Family Medicine Quiz 🦁

Q1

Prevention

A Family Physician decided to start with screening of visual acuity of preschool children in local schools. Which of the following best describes this activity?

✓ Explanation: Screening = early detection of a disease or problem before complications arise. This is secondary prevention — it detects existing (asymptomatic) conditions early. It is not primary prevention.

Q2

Prevention

A Family Physician decided to start with screening of hypertension among obese and diabetic patients. Which of the following best describes this activity?

✓ Explanation: Screening for hypertension = early detection of asymptomatic disease. This is secondary prevention.

Q3

Primary Care

A 70-year-old man presents with heaviness in the chest on exertion for the past few weeks. He has high cholesterol on medication; BP is 160/70 mmHg. Your FIRST step in management:

✓ Explanation: Chest heaviness on exertion = suspected ischemic cardiac pain. In primary care, ECG should be performed first when cardiac ischemia is suspected, before any other workup.

Q4

Primary Care

A 65-year-old hypertensive man presents with BP 200/110 mmHg, RR 28, HR 110 regular. What is your NEXT step?

✓ Explanation: Severe BP alone does not determine urgency vs emergency. The next step is assessment for target organ damage (TOD). If TOD is present, urgent referral follows.

Q5

Primary Care

A 55-year-old woman has intermittent chest pain for 3 months and stopped exercising. Which feature SUGGESTS the pain is NOT related to myocardial ischemia?

✓ Explanation: Ischemic pain is pressure-like, squeezing, exertional, possibly with dyspnea. Sharp pleuritic pain increasing with inspiration is NOT typical for myocardial ischemia — it suggests a pleuropericardial cause.

Q6

Communication

Which of the following is NECESSARY for successful consultation?

✓ Explanation: Successful consultation requires both good communication AND clinical competence. The family physician must handle undifferentiated problems with relevant clinical knowledge and skills.

Q7

Communication

A patient comes with headache; you suspect a psychosocial etiology. Which question BEST preserves trust while starting history?

✓ Explanation: The best opening is open-ended and non-judgmental. 'Tell me more about your headache' lets the patient speak freely before directing toward psychosocial questions.

Q8

Communication

A patient presents with abdominal pain. Which statement is MOST likely to elicit a patient-centered description?

✓ Explanation: 'Tell me more about that' is an open-ended invitation that allows the patient to describe the problem from their own perspective, not from the doctor's narrow framework.

Q9

Communication

A 33-year-old woman has recurrent nausea and vomiting for 20 years. All endoscopic, pathologic, and radiologic evaluations are repeatedly normal. Which approach offers MOST diagnostic and therapeutic benefit?

✓ Explanation: Repeated normal investigations + chronic unexplained symptoms = the physician must look for a hidden agenda or psychosocial factors rather than repeating the same investigations.

Q10

Communication

A 30-year-old secretary presents with headaches for 1 week (band-like, improved by paracetamol). She has work stress, guilt about her children, and poor sleep/eating. Your NEXT step:

✓ Explanation: Clear psychosocial clues: guilt, poor sleep, poor appetite, work stress. The correct next step is screening for depression by asking about mood and loss of interest.

Q11

Communication

An 87-year-old man has bronchoscopy-confirmed malignancy. The family urges you not to tell him the diagnosis. What is the CORRECT course of action?

✓ Explanation: A competent patient has autonomy and the right to know his diagnosis. You acknowledge the family's concern but do not lie or conceal a confirmed diagnosis.

Q12

Lifestyle

Mr. Ali, 35-year-old programmer, BMI 28, waist 43 inches, BP 135/88, family history of DM/HTN/CAD, no exercise, high stress. What is the MODIFIABLE risk factor?

✓ Explanation: Family history, age, and sex are non-modifiable. Elevated BP is modifiable through lifestyle changes and follow-up.

Q13

Lifestyle

Regarding Mr. Ali's calorie intake, choose the BEST answer:

✓ Explanation: Body weight depends mainly on total calorie balance. Meal timing/redistribution (more at breakfast) may help appetite control and reduce snacking. Both A and C are correct.

Q14

Lifestyle

Which of the following is NOT one of the Five A's counselling approach?

✓ Explanation: The Five A's are: Ask, Advise, Assess, Assist, Arrange. 'Alter' is not one of them.

Q15

Lifestyle

Which should NOT be a component of the family medicine approach for Mr. Ali's lifestyle modification?

✓ Explanation: Family medicine counselling is patient-centered and negotiated. A strict doctor-imposed plan reduces adherence and contradicts patient-centered care.

Q16

Lifestyle

A 40-year-old executive who smokes 3 packs/day wants to quit. He has resistant hypertension and family history of premature CVD. Which diseases have been LINKED to cigarette smoking?

✓ Explanation: Smoking is linked to malignancy, cardiovascular disease, pregnancy complications, and vascular/cognitive risks including all options listed.

Q17

Lifestyle

Which is the MOST IMPORTANT factor in determining the success of a smoking cessation program in an individual?

✓ Explanation: Readiness and motivation (patient's desire to quit) are the strongest determinants. Drugs and advice help, but they cannot replace patient readiness.

Q18

Lifestyle

Assuming patient interest in smoking cessation, which method results in the HIGHEST percentage of both short-term and long-term success?

✓ Explanation: Combined approach: behavioral support + nicotine replacement + quit plan + follow-up is more effective than any single isolated method.

Q19

Lifestyle

Which stage of the behavioral change process has the HIGHEST self-efficacy?

