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FMS CERTIFICATION EXAM
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FMS CERTIFICATION EXAM
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FMS CERTIFICATION EXAM NEWEST ACTUAL EXAM 100QUESTIONS AND CORRECT DETAILED ANSWERS (100%
VERIFIED ANSWERS) |AGRADE
A 65-year-old truck driver presents to your office complaining of right calf pain and
swelling. He has recently returned from a four-day cross-country trip after which he
had onset of his current symptoms. The patient reports that the week prior to his
four-day trip, he was mostly in bed recovering from a bout of the flu. His PMH is
significant for DM type 2 and COPD. He has a 25-pack-year smoking history. He
denies having any chest pain or SOB. His physical exam shows 2+ pitting edema of his
right leg. When measuring the circumference of his right leg, you note that it is 14
cm compared to the left, which has a circumference of 10 cm. What is the most
appropriate next step in diagnosis?
A. D-dimer
B. MRI
C. Lower extremity Doppler
D. CT angiography - ANSWER: C
A 45-year-old female presents to your office complaining of left calf pain and
swelling. She reports first noticing the pain after her yoga class earlier in the week.
She denies having any chest pain or shortness of breath. She has no significant PMH.
Her physical exam is significant for tenderness to palpation over the left calf. No
edema or redness is present. The circumference of her left calf is 10 cm and the
circumference of her right calf is 9 cm. What is the most appropriate next step in
diagnosis?
A. D-dimer
B. MRI
C. Lower extremity Doppler
D. CT angiography - ANSWER: A
A 65-year-old truck driver presents to your office complaining of right calf redness
and swelling. He reports that he has had these symptoms off and on for some time
but noticed that the redness and swelling on the right has worsened over the past
few days and he also noticed fevers and chills. His PMH is significant for DM Type 2,
COPD, and heart failure. He has a 25-pack-year smoking history. His physical exam
shows a temperature of 101.1, 2+ pitting edema of his calves bilaterally, and dry,
flaking skin over both calves. His right foot shows interdigital maceration and he has
redness, warmth, and tenderness just inferior to the knee. When measuring the
circumference of his right leg, you note that it is 12 cm compared to the left, which
has a circumference of 10 cm. What is the most appropriate next step in this
patient's care?
A. Initiate treatment with Low molecular weight heparin.
B. Order a lower extremity Do - ANSWER: C
,A 56-year-old Spanish-speaking male presents to your office for a six-month follow-
up visit for DM Type 2 diagnosed at his previous visit with a HbA1C of 7.0%. At that
visit, you discussed dietary modification including eliminating carbohydrates like rice
from his diet. You also emphasized the importance of exercise and recommended he
join a gym. On repeat testing of HbA1C today, you find that his HbA1C has increased
to 7.5%. What might you do differently when counseling the patient at this visit?
A. Suggest he get a personal trainer.
B. Recommend he follow a more strict dietary protocol including elimination of meat
from his diet.
C. Find out from the patient whether barriers exist to his adherence to your previous
suggestions.
D. Tell him you are disappointed that he was not able to adhere to your previous
recommendations. - ANSWER: C
A 55-year-old man presents to your office complaining of pain and stiffness in his
knees. He used to play basketball three times a week with his friends but stopped
about seven months ago because he was finding it difficult to keep up. His PMH is
significant for hypertension, hyperlipidemia, and obesity. His BMI is 32. On exam, he
is afebrile. There is no erythema or effusion of his knee joints but there is crepitus on
movement of each joint. His range of motion of the knees is full. His x-rays show
narrowed joint spaces and subchondral calcification. What is the most appropriate
initial counseling for this patient?
