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Family Medicine Aquifer Test-| Questions Solved 100% Correct
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Family Medicine Aquifer Test-| QuestionsSolved 100% Correct
A 25-year-old patient presents to the office for follow-up on anxiety and tobacco
dependence. She reports she is doing well on her new medication to help with both her
mood and smoking, though she continues to smoke. She recently started her first
sexual relationship with a new female partner. She received a tetanus vaccine at the
age of 18, and she received her flu vaccine this year. Her blood pressure is 122/70, and
her physical exam is within normal limits. You review her recent Pap test, which was
negative. Which of the following indicates the vaccines she should receive today? A.
HPV vaccine alone
B. HPV vaccine and pneumococcal conjugate vaccine (PCV13)
C. HPV vaccine and pneumococcal polysaccharide vaccine (PPSV23)
D. HPV vaccine and Zoster vaccine
E. No vaccines are needed - ANSWER C. HPV vaccine and pneumococcal
polysaccharide vaccine (PPSV23)
A 55-year-old male with no significant past medical history presents for a routine
physical exam. He last saw a doctor five years ago. Social history is remarkable for a
35-pack-year tobacco history since the age of 20. He indicates that his wife and children
have urged him to quit smoking for the last few months. When you ask him if he has
considered quitting, he replies, "I just don't see what the big deal is!" Which stage of
change best describes this patient at this time?
A. Action
B. Contemplation
C. Maintenance
D. Precontemplation
E. Preparation - ANSWER D. Precontemplation
A 48-year-old male with a past medical history that includes hypertension, chronic
obstructive pulmonary disease (COPD), and hyperlipidemia presents to clinic as a
new patient in October for a general physical exam. History reveals that he has been
smoking a pack of cigarettes daily since age 20. He drinks two beers daily. He is
,intermittently nonadherent with his medications. Review of the state immunization
database reveals that the only immunization he has received as an adult was a tetanus
diphtheria shot administered 12 years ago. Which of the following vaccine combinations
would be most appropriate for this patient?
A. Influenza, meningococcal, and zoster
B. Influenza, pneumococcal, and Tdap
C. Influenza, zoster, and Tdap
D. Meningococcal, pneumococcal, and Tdap
E. Meningococcal, pneumococcal, and zoster - ANSWER B. Influenza, pneumococcal,
and Tdap
A 55-year-old male comes to the clinic for a visit. He has read about the dangers of
being overweight and inquires about which category he fits into. He is 5' 10'' (1.78 m)
and weighs 220 lbs (100 kg), BMI = 31.6. Which of the following categories most
accurately describes the patient based on his BMI?
A. Ideal
B. Morbidly (very severely) obese
C. Obese
D. Overweight
E. Underweight - ANSWER C. Obese
A 55-year-old male with a family history of melanoma presents to the clinic for
evaluation of a skin lesion on his back which appeared three months ago. His wife
first alerted him to it, hasn't noticed it change and he has not noticed any symptoms
associated with it. Physical examination reveals a 7 mm uniformly black macule that is
symmetrically round with sharply demarcated borders on his upper back near the right
shoulder. Which of the following characteristics would most justify it being biopsied
today?
A. Borders
B. Color
C. Diameter
D. Location
E. Symmetry - ANSWER C. Diameter
A 55-year-old male with no significant past medical history and generally healthy
behaviors presents to clinic for a health care maintenance exam. He says, "I'd like to get
tested for all types of cancer." He does not have any family history of cancer. Review of
,systems is negative for any symptoms of prostate cancer, such as urinary frequency,
urgency, retention, hematuria, weight loss, or back pain. He is a lifelong non-smoker,
and he doesn't drink alcohol or use recreational drugs. Which of the following
screening tests is given either a USPSTF A or B recommendation in favor of its routine
use for patients such as this one?
