Family Practice Exam Preventive Medicine 3 — Questions and Answers
Question 1: Which breast cancer risk reduction medication is recommended by the USPSTF for high-risk women aged 35 and older who do not have a prior breast cancer diagnosis?
- Metformin
- Tamoxifen or raloxifene (Correct answer)
- Aromatase inhibitors only
- Medroxyprogesterone
Correct answer: Tamoxifen or raloxifene
USPSTF recommends clinicians offer risk-reducing medications (tamoxifen, raloxifene, or aromatase inhibitors) to women at increased risk for breast cancer.
Question 2: At what blood pressure level does the JNC/ACC-AHA define Stage 2 hypertension?
- 120–129 / <80 mmHg
- 130–139 / 80–89 mmHg
- ≥140 / ≥90 mmHg (Correct answer)
- ≥160 / ≥100 mmHg
Correct answer: ≥140 / ≥90 mmHg
The 2017 ACC/AHA guidelines define Stage 2 hypertension as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg.
Question 3: Hepatitis C screening is recommended by USPSTF for all adults in which age range, regardless of risk factors?
- 18–49 years
- 18–79 years (Correct answer)
- 25–65 years
- 40–75 years
Correct answer: 18–79 years
USPSTF recommends hepatitis C virus screening for all adults aged 18–79 years, reflecting high prevalence in birth cohorts beyond just 1945–1965.
Question 4: Which immunization series requires 3 doses and provides protection against cervical cancer caused by HPV types 16 and 18?
- Gardasil 9 given at 15 or older (Correct answer)
- Cervarix given at any age
- Gardasil 9 given before age 15
- Recombivax given in adolescence
Correct answer: Gardasil 9 given at 15 or older
When HPV vaccination is started at age 15 or older, a 3-dose schedule is required; starting before age 15 requires only 2 doses.
Question 5: Primary prevention of type 2 diabetes in a prediabetic patient is best achieved with which intervention?
- Metformin monotherapy
- Intensive lifestyle intervention (5–7% weight loss + 150 min/week exercise) (Correct answer)
- Low-dose aspirin therapy
- Annual HbA1c monitoring alone
Correct answer: Intensive lifestyle intervention (5–7% weight loss + 150 min/week exercise)
The Diabetes Prevention Program demonstrated that intensive lifestyle changes reducing 5–7% body weight and achieving 150 min/week of physical activity reduce diabetes onset by ~58%.
Question 6: The USPSTF recommends depression screening for adults. What is the essential prerequisite for implementing population-wide screening?
- Patient history of prior depressive episodes
- Adequate staff and systems in place to ensure diagnosis and treatment (Correct answer)
- Age ≥ 40 years
- Presence of a mental health specialist in the practice
Correct answer: Adequate staff and systems in place to ensure diagnosis and treatment
USPSTF specifies that screening for depression is indicated only when adequate systems are in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.
Question 7: Which osteoporosis screening recommendation is consistent with USPSTF guidelines for postmenopausal women?
- Screen all women at age 60 regardless of risk
- Screen women aged 65 and older, and younger postmenopausal women with increased fracture risk (Correct answer)
- Screen only women with a prior fragility fracture
- Screen all women beginning at menopause
Correct answer: Screen women aged 65 and older, and younger postmenopausal women with increased fracture risk
USPSTF recommends bone density screening for all women aged ≥65 and for postmenopausal women under 65 whose 10-year fracture risk is equal to or greater than that of a 65-year-old white woman.
Family Practice Exam Preventive Medicine 3
Which breast cancer risk reduction medication is recommended by the USPSTF for high-risk women aged 35 and older who do not have a prior breast cancer diagnosis?