Family Practice Exam Chronic Disease Management 2

Question 1

A 58-year-old patient with type 2 diabetes has an HbA1c of 9.2% despite metformin monotherapy. What is the most appropriate next step?

Accepted Answer

Add a second oral agent or injectable therapy

Answer

When HbA1c remains above target on metformin monotherapy, guidelines recommend adding a second agent such as a GLP-1 agonist, SGLT-2 inhibitor, or sulfonylurea.

Question 2

Which blood pressure target is recommended for a 72-year-old patient with hypertension but no diabetes or CKD, according to current ACC/AHA guidelines?

Accepted Answer

Less than 130/80 mmHg

Answer

The 2017 ACC/AHA guidelines recommend a BP target of less than 130/80 mmHg for most adults, including older patients who can tolerate treatment.

Question 3

A COPD patient with frequent exacerbations (≥2/year) and severe airflow limitation is best treated with which maintenance regimen?

Accepted Answer

LABA + LAMA + ICS triple therapy

Answer

Patients with frequent exacerbations and severe COPD benefit most from triple therapy combining LABA, LAMA, and inhaled corticosteroids to reduce exacerbation risk.

Question 4

Which laboratory finding most strongly indicates the need to initiate statin therapy in a patient without known cardiovascular disease?

Accepted Answer

10-year ASCVD risk ≥7.5% with LDL ≥70 mg/dL

Answer

ACC/AHA guidelines recommend initiating statin therapy for primary prevention when the 10-year ASCVD risk is ≥7.5% and LDL is ≥70 mg/dL.

Question 5

A patient with heart failure with reduced ejection fraction (HFrEF) is already on ACE inhibitor and beta-blocker. Which additional drug class has been shown to reduce mortality?

Accepted Answer

Mineralocorticoid receptor antagonist (spironolactone)

Answer

Aldosterone antagonists such as spironolactone reduce mortality in HFrEF when added to ACE inhibitor and beta-blocker therapy, as shown in the RALES trial.

Family Practice Exam Practice Test

Family Practice Exam Practice Test

Family Practice Exam Chronic Disease Management 2