ABFM Family Medicine Certification
Examination Questions and Correct Answers
(Verified Answers) Plus Rationales 2026 Q&A |
Instant Download Pdf
1. A 45-year-old man presents with sudden-onset, severe chest pain
radiating to his back. Blood pressure is 180/100 mmHg, and heart
rate is 110 bpm. What is the most likely diagnosis?
a. Acute myocardial infarction
b. Pulmonary embolism
c. Aortic dissection
d. Pericarditis
The sudden tearing chest pain radiating to the back with hypertension is
classic for aortic dissection. Immediate imaging and management are
required.
2. A 30-year-old woman presents with fatigue, weight gain,
constipation, and dry skin. Labs reveal elevated TSH and low free
T4. What is the most likely diagnosis?
a. Hyperthyroidism
b. Thyroid cancer
c. Primary hypothyroidism
d. Secondary hypothyroidism
Elevated TSH with low free T4 indicates primary hypothyroidism, most
commonly due to autoimmune thyroiditis.
, 3. Which of the following vaccines is recommended annually for
adults?
a. Tetanus
b. Influenza
c. MMR
d. Hepatitis B
Influenza vaccination is recommended yearly because the virus mutates
frequently, necessitating updated immunity.
4. A 60-year-old man with a history of diabetes presents with
sudden vision loss in one eye. Fundoscopy shows a pale retina
with a cherry-red spot at the fovea. What is the most likely
diagnosis?
a. Central retinal vein occlusion
b. Retinal detachment
c. Central retinal artery occlusion
d. Diabetic retinopathy
Central retinal artery occlusion presents with sudden, painless vision
loss and a cherry-red spot on fundoscopy.
5. A 55-year-old woman presents with right upper quadrant pain,
fever, and jaundice. Laboratory studies show elevated alkaline
phosphatase and bilirubin. What is the classic triad called?
a. Murphy’s sign
b. Charcot’s triad
c. Reynold’s pentad
d. Courvoisier sign
Charcot’s triad—fever, right upper quadrant pain, and jaundice—is
indicative of cholangitis.
, 6. A 25-year-old man presents with a painless genital ulcer. Which of
the following is the most likely cause?
a. Herpes simplex virus
b. Chancroid
c. Treponema pallidum (syphilis)
d. HPV
Primary syphilis presents as a painless chancre, whereas chancroid is
typically painful.
7. What is the first-line treatment for newly diagnosed hypertension
in a non-black adult without comorbidities?
a. Beta-blocker
b. ACE inhibitor
c. Calcium channel blocker
d. Thiazide diuretic
ACE inhibitors are first-line therapy for most adults with hypertension,
particularly if they have diabetes or CKD.
8. Which screening test is recommended for all adults aged 50-75 for
colorectal cancer?
a. Flexible sigmoidoscopy only
b. CT colonography
c. Colonoscopy or stool-based testing
d. Fecal occult blood test only
Multiple screening options exist, including colonoscopy every 10 years
or stool-based testing annually.
9. A 70-year-old man presents with resting tremor, bradykinesia,
and rigidity. What is the most likely diagnosis?
a. Essential tremor
b. Huntington disease
, c. Wilson disease
d. Parkinson disease
Parkinson disease is characterized by resting tremor, bradykinesia,
rigidity, and postural instability.
10. Which lipid-lowering agent is most effective for reducing LDL
cholesterol?
a. Niacin
b. Fibrate
c. Statin
d. Omega-3 fatty acids
Statins are first-line therapy for reducing LDL and preventing
cardiovascular events.
11. A 40-year-old woman presents with chronic diarrhea, weight
loss, and bloating. Anti-tissue transglutaminase IgA is positive.
What is the most likely diagnosis?
a. Irritable bowel syndrome
b. Lactose intolerance
c. Crohn disease
d. Celiac disease
Positive anti-tTG IgA antibodies and gastrointestinal symptoms are
diagnostic for celiac disease.
