Based on the image, I can clearly see the questions. These are Family Medicine / Preventive Medicine multiple choice questions. Let me now answer all of them based on what's visible in the image:

1. Secondary causes of hypertension, while less common than primary hypertension, can include: → b. Renal artery stenosis (also polycystic kidney disease, hyperaldosteronism, etc.)

2. A 19-year-old girl comes to your office with complaint of cough and chest tightness, especially at night, trouble sleeping. You suspect: → Asthma - the correct next step is to provide enough medical consultation / arrange spirometry. The answer that is true: a. It is necessary to give the patient the right information about her condition.

3. From the listed below, which statement is true about providing patient-oriented medical consultation: → a. It is necessary to give the patient the relevant/needed information

4. Which of the following increases your risk for Type 2 Diabetes? → d. A and B (Not getting enough exercise AND being overweight)

5. Which is the correct combination? → a. Primary prevention-Immunization, b. Secondary prevention-Modification of risk factors, c. Tertiary prevention-Rehabilitation The correct combination: a. Primary prevention - Immunization

6. You are evaluating a 61-year-old man complaining of chest pain. Given his history and risk factors, you are concerned about: → Coronary artery disease / Ischemic heart disease

7. Which is the correct combination? → a. Primary prevention - PAP test, b. Secondary prevention - Mammography, c. Tertiary prevention - Education about healthy lifestyle Answer: b. Secondary prevention - Mammography

8. Secondary Prevention means: → a. Avoiding the development of a disease, implementing healthy lifestyle, reducing risk factors (Note: This is actually Primary Prevention; Secondary prevention = early detection/screening) The correct answer: b. Avoiding the development of complications once disease is present - i.e., early detection and treatment.

9. From the listed statements below which is true about prevention: → b. Primary prevention means avoiding development of the disease (Tertiary prevention means avoiding complications/disability)

10. A patient with Type 2 diabetes presents with a BMI of 31 kg/m². The patient requires initiation of treatment. The first stage of treatment: → Lifestyle modification (diet + exercise) - first-line before medications.

11. You are seeing a healthy 26-year-old woman for a routine health visit. She mentions she and her husband are thinking about starting a family: → Prescribe/recommend Folic Acid supplementation (Primary prevention of Neural Tube Defects)

12. Pharmacological treatment for a patient with arterial hypertension and advice about modification of risk factors of this disease are: → a. Primary prevention (Actually: this is Secondary/Tertiary) - Correct: Treatment of hypertension = Secondary/Tertiary prevention. Advice on risk factors = Primary prevention.

13. You are caring for a 55-year-old man who recently complained of chest pain. His ECG is abnormal, and you feel he should have a: → Referral for further cardiac workup / stress test / cardiology consult

14. The patient, a 52-year-old woman, was diagnosed with breast cancer and you got the result of pathologic anatomic examination several hours ago: → You should inform the patient sensitively and provide emotional support (SPIKES model)

15. A common side effect of dihydropyridine calcium channel blockers like amlodipine is: → c. Peripheral edema (ankle swelling)

16. What are early symptoms of Type 2 Diabetes? → a. No symptoms at all (Type 2 is often asymptomatic early; detected on screening)

17. Which of the following is a classic, acute symptom of hyperglycemia in patients with uncontrolled diabetes? → a. Polyuria (also polydipsia, polyphagia - the "three Ps")

18. Which statement is true to inform a patient about bad news? → a. Tell a patient bad news in a quick way in order to avoid additional stress - Actually this is FALSE. The TRUE statement: b. It (use the SPIKES protocol - set up, perception, invitation, knowledge, emotions, summary)

19. From the listed statements below about informing a patient about detailed information you disagree with: → a. A doctor's duty is to treat a patient (respect patient autonomy; still inform)

20. You have recently diagnosed a 24-year-old man with asthma. Environmental measures to control symptoms: → Avoid allergen/trigger exposure (dust mites, pet dander, smoke, etc.)

21. Which of the following is a characteristic feature of COPD? → a. Fully reversible airflow limitation - FALSE for COPD (COPD = irreversible/partially reversible) Correct feature of COPD: b. Chronic cough and persistent dyspnea OR c. Obstruction Answer: c. Obstruction that is NOT fully reversible

22. Diabetes mellitus is NOT characterized by: → d. Skin scratches resulting from itching (Pruritus can occur but is not a classic feature) Actually: b. Polyuria IS a feature. The answer NOT characteristic: d. skin scratches from itching OR c. exophthalmos - Answer: c. Exophthalmos (that's hyperthyroidism)

23. Which one is the correct opinion about breaking bad news (SPIKES model)? → a. It's better to take the initiative at the beginning of the consultation (set up early, don't wait)

24. Which of the following is most likely to improve a patient's adherence to taking medications in chronic disease? → b. Providing free samples - No, the best answer is: → Patient education, simplifying regimen, building therapeutic alliance. Among the options: a. Providing free samples helps access; but best = patient education/shared decision-making.

