ABFM Family Medicine Certification
Examination Practice Questions And
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf
1. A 55-year-old man presents for routine health maintenance. He has no
history of cardiovascular disease but has a 30-pack-year smoking
history. Which of the following is recommended for lung cancer
screening?
A. Annual chest X-ray
B. Annual low-dose CT scan **
C. Sputum cytology annually
D. No screening needed
Answer: B. Annual low-dose CT scan
Rationale: The USPSTF recommends annual low-dose CT scan for adults
,aged 50–80 with a ≥20 pack-year smoking history who currently smoke or
quit within the past 15 years.
2. A 42-year-old woman presents with fatigue, weight gain, constipation,
and cold intolerance. Labs show elevated TSH and low free T4. What is
the most likely diagnosis?
A. Subclinical hyperthyroidism
B. Primary hypothyroidism **
C. Secondary hypothyroidism
D. Hyperthyroidism
Answer: B. Primary hypothyroidism
Rationale: Elevated TSH with low free T4 indicates primary
hypothyroidism. Secondary hypothyroidism would show low TSH.
3. A 28-year-old woman presents with dysuria and urinary frequency.
Urine dipstick shows positive leukocyte esterase and nitrites. Which of
the following is the first-line treatment?
A. Ciprofloxacin
B. Nitrofurantoin **
C. Amoxicillin
D. Trimethoprim alone
,Answer: B. Nitrofurantoin
Rationale: Nitrofurantoin is a first-line agent for uncomplicated cystitis in
non-pregnant women. Fluoroquinolones are reserved for complicated
cases.
4. A 60-year-old man presents with severe sudden-onset chest pain
radiating to the back. Blood pressure is 180/100 mmHg. A widened
mediastinum is seen on chest X-ray. What is the next best step?
A. ECG and troponin
B. Immediate aspirin and thrombolysis
C. CT angiography of the chest **
D. Stress test
Answer: C. CT angiography of the chest
Rationale: Suspected aortic dissection requires urgent imaging with CT
angiography to confirm diagnosis; ECG and troponin are used to rule out
myocardial infarction.
5. A 35-year-old woman presents with recurrent headaches and visual
changes. On exam, papilledema is noted. MRI is normal. Which of the
following is the most likely diagnosis?
A. Migraine with aura
B. Idiopathic intracranial hypertension **
, C. Subarachnoid hemorrhage
D. Temporal arteritis
Answer: B. Idiopathic intracranial hypertension
Rationale: Young obese women with headaches, visual symptoms,
papilledema, and normal MRI are typical for idiopathic intracranial
hypertension.
6. A 45-year-old man presents with joint pain and stiffness in the
morning lasting over an hour, affecting the small joints of the hands
symmetrically. Which is the most likely diagnosis?
A. Osteoarthritis
B. Rheumatoid arthritis **
C. Gout
D. Psoriatic arthritis
Answer: B. Rheumatoid arthritis
Rationale: RA presents with prolonged morning stiffness, symmetric small
joint involvement, and systemic inflammation, unlike OA which usually has
brief stiffness.
7. Which of the following vaccines is recommended annually for all
adults?
Examination Practice Questions And
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf
1. A 55-year-old man presents for routine health maintenance. He has no
history of cardiovascular disease but has a 30-pack-year smoking
history. Which of the following is recommended for lung cancer
screening?
A. Annual chest X-ray
B. Annual low-dose CT scan **
C. Sputum cytology annually
D. No screening needed
Answer: B. Annual low-dose CT scan
Rationale: The USPSTF recommends annual low-dose CT scan for adults
,aged 50–80 with a ≥20 pack-year smoking history who currently smoke or
quit within the past 15 years.
2. A 42-year-old woman presents with fatigue, weight gain, constipation,
and cold intolerance. Labs show elevated TSH and low free T4. What is
the most likely diagnosis?
A. Subclinical hyperthyroidism
B. Primary hypothyroidism **
C. Secondary hypothyroidism
D. Hyperthyroidism
Answer: B. Primary hypothyroidism
Rationale: Elevated TSH with low free T4 indicates primary
hypothyroidism. Secondary hypothyroidism would show low TSH.
3. A 28-year-old woman presents with dysuria and urinary frequency.
Urine dipstick shows positive leukocyte esterase and nitrites. Which of
the following is the first-line treatment?
A. Ciprofloxacin
B. Nitrofurantoin **
C. Amoxicillin
D. Trimethoprim alone
,Answer: B. Nitrofurantoin
Rationale: Nitrofurantoin is a first-line agent for uncomplicated cystitis in
non-pregnant women. Fluoroquinolones are reserved for complicated
cases.
4. A 60-year-old man presents with severe sudden-onset chest pain
radiating to the back. Blood pressure is 180/100 mmHg. A widened
mediastinum is seen on chest X-ray. What is the next best step?
A. ECG and troponin
B. Immediate aspirin and thrombolysis
C. CT angiography of the chest **
D. Stress test
Answer: C. CT angiography of the chest
Rationale: Suspected aortic dissection requires urgent imaging with CT
angiography to confirm diagnosis; ECG and troponin are used to rule out
myocardial infarction.
5. A 35-year-old woman presents with recurrent headaches and visual
changes. On exam, papilledema is noted. MRI is normal. Which of the
following is the most likely diagnosis?
A. Migraine with aura
B. Idiopathic intracranial hypertension **
, C. Subarachnoid hemorrhage
D. Temporal arteritis
Answer: B. Idiopathic intracranial hypertension
Rationale: Young obese women with headaches, visual symptoms,
papilledema, and normal MRI are typical for idiopathic intracranial
hypertension.
6. A 45-year-old man presents with joint pain and stiffness in the
morning lasting over an hour, affecting the small joints of the hands
symmetrically. Which is the most likely diagnosis?
A. Osteoarthritis
B. Rheumatoid arthritis **
C. Gout
D. Psoriatic arthritis
Answer: B. Rheumatoid arthritis
Rationale: RA presents with prolonged morning stiffness, symmetric small
joint involvement, and systemic inflammation, unlike OA which usually has
brief stiffness.
7. Which of the following vaccines is recommended annually for all
adults?