12. A 65-year-old man presents with acute onset of right knee
pain, swelling, and redness. Joint aspiration shows negatively
birefringent crystals. What is the most likely diagnosis?
a. Pseudogout
b. Septic arthritis
c. Rheumatoid arthritis
d. Gout
Examination Questions and Correct Answers
(Verified Answers) Plus Rationales 2026 Q&A |
Instant Download Pdf
1. A 45-year-old man presents with sudden-onset, severe chest pain
radiating to his back. Blood pressure is 180/100 mmHg, and heart
rate is 110 bpm. What is the most likely diagnosis?
a. Acute myocardial infarction
b. Pulmonary embolism
c. Aortic dissection
d. Pericarditis
The sudden tearing chest pain radiating to the back with hypertension is
classic for aortic dissection. Immediate imaging and management are
required.
2. A 30-year-old woman presents with fatigue, weight gain,
constipation, and dry skin. Labs reveal elevated TSH and low free
T4. What is the most likely diagnosis?
a. Hyperthyroidism
b. Thyroid cancer
c. Primary hypothyroidism
d. Secondary hypothyroidism
Elevated TSH with low free T4 indicates primary hypothyroidism, most
commonly due to autoimmune thyroiditis.
, 3. Which of the following vaccines is recommended annually for
adults?
a. Tetanus
b. Influenza
c. MMR
d. Hepatitis B
Influenza vaccination is recommended yearly because the virus mutates
frequently, necessitating updated immunity.
4. A 60-year-old man with a history of diabetes presents with
sudden vision loss in one eye. Fundoscopy shows a pale retina
with a cherry-red spot at the fovea. What is the most likely
diagnosis?
a. Central retinal vein occlusion
b. Retinal detachment
c. Central retinal artery occlusion
d. Diabetic retinopathy
Central retinal artery occlusion presents with sudden, painless vision
loss and a cherry-red spot on fundoscopy.
5. A 55-year-old woman presents with right upper quadrant pain,
fever, and jaundice. Laboratory studies show elevated alkaline
phosphatase and bilirubin. What is the classic triad called?
a. Murphy’s sign
b. Charcot’s triad
c. Reynold’s pentad
d. Courvoisier sign
Charcot’s triad—fever, right upper quadrant pain, and jaundice—is
indicative of cholangitis.
, 6. A 25-year-old man presents with a painless genital ulcer. Which of
the following is the most likely cause?
a. Herpes simplex virus
b. Chancroid
c. Treponema pallidum (syphilis)
d. HPV
Primary syphilis presents as a painless chancre, whereas chancroid is
typically painful.
7. What is the first-line treatment for newly diagnosed hypertension
in a non-black adult without comorbidities?
a. Beta-blocker
b. ACE inhibitor
c. Calcium channel blocker
d. Thiazide diuretic
ACE inhibitors are first-line therapy for most adults with hypertension,
particularly if they have diabetes or CKD.
8. Which screening test is recommended for all adults aged 50-75 for
colorectal cancer?
a. Flexible sigmoidoscopy only
b. CT colonography
c. Colonoscopy or stool-based testing
d. Fecal occult blood test only
Multiple screening options exist, including colonoscopy every 10 years
or stool-based testing annually.
9. A 70-year-old man presents with resting tremor, bradykinesia,
and rigidity. What is the most likely diagnosis?
a. Essential tremor
b. Huntington disease
, c. Wilson disease
d. Parkinson disease
Parkinson disease is characterized by resting tremor, bradykinesia,
rigidity, and postural instability.
10. Which lipid-lowering agent is most effective for reducing LDL
cholesterol?
a. Niacin
b. Fibrate
c. Statin
d. Omega-3 fatty acids
Statins are first-line therapy for reducing LDL and preventing
cardiovascular events.
11. A 40-year-old woman presents with chronic diarrhea, weight
loss, and bloating. Anti-tissue transglutaminase IgA is positive.
What is the most likely diagnosis?
a. Irritable bowel syndrome
b. Lactose intolerance
c. Crohn disease
d. Celiac disease
Positive anti-tTG IgA antibodies and gastrointestinal symptoms are
diagnostic for celiac disease.
12. A 65-year-old man presents with acute onset of right knee
pain, swelling, and redness. Joint aspiration shows negatively
birefringent crystals. What is the most likely diagnosis?
a. Pseudogout
b. Septic arthritis
c. Rheumatoid arthritis
d. Gout
