Family Practice Exam Family Practice Exam 2

Question 1

A 55-year-old male with type 2 diabetes presents for routine follow-up. His HbA1c is 8.9%. He is currently on metformin 1000 mg twice daily. What is the most appropriate next step?

Accepted Answer

Add a GLP-1 receptor agonist or SGLT-2 inhibitor

Answer

Switch to insulin immediately

Answer

Increase metformin to 2500 mg/day

Answer

Refer to endocrinology before any medication change

Question 2

A 32-year-old woman presents with a 3-day history of dysuria, urinary frequency, and suprapubic pain. Urinalysis shows pyuria and bacteriuria. She has no fever or flank pain. What is the most appropriate treatment?

Accepted Answer

Trimethoprim-sulfamethoxazole for 3 days only if local resistance <20%

Answer

Nitrofurantoin for 5 days

Answer

IV ceftriaxone for 7 days

Answer

Ciprofloxacin for 14 days

Question 3

Which vaccine is recommended for all adults aged 19–64 who smoke cigarettes, regardless of other indications?

Accepted Answer

Pneumococcal vaccine (PCV15 or PCV20)

Answer

Hepatitis A vaccine

Answer

Meningococcal vaccine

Answer

Varicella vaccine

Question 4

A 70-year-old woman on warfarin for atrial fibrillation presents with an INR of 6.2 but no active bleeding. What is the most appropriate management?

Accepted Answer

Hold warfarin and recheck INR in 1–2 days

Answer

Administer vitamin K 10 mg IV push immediately

Answer

Give fresh frozen plasma

Answer

Continue warfarin and recheck in 1 week

Question 5

A 45-year-old man is found to have a blood pressure of 148/94 mmHg on three separate visits. He has no other comorbidities. Which lifestyle modification has the greatest impact on lowering blood pressure?

Accepted Answer

Weight reduction of 5–10% of body weight

Answer

Eliminating all dietary fat

Answer

Reducing coffee intake to one cup per day

Answer

Starting a daily aspirin

Question 6

A 28-year-old woman presents 6 weeks postpartum with persistent sadness, inability to bond with her newborn, and passive thoughts of self-harm. She is breastfeeding. What is the safest first-line pharmacologic option?

Accepted Answer

Sertraline

Answer

Paroxetine

Answer

Bupropion

Answer

Venlafaxine

Question 7

A 62-year-old man with a 40 pack-year history presents for a preventive visit. He currently smokes. Per USPSTF guidelines, which screening is indicated?

Accepted Answer

Annual low-dose CT of the chest for lung cancer screening

Answer

Annual chest X-ray for lung cancer screening

Answer

Sputum cytology every 6 months

Answer

No lung cancer screening is indicated