Family Medicine Flashcards

A 32-year-old woman at 10 weeks gestation presents with nausea and vomiting. She is unable to keep fluids down and has lost 5% of her body weight. Urinalysis shows ketonuria. What is the diagnosis?

Answer: Hyperemesis gravidarum

Hyperemesis gravidarum is defined by intractable vomiting, dehydration, weight loss >5%, and ketonuria in pregnancy.

A 60-year-old man presents with progressive difficulty initiating urination, weak stream, and nocturia. PSA is 3.2 ng/mL. Rectal exam shows a smooth, enlarged prostate. What is the most likely diagnosis?

Answer: Benign prostatic hyperplasia

A smooth, enlarged prostate on exam with obstructive voiding symptoms and normal PSA is classic for benign prostatic hyperplasia.

A 45-year-old woman presents with a butterfly rash across both cheeks, joint pain, and fatigue. ANA is positive at 1:320. Which additional test best supports the diagnosis of SLE?

Answer: Anti-dsDNA antibody

Anti-dsDNA antibodies are highly specific for SLE and their levels correlate with disease activity, including lupus nephritis.

A 78-year-old man with a history of atrial fibrillation on warfarin presents with acute onset right-sided weakness and aphasia lasting 30 minutes that fully resolved. INR is 1.8. What is this presentation called?

Answer: Transient ischemic attack

Sudden focal neurologic deficits that completely resolve within 24 hours (typically <1 hour) define a transient ischemic attack (TIA).

A 19-year-old college student presents with productive cough, low-grade fever, and headache for 2 weeks. Chest X-ray shows patchy infiltrates. He remains ambulatory. What is the most likely causative organism?

Answer: Mycoplasma pneumoniae

Mycoplasma pneumoniae is the classic cause of atypical (walking) pneumonia in young adults with gradual onset and patchy infiltrates.

A 48-year-old woman presents with bilateral wrist pain, morning stiffness lasting over 1 hour, and symmetric joint swelling. RF and anti-CCP are positive. What is the recommended first-line disease-modifying therapy?

Answer: Methotrexate

Methotrexate is the anchor DMARD for rheumatoid arthritis and the preferred first-line agent due to its efficacy and cost-effectiveness.

A 65-year-old woman presents with sudden-onset severe vertigo, nausea, and vomiting without hearing loss or tinnitus. Dix-Hallpike test is negative. Neurologic exam shows gait ataxia and nystagmus that does not suppress with fixation. What is the most concerning diagnosis?

Answer: Posterior fossa stroke

Nystagmus that does not suppress with fixation and associated gait ataxia suggest a central cause such as cerebellar or brainstem stroke.