ABFM Family Medicine Certification
Examination – 100 Practice Questions
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf
1. A 45-year-old woman presents for routine screening. She has no
significant past medical history. Which of the following is
recommended for cervical cancer screening in average-risk women
aged 40–49?
A. HPV testing alone every 5 years
B. Pap smear alone every 3 years
C. Pap smear with reflex HPV testing every 3 years
D. No screening until age 50
B. Pap smear alone every 3 years
Cervical cancer screening guidelines recommend Pap smear every 3
, years for women aged 21–65; HPV testing alone is preferred starting
at age 30.
2. A 60-year-old man with hypertension presents for follow-up. His blood
pressure is 142/88 mmHg. He is already on amlodipine. What is the
next step?
A. Continue current therapy
B. Add hydrochlorothiazide
C. Switch to lisinopril
D. Refer to cardiology
B. Add hydrochlorothiazide
For persistent stage 2 hypertension, guideline-directed therapy
includes adding a second antihypertensive from a different class if
target blood pressure is not achieved.
3. A 30-year-old woman presents with fatigue and pallor. Labs show Hb 9
g/dL, MCV 70 fL. What is the most likely cause?
A. Iron deficiency anemia
B. Vitamin B12 deficiency
C. Anemia of chronic disease
D. Hemolytic anemia
A. Iron deficiency anemia
Microcytic anemia with low hemoglobin in adults is most commonly
caused by iron deficiency, often from chronic blood loss.
,4. A 28-year-old man presents with a sudden onset of severe testicular
pain. On exam, the testicle is high-riding and tender. What is the most
appropriate next step?
A. Urinalysis
B. Scrotal ultrasound
C. Immediate urologic consultation
D. Analgesics and observation
C. Immediate urologic consultation
Suspected testicular torsion is a surgical emergency; immediate
urology consultation is indicated before imaging if clinical suspicion
is high.
5. A 55-year-old man presents with fatigue and joint pain. Labs show ALT
80 U/L, AST 75 U/L, alkaline phosphatase normal, and positive anti-
mitochondrial antibody. What is the most likely diagnosis?
A. Hepatitis B
B. Primary biliary cholangitis
C. Alcoholic liver disease
D. Nonalcoholic fatty liver disease
B. Primary biliary cholangitis
AMA positivity with cholestatic pattern (elevated ALP, not seen here)
suggests primary biliary cholangitis; early stages may have mild
transaminase elevation.
, 6. A 40-year-old woman with type 2 diabetes presents for routine follow-
up. Which of the following is recommended for diabetic nephropathy
screening?
A. Serum creatinine only
B. Urine albumin-to-creatinine ratio annually
C. 24-hour urine collection every 5 years
D. No screening needed
B. Urine albumin-to-creatinine ratio annually
Annual screening with urine albumin-to-creatinine ratio is
recommended to detect early diabetic nephropathy.
7. A 65-year-old man presents for colon cancer screening. He has no
family history. Which is the preferred screening method?
A. Colonoscopy every 10 years
B. Flexible sigmoidoscopy every 5 years
C. Fecal occult blood test annually
D. No screening needed until age 70
A. Colonoscopy every 10 years
Average-risk adults should begin colonoscopy at age 45–50;
colonoscopy every 10 years is preferred.
8. A 32-year-old woman presents with irregular menses and hirsutism.
Labs show elevated LH/FSH ratio and testosterone. What is the most
likely diagnosis?
A. Hypothyroidism
Examination – 100 Practice Questions
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf
1. A 45-year-old woman presents for routine screening. She has no
significant past medical history. Which of the following is
recommended for cervical cancer screening in average-risk women
aged 40–49?
A. HPV testing alone every 5 years
B. Pap smear alone every 3 years
C. Pap smear with reflex HPV testing every 3 years
D. No screening until age 50
B. Pap smear alone every 3 years
Cervical cancer screening guidelines recommend Pap smear every 3
, years for women aged 21–65; HPV testing alone is preferred starting
at age 30.
2. A 60-year-old man with hypertension presents for follow-up. His blood
pressure is 142/88 mmHg. He is already on amlodipine. What is the
next step?
A. Continue current therapy
B. Add hydrochlorothiazide
C. Switch to lisinopril
D. Refer to cardiology
B. Add hydrochlorothiazide
For persistent stage 2 hypertension, guideline-directed therapy
includes adding a second antihypertensive from a different class if
target blood pressure is not achieved.
3. A 30-year-old woman presents with fatigue and pallor. Labs show Hb 9
g/dL, MCV 70 fL. What is the most likely cause?
A. Iron deficiency anemia
B. Vitamin B12 deficiency
C. Anemia of chronic disease
D. Hemolytic anemia
A. Iron deficiency anemia
Microcytic anemia with low hemoglobin in adults is most commonly
caused by iron deficiency, often from chronic blood loss.
,4. A 28-year-old man presents with a sudden onset of severe testicular
pain. On exam, the testicle is high-riding and tender. What is the most
appropriate next step?
A. Urinalysis
B. Scrotal ultrasound
C. Immediate urologic consultation
D. Analgesics and observation
C. Immediate urologic consultation
Suspected testicular torsion is a surgical emergency; immediate
urology consultation is indicated before imaging if clinical suspicion
is high.
5. A 55-year-old man presents with fatigue and joint pain. Labs show ALT
80 U/L, AST 75 U/L, alkaline phosphatase normal, and positive anti-
mitochondrial antibody. What is the most likely diagnosis?
A. Hepatitis B
B. Primary biliary cholangitis
C. Alcoholic liver disease
D. Nonalcoholic fatty liver disease
B. Primary biliary cholangitis
AMA positivity with cholestatic pattern (elevated ALP, not seen here)
suggests primary biliary cholangitis; early stages may have mild
transaminase elevation.
, 6. A 40-year-old woman with type 2 diabetes presents for routine follow-
up. Which of the following is recommended for diabetic nephropathy
screening?
A. Serum creatinine only
B. Urine albumin-to-creatinine ratio annually
C. 24-hour urine collection every 5 years
D. No screening needed
B. Urine albumin-to-creatinine ratio annually
Annual screening with urine albumin-to-creatinine ratio is
recommended to detect early diabetic nephropathy.
7. A 65-year-old man presents for colon cancer screening. He has no
family history. Which is the preferred screening method?
A. Colonoscopy every 10 years
B. Flexible sigmoidoscopy every 5 years
C. Fecal occult blood test annually
D. No screening needed until age 70
A. Colonoscopy every 10 years
Average-risk adults should begin colonoscopy at age 45–50;
colonoscopy every 10 years is preferred.
8. A 32-year-old woman presents with irregular menses and hirsutism.
Labs show elevated LH/FSH ratio and testosterone. What is the most
likely diagnosis?
A. Hypothyroidism