A. Colon cancer screening
B. ECG screening for coronary artery
disease C. Lung cancer screening
D. Pancreatic cancer screening
E. Prostate specific antigen (PSA) testing - ANSWER A. Colon cancer screening
Ms. Marcos is a 65-year-old woman with a past medical history of Type 2 diabetes,
hypertension, and hypercholesterolemia who presents with six months of insomnia
despite self-medication with acetaminophen, diphenhydramine, and herbal remedies.
She is 5' 2" and weighs 250 lbs.
When considering a differential diagnosis, which one of the following is a
common cause of insomnia in the elderly?
A. Asymptomatic coronary artery disease
B. Chronic sinusitis
C. Hypoparathyroidism
D. Pneumonia
E. Sleep Apnea - ANSWER E. Sleep Apnea
Ms. Anderson is a 60-year-old woman who comes in to clinic as a walk in appointment.
She is tearful and is carrying a box of tissues in her hand. She says she doesn't know
why but she has been very sad of late. She reports trouble falling asleep and staying
asleep. She used to be the head of her Bridge club, but quit two weeks ago and doesn't
feel like going out anymore. She also says she has lost interest in walking her dog, and
now just allows him to use the doggie door to let himself out. She also says she feels
weak and fatigued and no longer has the energy to do her gardening or shopping. She
spends most of her day on the sofa crying while watching TV. She also reports a
greatly diminished appetite. She denies suicidal or homicidal ideation, but she does
have a history of a previous suicide attempt following her divorce seven years ago for
which she was hospitalized. A recent CBC, CMP, CXR, TSH, U/A and CT of th -
ANSWER B. Two weeks
Mr. Jones is an 82-year-old man who presents to the office for his six-month chronic
disease visit. His diabetes and hypertension are controlled on his usual home
, medications. He reports that his wife died four weeks ago, and he is now experiencing
insomnia most days of the week and fatigue and loss of energy nearly every day;
reports decreased enjoyment of his activities, such as playing chess with his neighbor;
and is also experiencing loss of appetite but no weight loss. He denies any suicidal
ideation and has no previous suicide attempts. Mr. Jones says he often hears his wife's
voice while going to bed. He says he goes to church to pray. You are trying to
determine if your patient's symptoms are normal grief or if you should diagnose and
treat him for Major Depressive Disorder (MDD). Which feature of Mr. Jones' case would
suggest MDD rather than a normal grief reaction?
A. Change in appetite
B. Fatigue
C. Heari - ANSWER D. Inability to experience any joy
Mr. Brown is a 42-year-old male accountant with a significant past medical history of
obesity who presents to his primary care physician after one week of lower back pain.
After moving into a new home three days ago, he woke up the next morning with bilateral
lower back pain without any radiation. He denies any recent trauma, fever, chills,
numbness, tingling, or incontinence. He has not had any urinary frequency or dysuria.
He takes no medications and has no significant past medical history.
Which additional findings in his history or physical exam would make the diagnosis of
lumbosacral sprain/strain more likely?
A.) Abnormal gait
B.) Increased pain with coughing
C.) Loss of ankle jerk
D.) Point tenderness on spinous processes
E.) Spasm of paraspinous muscles - ANSWER E.) Spasm of paraspinous muscles
Mr. Giovanni is a 37-year-old male who drives a delivery truck. He presents to your
clinic after acute onset of severe lower back pain that began after lifting a large
package while at work. When you enter the room, you find him standing, unable to sit
comfortably.
On physical exam, he has limited lumbar flexion, reduced to 45 degrees, positive
straight leg test at 45 degrees on the left, normal gait, but difficulty with heel walk. He
has 4/5 strength on the left with ankle plantar flexion. Strength is preserved on the
right. Which additional physical exam finding would be consistent with this man's level
of disc herniation?
A. 2/5 strength on hip flexion
B. Decreased range of motion on lumbar extension
C. Decreased rectal tone
D. Hypoactive ankle tendon reflex
E. Positive Stoop test - ANSWER D.) Hypoactive ankle tendon reflex
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