Family Practice Exam MCQ Flashcards

A 27-year-old lady laments having trouble becoming pregnant. She observes a dramatic increase in weight, erratic menstruation cycles, acne, and hirsutism. Which of the following conditions should the doctor be on the lookout for?

Answer: Cushing syndrome

The constellation of symptoms described—dramatic weight gain, erratic menstruation, acne, and hirsutism—is highly suggestive of Cushing syndrome. This condition results from prolonged exposure to high levels of cortisol, leading to characteristic features like central obesity, menstrual irregularities, skin changes, and often infertility. These symptoms differentiate it from other endocrine disorders.

Which of the following symptoms is used to identify Parkinson's disease?

Answer: Bradykinesia, resting tremor, muscular rigidity, and postural instability

Parkinson's disease is primarily identified by four cardinal motor symptoms: bradykinesia (slowness of movement), a resting tremor (tremor that occurs at rest), muscular rigidity (stiffness), and postural instability (impaired balance and coordination). These symptoms arise from the degeneration of dopamine-producing neurons in the brain. Understanding these key features is essential for diagnosis.

Regarding acute bronchitis, which is accurate?

Answer: Antibiotics should be used if elderly (older than 65) and if the patient was hospitalized in the last year, has diabetes, congestive heart failure, or is on steroids

Acute bronchitis is predominantly viral, and antibiotics are generally not recommended. However, for elderly patients (over 65) with acute exacerbations of chronic bronchitis or those with significant comorbidities like recent hospitalization, diabetes, congestive heart failure, or steroid use, antibiotics may be considered. These factors increase the risk of bacterial infection and potential complications, warranting a more aggressive treatment approach.

Which of the following should be avoided while treating depression in the elderly due to the possibility of cardiotoxic adverse effects?

Answer: Amitriptyline

Amitriptyline is a tricyclic antidepressant (TCA) known for its significant anticholinergic and cardiotoxic side effects, including orthostatic hypotension, arrhythmias, and sedation. These adverse effects are particularly problematic and potentially dangerous in elderly patients, who are more susceptible to falls and cardiac complications. Therefore, TCAs like amitriptyline are generally avoided as first-line treatment for depression in this population.

A young couple comes in to get their 4-year-well-child old's checkup. You do a fluoride test after learning that their well is their main water supply. The test findings indicate 0.4 ppm (parts per million). Which of the following should the doctor tell the parents?

Answer: A Fluoride supplement should be provided through 16 years old

For children living in areas with suboptimal fluoride levels in their drinking water (below 0.6 ppm), fluoride supplementation is recommended to prevent dental caries. A level of 0.4 ppm indicates a need for supplementation, which should typically continue from infancy through age 16. This ensures adequate fluoride exposure during the critical years of tooth development, strengthening enamel and reducing cavity risk.

Which of the following does not pose a risk for cataract development?

Answer: Poor diet and insufficient vitamin intake

While factors like ultraviolet light exposure, smoking, alcohol use, diabetes, and certain eye conditions (like glaucoma) are established risk factors for cataract development, poor diet and insufficient vitamin intake are generally not considered primary, direct risk factors. The primary mechanisms involve oxidative stress and damage to lens proteins, which are more directly influenced by age, genetics, and specific environmental exposures.

Which of the following is important to know when treating influenza?

Answer: Both oseltamivir and zanamivir are effective against both influenza type 1 and 2

Influenza A is a common type of flu virus, including strains like H1N1 and H3N2, which are responsible for seasonal epidemics. Antiviral medications such as oseltamivir (Tamiflu) and zanamivir (Relenza) are effective against both influenza A and B viruses. While treatment is most effective when started within 48 hours, it can still offer some benefit beyond this window, especially in high-risk patients.