A. Instruct him to see an orthopedist for steroid injections.
B. Refer him for knee replacement surgery.
C. Develop a weight loss plan with the patient.
D. Prescribe opioids for pain relief. - ANSWER: C
A 34-year-old woman who has no past medical problems nor is currently taking any
medications comes into your office because she noticed a tender lump in her left
breast starting approximately one month ago. She is worried because she has an
aunt who had breast cancer that was BRCA positive. Her periods have been regular
since they started at the age of 12 and occur every 32 days. She is currently
menstruating. She has three children aged 12, 9, and 4. On exam, her BMI is 32 and
her other vital signs are stable. On breast exam, you note a mobile rubbery mass of
approximately 1 x 1cm and with regular borders that is tender to palpation. You
appreciate no axillary adenopathy. The rest of her physical exam is unremarkable. Of
the information provided, which of the following places this patient at increased risk
for breast cancer?
A. Age
B. Weight
C. Parity history
D. Family history of cancer
E. Age of menarche - ANSWER: B
,A 64-year-old woman who is overweight with well-controlled hypertension comes to
your office complaining of a lump in her breast that she noticed while showering.
She denies any pain, tenderness, or skin changes. A pertinent review of systems is
negative. Menarche began at the age of 10. Her first child was born when she was 29
and she had her second and last child at the age of 33. She experienced menopause
at the age of 44. Her mother died of colon cancer when she was 65 and her father
passed away from metastatic prostate cancer at the age of 70. She has no history of
tobacco use ever and occasionally drinks a glass of wine with dinner. Her BMI is 34.
Which of the information provided thus far puts the patient at decreased risk for
breast cancer?
A. Age
B. Weight
C. Age at first birth
D. Age at menarche
E. Age at menopause - ANSWER: E
A 63-year old woman comes into your office for her annual preventive exam. She has
hypertension and type 2 diabetes. She is not sexually active and experienced
menopause at the age of 52. Her blood pressure is 125/83 and her physical exam
otherwise is within normal limits. You recommend influenza and zoster vaccination.
Her last colonoscopy was 8 years ago and her last mammogram one year ago was
normal. She has never had an abnormal Pap smear. At the age of 45 she had a total
hysterectomy for fibroids. You tell her she does not require a Pap smear today
because:
A. She has never had an abnormal Pap smear
B. She is not sexually active
C. She had a total hysterectomy for fibroids
D. She is 63 years old
E. She experienced menopause more than 10 years ago - ANSWER: C
A 47-year-old woman comes into your office for a health care maintenance exam.
She has hypertension and type 2 diabetes. She is not sexually active and has not yet
experienced menopause. There is no family history of cancer. Her blood pressure is
118/78, her BMI is 34 and the remainder of her physical exam is within normal limits.
Her vaccinations are up-to-date, she has a PAP smear today and will have labs
drawn. According to USPSTF, which of the following is the best recommendation to
give her concerning mammography?
A. Should have started at age 40 and every year thereafter
B. Should have started at age 40 and every 2 years thereafter
C. Start at age 50 and every year thereafter
D. Start at age 50 and every 2 years thereafter
E. Screening mammography is not recommended at this time - ANSWER: D
, A 27-year-old woman comes into your office because she heard from her friend
about a vaccination against cervical cancer and would like one. She has no medical
problems and has had a Mirena IUD for three years. She has an allergy to latex and
penicillin. She began having sex at the age of 18 and is currently sexually active with
one partner. She occasionally uses condoms. She smokes half a pack of cigarettes per
day. Her mother had endometrial cancer several years ago and had a total
hysterectomy. Why is the patient not a good candidate for the Gardasil vaccination?
A. Age
B. Sexual activity
C. Mirena IUD
D. Allergy to penicillin
E. Family history of endometrial cancer
F. Tobacco use - ANSWER: A
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. Precontemplation
B. Contemplation
C. Preparation
D. Action
E. Maintenance - ANSWER: A
A 55-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 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
noncompliant 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 Tda
C. Influenza, Zoster, and Tda
D. Meningococcal, Pneumococcal, and Tda
E. Meningococcal, Pneumococcal, and Zoster - ANSWER: B
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?
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