Mixed Deck — All Family Practice Exam Topics Flashcards

A patient with atrial fibrillation has a CHA₂DS₂-VASc score of 3. What is the recommended management?

Answer: Anticoagulation with a DOAC or warfarin

A CHA₂DS₂-VASc score ≥2 in men or ≥3 in women indicates a high stroke risk warranting anticoagulation, preferably with a DOAC over warfarin.

Which of the following is the most common etiology of peptic ulcer disease in the United States?

Answer: Helicobacter pylori infection

H. pylori infection is responsible for approximately 70–90% of duodenal ulcers and 60–70% of gastric ulcers, making it the leading cause of peptic ulcer disease.

A 70-year-old woman is started on alendronate for osteoporosis. What is the most important instruction to give her?

Answer: Remain upright for 30 minutes after taking it

Patients must remain upright for at least 30 minutes after taking bisphosphonates to prevent esophageal irritation and ulceration.

What is the most common cause of secondary hypertension in adults under 40 years old?

Answer: Renovascular hypertension

Renovascular hypertension from renal artery stenosis (often fibromuscular dysplasia in young adults) is the most common cause of secondary hypertension in patients under 40.

A patient presents with jaundice, generalized pruritus, dark urine, and clay-colored stools. Lab results show markedly elevated direct bilirubin and alkaline phosphatase. What type of jaundice does this pattern represent?

Answer: Cholestatic (obstructive) jaundice

Elevated direct (conjugated) bilirubin, alkaline phosphatase, and the clinical features of pruritus, dark urine, and pale stools indicate obstruction of bile flow (cholestatic jaundice).

A patient is admitted with whiplash. The patient exhibits paresthesia along the spine when the neck is flexed, according to the examination. This is advantageous:

Answer: Lhermitte sign

The Lhermitte sign is a neurological finding characterized by an electric shock-like sensation that radiates down the spine and into the extremities upon neck flexion. This sign is indicative of cervical spinal cord dysfunction or demyelination, often seen in conditions like whiplash, multiple sclerosis, or cervical spondylosis. Its presence suggests potential spinal cord irritation or damage.

A 52-year-old patient with chronic constipation has failed dietary fiber supplementation and increased fluid intake. Which pharmacological agent is the most appropriate next step?

Answer: Polyethylene glycol (osmotic laxative)

Polyethylene glycol is the preferred first-line pharmacological agent for chronic constipation, with strong evidence for efficacy and long-term safety.

A 24-year-old male presents with periumbilical pain that migrated to the right lower quadrant over 12 hours, accompanied by nausea, low-grade fever, and leukocytosis. Which physical exam finding is most classic for acute appendicitis?

Answer: Rebound tenderness at McBurney's point

Rebound tenderness at McBurney's point—located one-third the distance from the right anterior superior iliac spine to the umbilicus—is the classic physical finding of peritoneal irritation in acute appendicitis.

Which intervention has the strongest evidence for improving liver histology in non-alcoholic fatty liver disease (NAFLD)?

Answer: Weight loss of 7–10% of body weight through diet and exercise

Lifestyle modification achieving 7–10% weight loss is the most effective intervention for NAFLD, consistently improving steatosis, inflammation, and fibrosis on histology.

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.

A patient with HFrEF on lisinopril develops a persistent dry cough. What is the best medication change?

Answer: Switch to an ARB

ARBs provide equivalent cardiovascular benefits to ACE inhibitors without causing bradykinin-mediated cough.

In Family Practice Exam practice, what is the best approach to quality improvement in musculoskeletal?

Answer: Use data-driven methods with measurable outcomes

Data-driven quality improvement with measurable outcomes ensures that changes actually produce the intended improvements and can be verified.

Which professional attribute is most valued in preventive medicine within the Family Practice Exam field?

Answer: Accountability and commitment to standards

Accountability and commitment to professional standards build trust and ensure consistent, high-quality practice.

What is the most important factor in effective communication with patients regarding geriatric care?

Answer: Using clear, understandable language and confirming understanding

Clear communication in understandable language, with confirmation of understanding, improves patient compliance and outcomes.

In Family Practice Exam practice, what is the primary purpose of strategic planning?

Answer: To align resources with goals and anticipate challenges

Strategic planning aligns organizational resources with goals and helps anticipate challenges before they become critical issues.

A 32-year-old woman presents with a painless, soft, mobile neck lump that moves upward when she swallows. What is the most likely diagnosis?

Answer: Thyroglossal duct cyst

A midline neck mass that elevates with swallowing or tongue protrusion is characteristic of a thyroglossal duct cyst.

Which of the following best describes the role of the SGLT-2 inhibitor empagliflozin in chronic disease management beyond glycemic control?

Answer: Reduces cardiovascular mortality and hospitalizations for heart failure in type 2 diabetes

The EMPA-REG OUTCOME trial demonstrated that empagliflozin significantly reduces cardiovascular death and heart failure hospitalizations in type 2 diabetes patients with established CVD.

A patient with severe right upper quadrant (RUQ) pain presents. Which imaging test should be used to evaluate this patient?

Answer: Ultrasound (US)

For a patient presenting with severe right upper quadrant (RUQ) pain, an ultrasound (US) is the initial imaging modality of choice. It is non-invasive, readily available, and highly effective at visualizing the gallbladder, bile ducts, and liver. This makes it ideal for diagnosing common causes of RUQ pain such as gallstones, cholecystitis, or liver abnormalities.

Which professional attribute is most valued in dermatology within the Family Practice Exam field?

Answer: Accountability and commitment to standards

Accountability and commitment to professional standards build trust and ensure consistent, high-quality practice.

Which antibody test is the preferred initial screening test for celiac disease in patients with adequate IgA levels?

Answer: Anti-tissue transglutaminase IgA (anti-tTG IgA)

Anti-tTG IgA is the single best screening test for celiac disease due to its high sensitivity (>95%) and specificity (~95%) and is recommended by all major guidelines.