is which of the following? - ✔✔Tobacco Which of the following statements is true regarding alcohol abuse counseling? - ✔✔The USPSTF recommends screening and counseling adults the risks of alcohol misuse Which immunization would be considered safe to administer during pregnancy? - ✔✔Tdap Self-help measures recommended for patients with NYHA class 2 HF is on optimal medications include which one of the following? - ✔✔Avoiding NSAID use How much daily vitamin D supplementation do infants need during the first month of life? - ✔✔Breastfed infants should have 400 IU of Vitamin D Following a scheduled repeat C-section delivery, a term infant has a respiratory rate >60. What is the most common cause of this presentation? - ✔✔Transient tachypnea of the newborn Breastfeeding jaundice is characterized by - ✔✔insufficient feeds What advice would you give parents to reduce the risk of death from sudden infant death syndrome (SIDS) in their infant? - ✔✔Avoid exposure of the infant to second-hand smoke The majority of failure to thrive cases in infants is due to - ✔✔inadequate caloric intakeWhat will Medicare cover for an elderly couple asks you how they will pay to live in facility. Which of the following is NOT true? - ✔✔Medicare will pay once a medical need for services is clearly documented The largest portion of the Medicare budget is spent on - ✔✔the 20% of Medicare recipients with five or more chronic diseases Patient on meds including risperdone, metoclopramide, and valproate presents with Parkinson's symptoms (trouble standing, walking then freezing, flat affect), so your next step is - ✔✔stop his risperdone, metoclopramide, and valproate Patient with Parkinson's doing well on carbidopa/levodopa therapy, but worried about dyskinesia. Which would be a good choice to decrease long term effects of this? - ✔✔Dopamine agonist, such as ropinirole Elderly patient develops C. Diff, so your next step is - ✔✔begin PO vancomycin 125mg QID What causes peripheral vision loss? - ✔✔glaucoma Presbycusis is typically associated with the reduction in what type of hearing loss? - ✔✔hearing threshold at higher frequencies Elderly woman presents with 4 week history of early morning shoulder and hip discomfort and ESR of 52. What condition associated this primary diagnosis is she at risk for developing? - ✔✔giant cell arteritis (polymyalgia rheumatica) A 72 yo obese, Black woman complains of sudden onset of mid-back pain. X-ray confirms T4 vertebral compression fracture and diffuse osteopenia. Your next step: - ✔✔work up for secondary causes of osteoporosis Which of the following has been shown to have analgesic benefit in acute osteoporotic fractures? - ✔✔calcitoninA demented 70 yo, widowed woman is admitted to your service and determined to lack capacity. There are no advance directives. Who is typically next in line for decision making: - ✔✔her sister Patient with dementia says no to pacemaker but DPOA/daughter says yes to pacemaker procedure for sick sinus syndrome. The most appropriate next step is - ✔✔not proceed with the procedure (has capacity) The most common cause of lack of sexual activity in older heterosexual couples is - ✔✔male's medical condition An 82 yo woman admitted to your nursing home has a urine culture that grew >100,000 e. coli. You should prescribe antimicrobials if - ✔✔she has frequency, urgency, dysuria, or suprapubic pain Of the following recommendations, which has not been shown to be helpful for recovery of acute low back strain? - ✔✔corticosteroids Which of the following is the USPSTF's recommendation regarding daily supplementation of vitamin D and calcium for postmenopausal women to prevent fracture? - ✔✔supplementation of vitamin D3 and calcium is not recommended for primary prevention only Type 2 DM, acute low back pain with dorsal foot paresthesias and dorsiflexion weakness, and positive straight leg test on right. Which of the following recommendations is best supported by the clinical evidence? - ✔✔consider surgical intervention due to motor deficit Which of the following statements best describes an overuse tendonopathy such as lateral epicondylosis or patellar tendonosis? - ✔✔rehabilitation with eccentric contractions are recommended to resolve these overuse tendinopathies New overweight runner with pain in patella first late in run and now earlier in run and after run along with crepitus. No acute injury. Which of the following is the most appropriate treatment for her condition? - ✔✔reduction in running distance and physical therapyWhich of the following is the most sensitive finding in patients with carpal tunnel syndrome? - ✔✔Flick sign Medial left heel pain for 5 weeks. Burning and worse with weight bearing or standing and better with rest. Aggravated by full passive dorsiflexion of the ankle .You conclude that: - ✔✔she has tarsal tunnel syndrome and you provide an orthotic The developmental examination on a 6-month-old boy reveals an infant who follows past midline, laughs, turns toward your voice, and has clenched fists. With these findings you - ✔✔refer to specialist for