Family Practice Exam Family Practice Exam MCQ 4

Question 1

A 75-year-old man presents with urinary urgency, frequency, nocturia, and a weak stream. DRE shows a smooth, symmetrically enlarged prostate. PSA is 2.1 ng/mL. What is the most likely diagnosis?

Accepted Answer

Benign prostatic hyperplasia

Answer

Smooth symmetric prostate enlargement with obstructive and irritative voiding symptoms and normal PSA in an elderly man is classic for BPH.

Question 2

A 28-year-old woman presents with a 3-day history of green vaginal discharge, cervical motion tenderness, and adnexal tenderness. Temperature is 38.2°C. What is the recommended outpatient treatment?

Accepted Answer

Ceftriaxone IM + doxycycline + metronidazole

Answer

CDC guidelines for outpatient PID recommend ceftriaxone plus doxycycline plus metronidazole for 14 days to cover gonorrhea, chlamydia, and anaerobes.

Question 3

A 50-year-old man presents with fatigue, arthralgia, bronze-colored skin, and elevated liver enzymes. Serum ferritin is 1200 ng/mL and transferrin saturation is 68%. What is the most likely diagnosis?

Accepted Answer

Hereditary hemochromatosis

Answer

The classic triad of bronze skin, liver disease, and arthralgia with markedly elevated ferritin and transferrin saturation points to hereditary hemochromatosis.

Question 4

A 6-year-old boy is noted to have a harsh systolic ejection murmur at the upper left sternal border that radiates to the back. Femoral pulses are diminished. What is the most likely diagnosis?

Accepted Answer

Coarctation of the aorta

Answer

Coarctation of the aorta presents with upper extremity hypertension, diminished femoral pulses, and a systolic murmur radiating to the back.

Question 5

A 65-year-old smoker presents with a new persistent cough, hemoptysis, and a 15-lb weight loss over 3 months. Chest X-ray shows a 3 cm hilar mass. Which investigation is most critical next?

Accepted Answer

CT chest with contrast and PET scan

Answer

CT of the chest with contrast and PET scan are used together for staging workup of suspected lung malignancy before tissue biopsy planning.

Family Practice Exam Practice Test

Family Practice Exam Practice Test

Family Practice Exam Family Practice Exam MCQ 4