Family Practice Exam Chronic Disease Management 3

Question 1

A 65-year-old woman with osteoporosis has a T-score of -2.8 at the lumbar spine. She has no history of fracture. What is the preferred first-line pharmacologic treatment?

Accepted Answer

Oral bisphosphonate (alendronate or risedronate)

Answer

Oral bisphosphonates are the preferred first-line pharmacologic treatment for osteoporosis due to their established efficacy, safety, and low cost.

Question 2

In a patient with CKD stage 3b (eGFR 35 mL/min/1.73m²) and type 2 diabetes, which glucose-lowering agent requires dose adjustment or avoidance?

Accepted Answer

Metformin (contraindicated below eGFR 30, use caution 30-45)

Answer

Metformin requires caution when eGFR is 30–45 mL/min and is contraindicated below 30 mL/min due to lactic acidosis risk, while many other agents are safer in moderate CKD.

Question 3

Which spirometry pattern is diagnostic of COPD?

Accepted Answer

Post-bronchodilator FEV1/FVC ratio less than 0.70

Answer

COPD is confirmed by a post-bronchodilator FEV1/FVC ratio less than 0.70, indicating irreversible airflow obstruction.

Question 4

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

Accepted Answer

Anticoagulation with a DOAC or warfarin

Answer

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

Question 5

Which of the following is the most appropriate treatment for stable angina refractory to nitrates and beta-blockers?

Accepted Answer

Add a long-acting calcium channel blocker (amlodipine)

Answer

Adding a long-acting dihydropyridine calcium channel blocker like amlodipine is appropriate for stable angina not controlled by nitrates and beta-blockers.

Family Practice Exam Practice Test

Family Practice Exam Practice Test

Family Practice Exam Chronic Disease Management 3