further evaluation A mother brings her 9-month-old daughter in for routine care. Which of the following should be addressed at this visit? - ✔✔stating table food At his well-child check, a 5-year-old boy is noted to have occasional bedwetting. You advise the parents that - ✔✔this occurs in 20-25% of boys this age What is the most appropriate automobile seating for a 7-year-old who is 50 inches tall? - ✔✔rear seat in belt-positioning booster seat with lap/shoulder belt You are seeing a young girl for her pre-high school physical. The form asks for Tanner stage. She has small but developed breasts and a small amount of dark, straight pubic hair. She is Tanner stage - ✔✔III Which of the following is true of bulimia nervosa in adolescent females? - ✔✔more prevalent than anorexia nervosa 79 yo F with mild dementia s/p right hip arthroplasty who screams when told to get out of bed. Picks at sheets and speaks nonsensically. The appropriate next step is - ✔✔review her outpatient medications 76 yo F with failing memory, unable to pay bills, and unable to knit which she liked to do before, and word finding. What is her diagnosis? - ✔✔dementiaWhat is the most common type of dementia? - ✔✔Alzheimer's What is the greatest risk factor for developing dementia? - ✔✔aging 76 yo M with memory not good as it used to be. Difficulty remember discussions from earlier, but still paying bills and doing puzzles. What is your diagnosis? - ✔✔mild neurocognitive disorder 80 yo M with unsteady gait, 2 falls. Uses walker. Speech diminished in volume, less distinct. Flat affect. Hypertensive, diabetic, smoker. Asymmetric reflexes, 1/5 on Mini-Cog Test, right group weak, muscle tone increased. This patient most likely has which type of dementia? - ✔✔vascular Which of the following is proven to be protective against Dementia? - ✔✔educational attainment 81 yo F with advanced dementia who is hoarding food, making sexual inappropriate remarks, walking out of room in underwear only. What can you do to help? - ✔✔offer to help the staff find ways to manage the behaviors non-pharmacologically A 14-day-old infant is brought to your office for a routine visit. The rectal temperature is 100.8ºF. The infant appears well and parents have zero concerns. What should you do? - ✔✔admit and do inpatient sepsis workup A 3-year-old girl presents with 4-day history of fever without other symptoms. Ears, throat, lungs and abdominal exams are normal, but she appears lethargic. What should be your next step? - ✔✔order urinalysis with cultures A 16-year-old female patient is evaluated for a 4-day history of sore throat, nonproductive cough and rhinorrhea. She is afebrile, and exam reveals enlarged erythematous tonsils without exudate, and no lymphadenopathy. What is the next step? - ✔✔supportive care A 2-year-old child is brought to the emergency department with a barking cough, stridor that worsened tonight, and a temperature of 101º F. What is the treatment? - ✔✔nebulized epinephrine and dexamethasoneA 9-month-old child is admitted in Jan. for cough, wheezing, feeding, and fever of 38ºC. CXR shows mild peribronchial cuffing. Which treatment is indicated? - ✔✔supplemental O2 and fluids A 2-year-old boy has very red cheeks and a fine rash but does not appear ill. He had a fever a couple of days ago. When can he return to day care? - ✔✔today A 5-year-old male has 7 days of spiking high fevers and a diffuse erythematous rash. His tongue and lips are red, dry, and cracked, and he has large cervical lymph nodes. In addition to rehydration, what are the next treatment steps? - ✔✔inpatient immune globulin and high-dose aspirin 3 yo M walking home with mom and cries of pain when elbow is moved and keeping it to left side. Negative x-rays. Using an evidence-based approach to your patient, what would be the best treatment? - ✔✔hyperpronation of the forearm A 44 yo female tripped and fell on the ice on an outstretched left hand [FOOSH]. She presents with this radiograph showing distal radial fracture. What is the most commonly injured nerve in this injury? - ✔✔median nerve A 36 yo female presents to your office and reports that she fell on an outstretched left hand [FOOSH] 3 days ago and presents with left wrist pain, minor swelling, and this radiograph showing a scaphoid fracture. What is the best treatment option? - ✔✔thumb spica cast for 8 weeks Football player injured ring finger after grabbing the jersey of another place and feeling pain in the distal aspect of the affected finger. Can't flex DIP joint and small bony fragment seen at solar surface of the proximal distal phalanx. Which one of the following would be the most appropriate management? - ✔✔referral to hand surgeon Volleyball player who jammed his left 5th finger with full passive ROM but not active extension of the distal phalanx. Normal hand x-ray. Which of the following is the most appropriate treatment? - ✔✔immobilization of the DIPJ in extension for 6-8 weeks 74 yo F with HTN, osteoporosis, and arthritis has had increased back pain over 2 months. Radiograph shows vertebral compression fracture. Which