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

Adding a GLP-1 agonist or SGLT-2 inhibitor is recommended when HbA1c remains above goal on metformin, as both classes offer cardiovascular and renal benefits.

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

TMP-SMX for 3 days is first-line for uncomplicated UTI if local E. coli resistance is below 20%; otherwise nitrofurantoin or fosfomycin are preferred alternatives.

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

Current smokers aged 19–64 are at increased risk for invasive pneumococcal disease and should receive pneumococcal vaccination.

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

For supratherapeutic INR without bleeding (INR 5–10), holding warfarin and rechecking in 1–2 days is appropriate; low-dose oral vitamin K may be added if INR >10 or bleeding risk is high.

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

Weight reduction of 5–10% can lower systolic blood pressure by 5–20 mmHg, making it the single most impactful lifestyle intervention for hypertension.

Family Practice Exam Practice Test

Family Practice Exam Practice Test

Family Practice Exam Family Practice Exam 2