✓ Explanation: Self-efficacy is highest in the Maintenance stage, when the patient has already sustained the behavior change and successfully resisted relapse over time.

Q20

Geriatrics

A 75-year-old female admitted with pneumonia has dementia, osteoporosis, and hypertension. What are the KEY elements of a comprehensive geriatric assessment (CGA)?

✓ Explanation: CGA includes cognitive, functional, medication, nutritional, fall risk, and social domains. Both sets of elements are required.

Q21

Geriatrics

A 75-year-old female admitted with pneumonia (dementia, osteoporosis, HTN). How would you ASSESS her cognitive function?

✓ Explanation: All are valid cognitive assessment tools. Mini-Cog is practical in primary care; MMSE and MoCA are also accepted. The choice depends on clinical context.

Q22

Geriatrics

Based on the CGA of this 75-year-old patient with pneumonia, dementia, osteoporosis, and HTN, what INTERVENTIONS would be recommended?

✓ Explanation: CGA leads to coordinated interventions including medication review, nutrition, physiotherapy, cognitive support, social support, and fall prevention.

Q23

Geriatrics

Activities of daily living (ADLs) include ALL EXCEPT:

✓ Explanation: Bathing, dressing, toileting, and feeding are basic ADLs. Handling finance is an Instrumental ADL (IADL), not a basic ADL.

Q24

Geriatrics

A 70-year-old hospitalized for pneumonia (50 pack-year smoker, on oxygen) becomes confused, disoriented, and has visual hallucinations of spiders on day 3. What is the RIGHT diagnosis?

✓ Explanation: Acute onset confusion + disorientation + visual hallucinations during acute illness = Delirium. Dementia is chronic and progressive, not acute-onset.

Q25

Geriatrics

A 60-year-old woman presents with daily low back pain for 3 months just after retirement. Pain is dull and diffuse; temporary improvement with analgesics/warm pads. Most appropriate NEXT step:

✓ Explanation: Retirement + chronic diffuse pain + poor response to simple measures = important to assess for depression/psychosocial factors, especially in older adults.

Q26

Geriatric Health

A 75-year-old male (HTN, hyperlipidemia, on atenolol + simvastatin) presents for routine health maintenance. What is the recommended SCREENING TEST for colorectal cancer?

✓ Explanation: The recommended colorectal cancer screening is colonoscopy every 10 years for average-risk adults.

Q27

Geriatric Health

Same 75-year-old male (HTN, hyperlipidemia). What is the recommended VACCINATION SCHEDULE?

✓ Explanation: Elderly health maintenance includes: annual influenza vaccine, pneumococcal vaccine (once), and Td booster every 10 years.

Q28

Geriatric Health

A 70-year-old male smoker with COPD (on bronchodilators + inhaled corticosteroids). What is the recommended LUNG CANCER SCREENING?

✓ Explanation: For high-risk older smokers, lung cancer screening is by annual low-dose CT (LDCT) — not chest X-ray or sputum cytology.

Q29

Geriatric Health

Same 70-year-old smoker with COPD. What is the MOST IMPORTANT aspect of managing COPD?

✓ Explanation: COPD management requires smoking cessation, pulmonary rehabilitation, and medication adherence. While smoking cessation is critical, all are important components.

Q30

Geriatric Health

A 72-year-old male (HTN, hyperlipidemia, prostate cancer post-surgery 5 years ago; on atenolol, simvastatin, aspirin) presents for routine maintenance. Most important health maintenance issues to address?

✓ Explanation: Geriatric health maintenance is broad: chronic disease control, cancer surveillance/screening, cognition, bone health, and vaccines. All apply.

Q31

Geriatric Health

Same 72-year-old patient on aspirin. What are the POTENTIAL RISKS AND BENEFITS of continuing aspirin therapy?

✓ Explanation: Aspirin can reduce cardiovascular events in selected patients but increases bleeding risk, especially in older adults.

Q32

Geriatric Health

An 85-year-old female (osteoporosis, HTN, hyperlipidemia; on Ca/Vit D, atenolol, simvastatin) presents with memory loss and difficulty with daily activities. Most appropriate approach to assessing cognitive function?

✓ Explanation: Memory loss + difficulty with ADLs needs full CGA — not just one cognitive test. CGA assesses cognition, function, medications, nutrition, social support, and safety.

Q33

Geriatric Health

Same 85-year-old patient. What are the POTENTIAL CAUSES of her memory loss and difficulty with daily activities?

✓ Explanation: In geriatrics, cognitive/functional decline can be neurodegenerative, vascular, medication-related, nutritional, sleep-related, social, or due to chronic illness. All are valid causes.

Q34

Geriatric Health

Same 85-year-old patient with osteoporosis. What are the RECOMMENDED STRATEGIES for managing her osteoporosis?

✓ Explanation: Osteoporosis management includes supplementation, weight-bearing exercise, antiresorptive therapy (bisphosphonates), and fall prevention strategies.

Q35

Communication

What does the 'S' in SPIKES stand for?

✓ Explanation: S = Setting up the interview: arrange privacy, sit down, avoid interruptions, involve significant others if appropriate, and prepare the interview environment.

Q36

Communication

In breaking bad news, what should you AVOID?

✓ Explanation: You should NOT assume the patient's coping preference. Ask, assess, support, and respond to the patient's emotional state rather than acting on assumptions.

Q37

Communication

The patient complains of constipation and mentions his mother's recent death. What should you ask him?

✓ Explanation: This explores the emotional context and hidden agenda rather than treating the physical symptom mechanically. The bereavement is likely the underlying driver of the visit.

Clinical Knowledge Quiz

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