Family Medicine Board Exam Started: Jul 12, 2026 21:57 Page 109 of 112 Attempt #1148 Overall: 0 / 560 questions answered Question 541 / 560 Not answered During a same-day outpatient consultation: a 68-year-old man is being assessed for initial therapy in type 2 diabetes; What is the most appropriate next step? A. Start insulin in every newly diagnosed patient B. Avoid lifestyle intervention at diagnosis C. Treat only after A1c exceeds 12% D. Use metformin as first-line therapy unless contraindicated E. Use sulfonylurea first in all overweight patients Show Answer & Explanation Correct Answer: D Explanation: Use metformin as first-line therapy unless contraindicated. This aligns with current family medicine standards and should be tailored to patient context, comorbidities, risk profile, and shared decision-making. Reference: ADA Standards of Care in Diabetes (2024) Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 542 / 560 Not answered In a community health center follow-up: a 35-year-old woman is being assessed for glycemic target; What is the most appropriate next step? A. For many nonpregnant adults, target A1c around <7% with individualized goals B. Use one fixed A1c target regardless of frailty or comorbidity C. Ignore A1c and rely only on fasting glucose D. Stop A1c monitoring after diagnosis E. Target A1c <5% for all patients Show Answer & Explanation Correct Answer: A Explanation: For many nonpregnant adults, target A1c around <7% with individualized goals. This aligns with current family medicine standards and should be tailored to patient context, comorbidities, risk profile, and shared decision-making. Reference: ADA Standards of Care in Diabetes (2024) Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 543 / 560 Not answered At a continuity-of-care review: a 61-year-old man is being assessed for diabetic kidney protection; What is the most appropriate next step? A. Avoid RAAS blockade when albuminuria is present B. Replace BP control with high-protein diet C. Use ACE inhibitor or ARB in diabetes with hypertension and albuminuria D. Delay kidney-protective therapy until dialysis is required E. Use NSAIDs long-term to protect renal function Show Answer & Explanation Correct Answer: C Explanation: Use ACE inhibitor or ARB in diabetes with hypertension and albuminuria. This aligns with current family medicine standards and should be tailored to patient context, comorbidities, risk profile, and shared decision-making. Reference: KDIGO CKD Guideline; ADA Standards of Care Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 544 / 560 Not answered During an annual wellness examination: a 44-year-old woman is being assessed for persistent asthma controller; What is the most appropriate next step? A. Use antibiotics as maintenance therapy B. Initiate inhaled corticosteroid-containing therapy for persistent asthma C. Avoid spirometry in asthma follow-up D. Use short-acting beta agonist alone as long-term controller E. Start chronic oral steroid in all mild cases Show Answer & Explanation Correct Answer: B Explanation: Initiate inhaled corticosteroid-containing therapy for persistent asthma. This aligns with current family medicine standards and should be tailored to patient context, comorbidities, risk profile, and shared decision-making. Reference: GINA Global Strategy for Asthma Management (2024) Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 545 / 560 Not answered At a preventive-care visit: a 52-year-old man is being assessed for copd exacerbation outpatient treatment; What is the most appropriate next step? A. Use long-term antibiotics for every COPD visit B. Use diuretics as primary exacerbation treatment C. Delay treatment until sputum culture is finalized in all cases D. Treat moderate exacerbation with bronchodilators, short steroid course, and antibiotics when indicated E. Stop all inhalers during exacerbation Show Answer & Explanation Correct Answer: D Explanation: Treat moderate exacerbation with bronchodilators, short steroid course, and antibiotics when indicated. This aligns with current family medicine standards and should be tailored to patient context, comorbidities, risk profile, and shared decision-making. Reference: GOLD COPD Report (2024) Comments & Discussion No comments yet. 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