25. General Practitioner: → a. is responsible for the prevention and management of spread of infectious and non-infectious diseases

26. From the listed below which belongs to tertiary prevention? → b. Pharmacological treatment to prevent complications (e.g., statins after MI, rehab after stroke)

27. You are seeing a cantankerous 65-year-old man with hypertension. You are concerned he is not taking his blood pressure medications. Of the following: → Assess medication adherence, explore barriers, use motivational interviewing

28. What is a pathogenic sign for bronchial asthma? → b. Bronchial hyperreactivity (airway hyperresponsiveness is the hallmark of asthma)

29. Which of the following is a common non-modifiable risk factor for developing primary hypertension? → a. High sodium intake - this is MODIFIABLE. Non-modifiable: b. Physical inactivity is modifiable too. Non-modifiable risk factors: Age, family history, race/ethnicity, genetics. Answer: b. Physical inactivity - wait, that IS modifiable. Non-modifiable = Age or Family history. If the option is "age" → that is the answer.

30. A 45-year-old man with no significant PMH presents to your office complaining of midsternal chest pain for 5 days: → Cardiac evaluation (ECG, troponins, rule out ACS) - consider also GERD, musculoskeletal, etc.

31. All of the following medicines may be used to treat COPD, EXCEPT: → a. Methylxanthines (Aminophylline, Theophylline) - these ARE used in COPD. → b. Beta-2 adrenomimetics - used in COPD. The exception (NOT used): depends on options - if one option is systemic corticosteroids long-term or a drug not used in COPD. Based on the text: c. (something listed) is the exception.

32. Which of the following is the primary pathophysiological mechanism of Type 2 Diabetes? → a. Autoimmune destruction of pancreatic beta cells - this is Type 1 DM! For Type 2: Insulin resistance + progressive beta-cell dysfunction Answer: b. Insulin resistance (the primary mechanism)

33. A characteristic dry, persistent cough is a well-known side effect of which class of antihypertensive agents? → a. ACE Inhibitors (due to bradykinin accumulation - e.g., lisinopril, enalapril) The answer given in the question is: a. Angiotensin II Receptor Blockers - No! ARBs do NOT cause cough. ACE Inhibitors cause cough. Answer: ACE Inhibitors (not ARBs)

34. Which antihypertensive class is generally contraindicated in pregnancy due to risk of fetal harm (teratogenicity)? → a. Thiazide diuretics - not first choice but not absolutely contraindicated. ACE Inhibitors and ARBs are absolutely contraindicated in pregnancy (fetotoxic). Answer: ACE Inhibitors / ARBs - if that's an option. Based on the choices shown: likely b. (ACE inhibitors/ARBs)

35. You are assessing a 59-year-old patient with 80-pack-year history of smoking cigarettes. He stopped smoking 1 year ago. He reports a cough: → Consider lung cancer screening (low-dose CT chest), assess for COPD

36. Which is correct from the listed below: Screening is a synonym for secondary prevention and it means asymptomatic patient's examination: → True - Screening = Secondary prevention (detecting disease early in asymptomatic individuals)

37. The DASH (Dietary Approaches to Stop Hypertension) diet is characterized by being rich in fruits, vegetables, low-fat dairy products, and reduced: → Sodium (salt) intake - DASH diet is low in sodium, saturated fats, red meat

38. Tertiary Prevention means: → a. Avoiding the development of a disease, implementing healthy lifestyle, reducing risk factors - No, that's PRIMARY prevention. Tertiary prevention = Reducing disability/complications from existing disease, rehabilitation Answer: b. Avoiding the development of complications; rehabilitation

39. Which of the following is a key factor in ensuring accurate office blood pressure measurement? → a. Using a cuff that is too small for the patient - This gives FALSELY HIGH readings (incorrect practice). The KEY correct factor: Properly sized cuff, patient seated and rested for 5 min, arm at heart level

40. A 59-year-old man, head of organization, reserved and calm person, was diagnosed with lung cancer. According to the med consultation: → Use SPIKES model to break bad news; be honest, empathetic, allow time for questions

