Sample NBME Family Medicine Shelf Exam Questions

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1. An 18-year-old college student is brought to the emergency department by her friend because she has been crying for 3 hours. The friend reports that earlier in the day the patient gave away her ... books, furniture, and other personal items as gifts to friends and spent the rest of the day writing letters and crying. The patient states that she is displeased with her academic performance and upset about a recent failed relationship. She has not been sleeping well. Which of the following is the most appropriate next step in management? (A) Recommend a study skills course (B) Arrange a family conference (C) Prescribe a benzodiazepine (D) Prescribe a tricyclic antidepressant (E) Immediate psychiatric evaluation 2. A 23-year-old man comes to the physician because of a 1- week history of painful urination and a clear urethral discharge. One month ago, he had similar symptoms and completed a course of doxycycline therapy for a chlamydial infection. He has no previous history of sexually transmitted diseases. He has been sexually active with one female partner for 2 years, and she takes an oral contraceptive. Examination shows no abnormalities. A urine polymerase chain reaction test is positive for Chlamydia trachomatis. In addition to resuming doxycycline therapy, which of the following is the most appropriate next step? (A) Recommend testing for his partner (B) Obtain a urethral culture (C) Order a pelvic ultrasonography (D) Order a voiding cystourethrography (E) Begin acyclovir therapy 3. A 37-year-old woman comes to the physician because of a 3-year history of intermittent, mild, diffuse abdominal cramps and bloating. Her symptoms occur after meals and are relieved with bowel movements. She also has constipation four to six times monthly. She says the constipation resolves spontaneously, but she sometimes has diarrhea for 1 to 2 days afterwards. She has not had any other symptoms. She has no history of serious illness and takes no medications. Examination shows no abnormalities. Which of the following is the most likely diagnosis? [Show More]

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