Family Practice Exam Family Medicine Exam 4

Question 1

A 6-year-old boy is brought in for bed-wetting at night. He has been dry during the day since age 3. No urinary symptoms or polyuria. What is the most appropriate initial management?

Accepted Answer

Behavioral interventions and bed alarm

Answer

Primary nocturnal enuresis is managed initially with behavioral interventions including fluid restriction at night and moisture alarms, which are most effective.

Question 2

A 50-year-old woman presents with hot flashes, night sweats, and irregular periods. FSH is elevated. Which long-term risk is most important to counsel her about?

Accepted Answer

Accelerated bone loss

Answer

Menopause leads to estrogen deficiency, which accelerates bone resorption and significantly increases the risk of osteoporosis and fractures.

Question 3

A 30-year-old man presents with sudden onset severe unilateral headache described as 'the worst headache of my life.' Neurological exam is normal. What is the next step?

Accepted Answer

Non-contrast CT head

Answer

A thunderclap headache requires immediate non-contrast CT head to evaluate for subarachnoid hemorrhage before any other management.

Question 4

A 62-year-old woman with a 40 pack-year smoking history is being screened for lung cancer. Which imaging modality is recommended?

Accepted Answer

Low-dose CT of the chest annually

Answer

USPSTF recommends annual low-dose CT (LDCT) for adults aged 50–80 with a 20 pack-year history who currently smoke or quit within 15 years.

Question 5

A 4-year-old child is brought in with fever, drooling, and sitting in a tripod position with neck hyperextended. What is the most likely diagnosis?

Accepted Answer

Epiglottitis

Answer

Epiglottitis presents with the classic tripod position, drooling, dysphagia, and high fever and requires emergent airway management.

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Family Practice Exam Family Medicine Exam 4