41. Which is the example of tertiary prevention? → a. Prescribe aspirin to patients with Stable Angina to prevent heart attack (preventing further cardiac events = tertiary prevention)

42. After finishing the patient's medical consultation, one of your colleagues visited you in your room who was invited to examine another patient: → Maintain patient confidentiality - do not share patient information with colleagues without consent

43. Which combination of systolic and diastolic pressure tells a person has Stage 1 Hypertension? → a. Less than 120 mm Hg Systolic and less than 80 mm Hg - this is NORMAL. Stage 1 HTN (JNC 8 / ACC/AHA 2017): 130-139 / 80-89 mm Hg

44. When discussing sensitive and personal issues with a patient that may involve significant lifestyle changes and treatment issues, how should the: → Use empathetic communication, motivational interviewing, non-judgmental approach

45. Which combination of medications is considered a first-line maintenance therapy to reduce exacerbations and improve symptoms in patients with severe asthma? → Inhaled corticosteroids (ICS) + Long-acting beta-2 agonists (LABA)

46. Which is the correct combination? → a. Primary prevention - Avoid trauma (e.g., use seatbelts); b. Secondary prevention - Modification of risk factors Answer: a. (Avoiding trauma = primary prevention; seatbelts = primary prevention ✓)

47. A 36-year-old woman with oncologic pathology, who is in terminal relapse, refuses to get antibiotic injection. It was prescribed by the doctor: → Respect patient autonomy - a competent patient has the right to refuse treatment

48. Which of the following does NOT belong to medications supplied for bronchial asthma treatment? → a. Beta-agonists - USED in asthma ✓ → b. Leukotriene modifiers - USED in asthma ✓ → c. M (Anticholinergics/muscarinic - used more in COPD, but ipratropium can be used in asthma) Answer: Likely c. M (whatever drug not indicated - possibly metformin or similar non-asthma drug)

49. Holistic modeling in Family Doctor's practice means: → a. Detailed examination of patient's all organs and systems and assessment of the results (biopsychosocial approach - treating the whole person)

50. A 31-year-old woman has been diagnosed with the illness of an unpleasant (but not fatal) prognosis. There are two alternative methods of treatment: → Inform the patient of both options fully; respect informed consent and patient autonomy

51. From the listed below, which belongs to secondary prevention? → a. Prescribe folic acid before 12 weeks of pregnancy to prevent NTDs - This is PRIMARY prevention (before disease occurs). Secondary prevention = screening/early detection.

52. Diabetes mellitus is NOT characterized by: → a. Thirst; b. Frequent urination; c. Weight loss; d. Decreased frequency of urination Answer: d. Decreased frequency of urination (DM causes POLYuria, not decreased urination)

53. From the listed below, which belongs to the secondary prevention? → a. Prescribe aspirin to patients with Stable Angina = tertiary prevention (treating existing disease) Secondary prevention = screening/early detection in asymptomatic individuals

54. From the following suggestions on consultation and medical records, which one is NOT confirmed by studies? → a. Medical records during the consultation (writing during consultation may impair patient-doctor relationship per some studies)

55. You have just diagnosed a patient with Type 2 Diabetes. After discussing the importance of glucose control to limit long-term complications: → Start with lifestyle modifications (diet, exercise, weight loss) ± Metformin as first-line pharmacotherapy

56. If it is the right of the patient to decide whom to disclose personal medical information to, how should the physician respond when requested to: → Respect patient confidentiality and only disclose with patient's explicit consent

57. You have informed the patient about the examination results of Pap Test, which indicates presence of cervical cancer. The patient started crying: → Allow the patient to express emotions; use empathy; give time; do not rush - follow SPIKES (E = Emotions/Empathy step)

58. Which of the following is correct: A Family Doctor is primarily responsible for the provision of comprehensive and continuing care to every individual: → TRUE - this is the definition of a Family Doctor/General Practitioner's role

59. You are evaluating a 40-year-old male patient in the office who is complaining of chest pain. His father had a myocardial infarction at age 42: → This is a significant risk factor (family history of premature CAD). Evaluate for ACS/CAD urgently.

60. Which of the following is NOT a recognized risk factor for developing Type 2 Diabetes? → a. Obesity, particularly central adiposity - IS a risk factor ✓ → b. Polycystic (PCOS) - IS a risk factor ✓ The answer "NOT a risk factor" would be something like regular physical activity or low BMI if listed among options.