NBME Clinical Science Mastery Series: Family Medicine 2

Question 1

The “x-ray an ankle if there is tenderness to the malleolus” rule only applies if _____________.

Answer 1

the tenderness is on all sides of the malleolus –not just one side; one side suggests tendonous injury

Question 2

A person with constipation tries a laxative and complains of diarrhea. You should recommend _____________.

Answer 2

fiber supplementation

Question 3

Describe pleurodynia.

Answer 3

• Infection caused by Enteroviruses (often Coxsackie) that leads to necrosis of the intercostal muscles
• Produces periodic, lancinating pleuritic chest pain (like stabbing pain with breaths)
• Often follows a general viral infection (malaise, sore throat, etc.)
• Labwork shows an elevated creatine kinase

Question 4

Being slow to answer questions but ultimately answering questions correctly is suggestive of ____________ in the elderly.

Answer 4

depression

Question 5

A mother wants her 16-year-old son to be drug tested. What is the legality of the son’s wishes?

Answer 5

Do not test him unless he agrees to be tested.

Question 6

Gastric bypass is reserved for those with BMIs above 35 who have complications (above 40 without complications). What qualifies as a complication?

Answer 6

• Diabetes
• Prediabetes
• Hypertension
• Dyslipidemia

Question 7

If a woman seems to have CHF, which should you do first, a creatinine level or an echo?

Answer 7

Echo

Question 8

The first-line treatment for lateral epicondylitis is _______________.

Answer 8

forearm strap

Question 9

An 80-year-old guy complains of recent morning stiffness and weakness, particularly in the hips and shoulders. What is the diagnosis and treatment?

Answer 9

• Polymyalgia rheumatica

* Corticosteroids (short dose)

Question 10

The AAFP still recommends that LDL be targeted to less than ____________ in diabetics.

Answer 10

100

Question 11

Those with HTN due to ADPCKD should be treated with ________________.

Answer 11

lisinopril