FAMILY MEDICINE (FM EOR) PAEA EXAM 2024/2025 –
QUESTIONS WITH CORRECT SOLUTIONS
51 year-old patient presents for follow-up after a recent stroke. Cardiac examination reveals a moderately loud systolic ejection murmur in the 2nd and 3rd interspaces parasternally. The second heart sound is fixed and widely split. Which of the following is the most likely diagnosis in this patient?
- Aortic stenosis
- Mitral valve regurgitation
- Patent foramen ovale
- Ventricular septal defect Right Ans - C. A patent foramen ovale is
- Rubeola
- Parvovirus B19
- Respiratory syncytial virus
- Epstein-Barr virus Right Ans - B. This is a classic presentation of Fifth
- D dimer assay
- PT with INR
- Factor V assay
- Clotting time Right Ans - A. Even though useful in ruling in a
present in 25% of the population and can lead to paradoxic emboli and cerebrovascular events. Suspicion should be highest in patients who have cryptogenic stroke before age 55 years.A 5 year-old male is brought to the office by his father who reports a 2 day history of low grade fever and coryza. The child awoke this morning with bright red cheeks. Physical examination reveals edematous, confluent plaques over the malar region of the face and reticular rash over the child's extensor surfaces. Which of the following is the most likely diagnosis?
Disease, a childhood exantham associated with human parvovirus B19 In a patient with a low probability of pulmonary embolism (PE) based on the Wells criteria, which of the following lab studies is most helpful in ruling out a PE?
pulmonary 1 / 4
Which subset of the asymptomatic general population should undergo one- time screening for abdominal aortic aneurysm?
- 65 year-old female with chronic kidney disease
- 65 year-old healthy male who has smoked since age 20
- 74 year-old male who has diabetes mellitus
- 74 year-old female who has smoked since age 15 Right Ans - B. . Data
- Selective serum reuptake inhibitor (SSRIs)
- Selective estrogen receptor modulator (SERMs)
- Testosterone
- Progesterone Right Ans - B. SERM therapy is particularly effective in
- Ultrasound
- Physical examination
- Anterior/posterior radiograph
- Computed tomography Right Ans - B. A careful physical examination
support the use of abdominal ultrasound to screen 65- to 74-year old men, but not women, who have a history of smoking. Repeated screening does not appear to be needed if the aorta shows no enlargement.Which of the following is the pharmacologic therapy of choice in male patients suffering from mild-moderate gynecomastia?
glandular ("lumpy") gynecomastia. Examples of SERMS are tamoxifen and raloxifene.A 4 week-old female is seen for a well child visit. Birth history is significant for breech presentation and weighing 9 pounds 8 ounces at delivery. Which of the following is indicated to rule out developmental dysplasia of the hip?
at birth and repeated evaluation at each well visit until the child walks is indicated to identify DDH. A high degree of suspicion is necessary in children with risk factors for DDH, such as positive family history, ligamentous laxity, breech presentation, female gender, large fetal size, and first-born status. 2 / 4
A 72 year-old female with a history of diabetes mellitus presents with sudden onset of painless flashing lights and floaters followed by curtain-like vision loss sparing the central vision in the right eye. Which of the following is the most likely diagnosis?
- Classic migraine
- Retinal detachment
- Optic neuritis
- Transient ischemic attack Right Ans - (u) A. Classic migraine may
- January 4
- January 11
- February 11
- February 12 Right Ans - C. Calculation is based on Naegele's rule by
- Haemophilus influenzae
- Moraxella catarrhalis
- Mycoplasma pneumoniae 3 / 4
present with the above symptoms; however, the symptoms are typically bilateral.Additionally, given the advanced age of the patient migraine would be considered less likely.(c) B. Non-traumatic retinal detachment usually presents in an older individual. The classic symptoms include abrupt onset of painless flashing lights and floaters followed by progressive vision loss.(u) C. Optic neuritis may present with the above symptoms; however, the mean age of onset is 32 years of age and the presentation typically involves ocular pain.(u) D. Vertebrobasilar insufficiency may result in dysfunction of the visual cortex with subsequent vision disturbance similar to the above presentation. In contrast the patient may present with additional findings of sensorimotor dysfunction.A patient presents to the office with a last menstrual period of May 4th.What is the estimated date of confinement?
adding 7 days to the first day of the last menstrual period and then subtracting 3 months Empiric treatment for infective endocarditis should target which organism?
- Staphylococcos aureus Right Ans - D. Empiric regimens for
- Adhesions
- Sigmoid volvulus
- Incisional hernia
- Intussusception Right Ans - (c) A. The patient's surgical history,
- / 4
endocarditis while culture results are pending should include agents active against staphylococci, streptococci, and enterococci A 68 year-old woman presents with intermittent crampy abdominal pain and vomiting of 6 hours' duration. She feels bloated but denies rectal bleeding. Examination of the abdomen reveals no palpable mass and you note an upper midline scar from previous abdominal surgery. An abdominal radiograph demonstrates dilated loops of small bowel with air-fluid levels. Which of the following is the most likely cause of this patient's symptoms?
presenting symptoms and abdominal imaging are consistent with small bowel obstruction. Peritoneal adhesions are the most common cause of small bowel obstruction.(u) B. Sigmoid volvulus or twisting of the sigmoid colon on its mesentery leads to colonic obstruction. This patient does not complain of constipation or report laxative use. Abdominal radiographs would show a dilated colon lacking haustral folds.(u) C. Hernias may occur after abdominal surgery but are usually more chronic in nature and a mass would be palpable especially with maneuvers that increase intra-abdominal pressure.(u) D. Intussusception, although rare in adults, may occur due to small bowel neoplasia but this patient does not complain of bleeding and no mass was palpable on exam. Also a CT scan would usually show a target lesion representing the layers of intussuscepted segment.An 18 year-old college freshman presents to the student health clinic complaining of an outbreak of "athlete's foot" in his dormitory. He has no current signs or symptoms of infection, but is asking for advice on how to prevent