1.

A 30-year-old man has both mild persistent asthma and chronic environmental
allergies. Which of the following medications is indicated for the management
of this patient's conditions?
A. Inhaled albuterol

B. Intranasal fluticasone

C. Oral montelukast

D. Oral cetrizine

2. A 24-year-old woman presents for an initial prenatal visit. She is at 9 weeks'

gestation based on her LMP but, on further questioning, she is not certain of
the first day of her LMP. Which of the following would be the most accurate
estimate of her gestational age?
A. Using her LMP if her uterine size is consistent

B. A first trimester ultrasound

C. A 2nd trimester USG

D. A quantitative serum HCG level

3. A 38-year-old pregnant woman presents for initial visit at 12 weeks' gestation. She requests a
"genetic screen" because she is concerned about her advanced maternal age. She does not want any
invasive testing that may cause a potential miscarriage. Which of the following is most appropriate to
offer this patient?

A. No screening required
B. Draw blood and send for triple or quad screen, as patient has advanced maternal age
C. Nuchal translucency screening and HCG and papp-a
D. Offer chorionic villus sampling

4. A 28-year-old GlPO woman at 16 weeks' gestation is noted to be Rh negative.

Which of the following is the most appropriate next step for this patient?
A. Administer RhoGAM at this time

B. Check patient's antibody screen (indirect coombs)

C. Schedule for amniocentesis to assess for iso immunization

D. Counsel to terminate the pregnancy

5. A 7-month-old male infant is brought into the office for a possible ear infection.
In assessing the infant's posture, you note that he is not able to sit very
well without support. You also observer other fine motor skills and speech.
Which of the following is the most accurate statement?
A. By 3m, child should be able to sit up without support
B. By 6m, child should be able to transfer objects from one hand to another
C. By 9m, child should be able to walk
D. By12m, child should be able to put2words together

6. A 5-year-old child presents to your clinic for a school physical. The child
weighs 42 lb and is up-to-date on his immunizations. Which of the following
anticipatory guidances is most appropriate for a child at this age?
A. He should ride in a rear facing car seat in the back seat of the vehicle
B. He should ride in a forward facing car seat in the back seat of the vehicle
C. He should ride in a forward facing car seat in the front seat of the vehicle
D. He should ride in a booster seat in the back of the vehicle

7. A 42-year-old woman presents to your office for evaluation of chronic abdominal

pain. She has seen you multiple times for this complaint, but the workup
has always been negative. On examination, her abdomen is soft and there are
no peritoneal signs. She has no rash, but does have a purpuric lesion lateral
to her left orbit. Which of the following is the best next step in management?
A. Ask the pt about physical abuse and report suspicions to the local police

B. Ask the pt about physical abuse and provide information about local support services

C. Exclude a bleeding diathesis before inquiring about abuse

D. Order an abdominal x-ray

E. Refer to psychiatry

8. A 7-month-old male infant presents to the emergency department (ED) with

his father after a 1-day history of intractable vomiting. On examination, the
child is lethargic. The anterior fontanel is closed. An abdominal x-ray shows
a nonspecific bowel gas pattern and incidentally reveals a mid-shaft fracture
of the right femur. When confronted about the fracture, the father states that
the child climbed onto a chair and jumped off yesterday. Which of the following
is the most appropriate next step in management?
A. Radiographic bone survey
B. Consulting a child abuse specialist
C. Social services consult
D. Disclosing the parent intension of contactitchild protection services
E. Noncontrast ct of the head

9. An 18-year-old woman reported having intercourse with her boyfriend

20 hours ago. She was concerned because the condom broke. She used no
other form of contraception. The patient reported a history of regular periods
since age 14 of heavy flow that usually lasts for longer than 7 days. She
is 5 ft 8 in tall and weighs 165 lb. She plays as a forward on her high school
basketball team and is worried about becoming pregnant. Which of the following
is the most appropriate method of"emergency contraception"?
A. Yuzpe method
B. Plan B method
C. Insertion of an iud
D. Intramuscular methotrexate
10. A 16-year-old adolescent girl presents to your clinic for a well-child check.
She has been having regular periods for over 2 years, does not drink or smoke,
gets straight As on her report cards, and is in the 75% for height and weight.
She is Tanner Stage 5 for both breast and pubic hair development. During
your interview, she reveals that she is sexually active and not using contraception.
If she continues to have unprotected intercourse, what is the likelihood
that she will become pregnant over the course of the next year?

A. 20%

B. 40%

C. 80%

D. 100%