statement is correct? - ✔✔she has an increased mortality rate of 15% over those without this condition72 yo M with left hip pain has pain with ambulation after fall. Wants to be non-weightbearing. What is your diagnosis? - ✔✔left hip fracture Which of the following is NOT a factor in the Ottawa Ankle Rules? - ✔✔discrete bony tenderness at the anterior distal fibula Examination findings of a 17 yo male athlete with near syncope and suspicion for hypertrophic cardiomyopathy would include the following finding: - ✔✔a crescendo-decrescendo systolic murmur at the left sternal border that increases with valsalva The defining characteristic distinguishing between heat exhaustion and heat stroke is which of the following? - ✔✔mental status changes Which of the following statements is true regarding sports related concussion? - ✔✔physical rest is recommended during the first 24-48 hours post-concussion You have been invited to present a grand rounds lecture on "Sports Injuries in High School Athletes." Which of the following statements would you include in your talk? - ✔✔football has the highest injury rate Which physical exam test is the most sensitive maneuver for the corresponding knee injury? - ✔✔Thessaly test- meniscal tear Which one of the following statements is true regarding ACL injuries? - ✔✔in high school sports, football has the highest rate of ACL injury A 26 yo male suffers an inversion ankle injury and ambulates to the ED for evaluation. You find lateral ankle swelling and tenderness over the anterior distal fibula. The next best course of action includes - ✔✔recommendation for early range of motion for the ankle Which of the following pharmacokinetic factors changes least with age? - ✔✔absorptionAn 80 yo hypertensive woman is switched from atenolol to propranolol to treat tremor. A week later she seems more bradycardic, confused, and despondent. The most likely cause is: - ✔✔lipophila of propranolol An 84 yo man has been less alert and his balance is deteriorating. He was taking 5 mg of diazepam twice a day and agrees to stop. One week later, he's no better. Three weeks later he's improved. The most likely explanation is: - ✔✔active drug metabolites Which pharmacokinetic factor changes the most with age? - ✔✔elimination An 80 yo on warfarin has an INR of 2.5. The best explanation for increased bleeding risk compared with a younger patient is - ✔✔pharmacodynamic differences 75 yo female is following up for recent L femur fracture. Which long term medicine most likely contributed to her osteoporosis? - ✔✔pantoprazole 92 yo has T2DM with A1c of 7.1 and taking metformin, jardiance, and glimiperide. Regarding his A1C, you counsel that - ✔✔he should discontinue his glimiperide Which medicine is best to stop to improve cognition and falls? - ✔✔amitriptyline 25mg PO qHS Which of the following statements is true regarding congenital pediatric musculoskeletal conditions? - ✔✔Duchenne's muscular dystrophy is more common in males Which of the following statements is true regarding bone tumors in the pediatric & adolescent population? - ✔✔non-ossifying fibromas resolve with skeletal maturity 6 yo F has been more clumsy and falling more. Patellae and toes point inward. Normal neuro exam. What is the most likely diagnosis? - ✔✔femoral anteversion12 yo M with limp for the past 3 days. Antalgic gait, overweight, and painful right hip with ROM. No trauma. Radiographs are normal. What is your presumptive diagnosis? - ✔✔slipped capital femoral epiphysis 7 yo F with right hip pain and new limp abruptly over the last 12 hours. No trauma. Antalgic gait. Febrile. Hip radiographs are normal. Which of the following is most useful in determining your treatment plan? - ✔✔CBC, ESR, CRP 12 yo M with right elbow pain and is a pitcher. 3 weeks he has had pain aggravated by throwing and better with rest. Tenderness of the right medial epicondyle. You conclude the following. - ✔✔this is an apophysitis 11 yo male with bilateral posterior heel pain when you passively and fully dorsiflex the ankles. Better with rest and worse with activity. Which one of the following is the most likely diagnosis? - ✔✔Sever's disease Pediatric obesity is associated with each of the following except - ✔✔decreased risk of herniated lumbar disc You are on a plane ride when a passenger suddenly becomes unresponsive. Which statement below is true? - ✔✔you should check a pulse, if none present, immediately start chest compressions 65 y/o with a fib on warfarin with acute intracerebral hemorrhage after a fall. The ACCP and AHA/ASA recommends - ✔✔start 4-factor Prothrombin Complex Concentrate (KCentra) + Vitamin K 10mg IV 31 yo M brought to ED after trauma to leg with blood positive in dipstick, but no blood seen under microscope. This patient should be admitted for the management of - ✔✔rhabdomyolysis A 37 y/o male in good health presents with a laceration of the 5th finger due to broken glass. Which one of the following statements is true? - ✔✔wound irrigation with tap water h [Show More]

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