Family Practice Exam Family Practice Exam MCQ 3 — Questions and Answers
Question 1: A 67-year-old man with a 40 pack-year smoking history presents for a wellness visit. He quit smoking 2 years ago. Which cancer screening is specifically recommended for him?
- Low-dose CT of the chest (Correct answer)
- Sputum cytology
- Chest X-ray annually
- PET scan every 2 years
Correct answer: Low-dose CT of the chest
USPSTF recommends annual low-dose CT for lung cancer screening in adults aged 50-80 with a 20 pack-year history who currently smoke or quit within 15 years.
Question 2: A 55-year-old woman presents with a 2-week history of epigastric pain, early satiety, and unintentional 10-lb weight loss. She denies dysphagia. What is the most appropriate next step?
- Upper endoscopy (Correct answer)
- H. pylori breath test
- PPI trial for 4 weeks
- Barium swallow
Correct answer: Upper endoscopy
Alarm symptoms (age >45, unintentional weight loss, early satiety) mandate prompt upper endoscopy to rule out malignancy.
Question 3: A 4-year-old boy is brought in for fever, ear pain, and irritability for 2 days. Otoscopy shows a bulging, erythematous tympanic membrane with loss of landmarks. He has no drug allergies. What is the first-line treatment?
- Amoxicillin 80-90 mg/kg/day (Correct answer)
- Watchful waiting for 48-72 hours
- Azithromycin for 5 days
- Amoxicillin-clavulanate
Correct answer: Amoxicillin 80-90 mg/kg/day
Children under 2 or those with severe symptoms (bilateral AOM, fever ≥39°C, severe otalgia) should be treated with high-dose amoxicillin as first-line.
Question 4: A 32-year-old woman at 10 weeks gestation asks about prenatal vitamins. Which supplement is most important to prevent neural tube defects when started before conception?
- Folic acid 400-800 mcg daily (Correct answer)
- Iron 30 mg daily
- Calcium 1000 mg daily
- Vitamin D 600 IU daily
Correct answer: Folic acid 400-800 mcg daily
Folic acid supplementation before conception and through the first trimester reduces the risk of neural tube defects such as spina bifida.
Question 5: A 68-year-old woman presents with a T-score of -2.7 on DEXA scan at the lumbar spine. She has no prior fractures. What is the most appropriate initial pharmacologic therapy?
- Alendronate (Correct answer)
- Teriparatide
- Estrogen therapy
- Calcitonin nasal spray
Correct answer: Alendronate
Oral bisphosphonates such as alendronate are first-line pharmacologic treatment for postmenopausal osteoporosis due to proven fracture risk reduction.
Question 6: A 19-year-old college student presents with pharyngitis, cervical lymphadenopathy, fatigue, and splenomegaly. Monospot test is positive. What activity restriction is most critical?
- No contact sports for at least 3-4 weeks (Correct answer)
- No swimming for 2 weeks
- Strict bed rest for 1 week
- No physical activity for 3 months
Correct answer: No contact sports for at least 3-4 weeks
Patients with infectious mononucleosis should avoid contact sports for at least 3-4 weeks due to risk of splenic rupture.
Question 7: A 42-year-old man with obesity (BMI 34) and type 2 diabetes has an HbA1c of 8.2% on metformin monotherapy. Which add-on agent provides both glycemic control and cardiovascular/renal benefit?
- SGLT-2 inhibitor (Correct answer)
- Sulfonylurea
- DPP-4 inhibitor
- Acarbose
Correct answer: SGLT-2 inhibitor
SGLT-2 inhibitors (e.g., empagliflozin) reduce HbA1c and have proven cardiovascular and renal protective benefits in T2DM.
Family Practice Exam Family Practice Exam MCQ 3
A 67-year-old man with a 40 pack-year smoking history presents for a wellness visit.
He quit smoking 2 years ago.
Which cancer screening is specifically recommended for him?