Rotation Exam: Family Medicine

Rotation Exam: Family Medicine

Family Practice Clinical Rotation Exam

Are you preparing for your family practice End of Rotation™ (EOR) Exam?

Then get ready to ace your exam with this 84 Question Family Medicine Rotation Practice Exam available to PA students and all members of Smarty PANCE.

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The Smarty PANCE family practice rotation exam follows the format of the PAEA Family Medicine End of Rotation Exam™ Blueprint and is ideal as preparation for your family practice clinical rotation exam and as preparation for your PANCE or PANRE. Smarty PANCE is not sponsored or endorsed by, or affiliated with, the Physician Assistant Education Association. All trademarks are the property of their respective owners.

  • Cardiovascular (15%) 
  • Pulmonology (12%)
  • Gastrointestinal/nutritional (11%)
  • ENOT/ophthalmology (8%)
  • Obstetrics/gynecology (8%)
  • Orthopedics/rheumatology (8%) 
  • Neurology (6%) 
  • Dermatology (5%) 
  • Endocrinology (5%) 
  • Psychiatry/behavioral medicine (5%)
  • Urology/renal (5%) 
  • Hematology (4%) 
  • Infectious diseases (4%) 
  • Urgent care (4%)

Here is a five-question sample from the Smarty PANCE Family Medicine Clinical Rotation Exam:

Family Practice Rotation Sample Exam

Question 1
A 65-year-old female type II diabetic with a history of hypertension, coronary artery disease, and borderline CHF presents to your office. She is currently on metformin 1000 mg QD,  metoprolol 50 mg QD, and hydrochlorothiazide 50 mg QD.  The patient reports increasing shortness of breath and suspects that her CHF is worsening.  A BNP and echocardiogram have been ordered.  The BNP is normal and her ejection fraction is 8% less than her last echo one year ago. Which of the following medications is most important to add or increase in her regimen that will help with her congestive heart failure?
A
Add Lisinopril 20 mg
B
Increase Metoprolol to 100 mg QD
Hint:
See A for explanation
C
Add Lasix 20 mg QD
Hint:
The only time Lasix becomes the primary answer is during acute CHF
D
Add Digoxin
Hint:
Digoxin is only added to increase contractility however it does not decrease the morbidity or the mortality and CHF and lisinopril does.
Question 1 Explanation: 
The important question is that what drug will decrease her morbidity and mortality in congestive heart failure? The answer is ACE inhibitors. This patient is not on an ACE inhibitor so lisinopril 20 mg will be the correct answer. The only time Lasix would be the best answer is during acute CHF, digoxin is only added to increase contractility however it does not decrease the morbidity or the mortality and CHF and lisinopril does. Take home point: In the end, ACEI drive the car for CHF and diuretics are the passengers the only time diuretics (Lasix) drives the car is during an acute CHF. Review Topic
Question 2
A 26-year-old male presents to your office complaining of gynecomastia that has progressively worsened over the past 2 years. He is not obese. Which of the following medications may be the reason for this patient’s condition?
A
Benadryl
B
Allegra
C
Spironolactone
D
Advil
E
Tagamet
Question 2 Explanation: 
Spironolactone is a potassium-sparing diuretic that also decreases androgens in the human body. This is why we use it in PCOS to lower the androgens in a female with a high level of androgens. If you give it to a normal male it will lower his androgen levels producing more estrogen effect and can cause gynecomastia. Review Topic
Question 3
A 75-year-old male presents to your office complaining of palpitations. The EKG rhythm strip shows the following rate. The treatment of choice for this patient is which of the following?
A
Atenolol
Hint:
See C for explanation
B
Amiodarone
Hint:
See C for explanation
C
Cardizem
D
Lasix
Hint:
See C for explanation
E
Cardioversion
Hint:
See C for explanation
Question 3 Explanation: 
This rhythm strip shows atrial fibrillation with a rate greater than 100 BPM. The drug of choice would be a Non-DHP calcium channel blocker such as Cardizem or Diltiazem. Since there is no mention of timeline cardioversion cannot be a choice because they must give you a specific timeline of less than 48 hours for this to be the best treatment. Review Topic
Question 4
A 57-year-old female with a long history of tremors, palpitations, heat intolerance, weight loss, and anxiety presents to the clinic for a physical exam. A resting EKG shows an irregular rate. Which of the following medications would be the best treatment for this condition?
A
Amiodarone
Hint:
See C for explanation
B
Flecainide
Hint:
See C for explanation
C
Labetalol
D
Cardizem
Hint:
See C for explanation
E
Coumadin
Hint:
See C for explanation
Question 4 Explanation: 
This patient in this question has symptoms of Graves disease (tremors, palpitations, heat intolerance, weight loss, and anxiety) and one of the common presentations on EKG is atrial fibrillation. When treating atrial fibrillation due to Graves' disease the treatment of choice will be a beta-blocker such as Labetalol. The take-home point is that this atrial fibrillation is due to overstimulation of the beta receptors from all the extra thyroxine not between the SA-AV node. So the right answer would be to stop stimulation of the beta nerve i.e. a beta-blocker. Review Topic
Question 5
A 37-year-old female PA sustained a needlestick from an IVDA while giving him an IM injection of antibiotics. The patient refuses any blood draw and refuses to give any further history. What is the appropriate post-exposure prophylaxis (PEP) management of this PA?
A
Nothing
Hint:
See C for explanation
B
AZT
Hint:
See C for explanation
C
Emtricitabine/tenofovir (Truvada®) plus dolutegravir (Tivicay ®)
D
Emtricitabine/tenofovir disoproxil (Truvada®)
Hint:
See C for explanation
E
Tenofovir disoproxil (Truvada®)
Hint:
See C for explanation
Question 5 Explanation: 
The CDC now recommends emtricitabine plus Tenofovir Disoproxil Fumarate (these 2 agents dispensed as Truvada, a fixed-dose combination tablet) plus raltegravir as HIV PEP for occupational exposures to HIV. This regimen is tolerable, potent, and conveniently administered, and it has been associated with minimal drug interactions Preparation of this PEP regimen is in single-dose starter packets.
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Smarty PANCE Clinical Rotation Exams

We're excited to add this family practice clinical rotation exam to our growing list of rotation exams available exclusively to all Smarty PANCE members.

Every rotation exam is included with all membership levels at one very low price

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