ABFM ITE Exam V2 (Latest Update
) | Questions & Answers
| Grade A | 100% Correct
Question:
A hemoglobin level ≤8 g/dL would be an appropriate RBC transfusion
threshold for which one of the following hospitalized patients?
A) A 19-year-old with symptomatic sickle cell pain crisis
B) A 63-year-old who is hemodynamically stable after a major trauma
C) A 79-year-old with inoperable femur and hip fractures
D) An 81-year-old who underwent cardiac bypass surgery 3 days ago
E) An 85-year-old with diverticulosis and chronic anemia
Answer: D
The transfusion of blood products, specifically RBCs, is a common medical
procedure.
The transfusion threshold of RBCs for most adults is a hemoglobin level ≤7-8
g/Dl (SOR A). However, a slightly less restrictive transfusion threshold of a
hemoglobin level ≤8 g/dL should be used for patients who have preexisting
cardiovascular disease or are undergoing orthopedic or cardiac surgery, such
as a patient who underwent cardiac bypass surgery 3 days ago (SOR C).
,Question:
You see a 45-year-old male with a history of opioid use disorder for a health
maintenance examination. The patient has successfully remained in a
treatment program using methadone, and an examination is normal. He has
not had a recent EKG.
You order an EKG because which one of the following is a very rare but serious
complication of methadone treatment?
A) Paroxysmal atrial fibrillation
B) QTc prolongation
C) First-degree heart block
D) Second-degree Mobitz type II heart block
E) Complete heart block
Answer: B
QTc prolongation is a very rare but serious complication of methadone
treatment.
Expert organizations recommend obtaining a baseline EKG in patients with
other risk factors. Although the optimal strategy for patients with a QTc
interval ≥500 milliseconds is debated, physicians should review risks and
discuss alternatives to other QTc prolongation medications. If the risk of
continuing methadone outweighs the high-risk potential for opioid overdose
with methadone discontinuation, alternatives to methadone can be pursued
,Question:
Lymphadenopathy in which one of the following sites in a 55-year-old male
would suggest malignancy?
A) Anterior cervical
B) Posterior cervical
C) Axillary
D) Inguinal
E) Supraclavicular
Answer: E
While lymphadenopathy is generally self-limited with a benign etiology,
lymphadenopathy at the supraclavicular, popliteal, and iliac locations is
abnormal.
Epitrochlear nodes >5 mm in diameter are also abnormal. Because it is
associated with a high risk for intra-abdominal malignancy, supraclavicular
lymphadenopathy should be evaluated immediately. This applies to both
adults and children although patients >40 years of age are at highest risk.
Studies indicate that 34%-50% of these patients with supraclavicular
lymphadenopathy have malignancy.
Question:
A 15-year-old patient who was recently hospitalized for anorexia nervosa sees
you for a follow-up visit in your clinic to discuss the next steps in treatment.
Which one of the following therapies is the recommended next step in
treatment for this patient?
, A) Self-guided treatment
B) Cognitive behavioral therapy
C) Focal psychodynamic psychotherapy
D) Interpersonal psychotherapy
E) Family-based therapy
Answer: E
Family-based therapy is recommended as first-line therapy for anorexia
nervosa in adolescents and some young adults. Studies have shown that
family-based therapy results in higher remission rates and weight gain than
individual therapy such as self guided treatment, cognitive behavioral
therapy, focal psychodynamic psychotherapy, and interpersonal
psychotherapy
Question:
A 67-year-old female presents for an annual health maintenance examination.
She has a history of GERD, asthma, and hypothyroidism. Her last colonoscopy
revealed tubular adenomas. She has smoked 1 pack of cigarettes per day since
age 20. She does not have any current medical concerns.
Which one of the following would be most appropriate for this patient?
A) Urinalysis screening for bladder cancer
B) Stool DNA testing (Cologuard) for colon cancer
C) Cytology and HPV co-testing for cervical cancer
D) Annual EKG screening for coronary artery disease
E) Annual low-dose CT screening for lung cancer
) | Questions & Answers
| Grade A | 100% Correct
Question:
A hemoglobin level ≤8 g/dL would be an appropriate RBC transfusion
threshold for which one of the following hospitalized patients?
A) A 19-year-old with symptomatic sickle cell pain crisis
B) A 63-year-old who is hemodynamically stable after a major trauma
C) A 79-year-old with inoperable femur and hip fractures
D) An 81-year-old who underwent cardiac bypass surgery 3 days ago
E) An 85-year-old with diverticulosis and chronic anemia
Answer: D
The transfusion of blood products, specifically RBCs, is a common medical
procedure.
The transfusion threshold of RBCs for most adults is a hemoglobin level ≤7-8
g/Dl (SOR A). However, a slightly less restrictive transfusion threshold of a
hemoglobin level ≤8 g/dL should be used for patients who have preexisting
cardiovascular disease or are undergoing orthopedic or cardiac surgery, such
as a patient who underwent cardiac bypass surgery 3 days ago (SOR C).
,Question:
You see a 45-year-old male with a history of opioid use disorder for a health
maintenance examination. The patient has successfully remained in a
treatment program using methadone, and an examination is normal. He has
not had a recent EKG.
You order an EKG because which one of the following is a very rare but serious
complication of methadone treatment?
A) Paroxysmal atrial fibrillation
B) QTc prolongation
C) First-degree heart block
D) Second-degree Mobitz type II heart block
E) Complete heart block
Answer: B
QTc prolongation is a very rare but serious complication of methadone
treatment.
Expert organizations recommend obtaining a baseline EKG in patients with
other risk factors. Although the optimal strategy for patients with a QTc
interval ≥500 milliseconds is debated, physicians should review risks and
discuss alternatives to other QTc prolongation medications. If the risk of
continuing methadone outweighs the high-risk potential for opioid overdose
with methadone discontinuation, alternatives to methadone can be pursued
,Question:
Lymphadenopathy in which one of the following sites in a 55-year-old male
would suggest malignancy?
A) Anterior cervical
B) Posterior cervical
C) Axillary
D) Inguinal
E) Supraclavicular
Answer: E
While lymphadenopathy is generally self-limited with a benign etiology,
lymphadenopathy at the supraclavicular, popliteal, and iliac locations is
abnormal.
Epitrochlear nodes >5 mm in diameter are also abnormal. Because it is
associated with a high risk for intra-abdominal malignancy, supraclavicular
lymphadenopathy should be evaluated immediately. This applies to both
adults and children although patients >40 years of age are at highest risk.
Studies indicate that 34%-50% of these patients with supraclavicular
lymphadenopathy have malignancy.
Question:
A 15-year-old patient who was recently hospitalized for anorexia nervosa sees
you for a follow-up visit in your clinic to discuss the next steps in treatment.
Which one of the following therapies is the recommended next step in
treatment for this patient?
, A) Self-guided treatment
B) Cognitive behavioral therapy
C) Focal psychodynamic psychotherapy
D) Interpersonal psychotherapy
E) Family-based therapy
Answer: E
Family-based therapy is recommended as first-line therapy for anorexia
nervosa in adolescents and some young adults. Studies have shown that
family-based therapy results in higher remission rates and weight gain than
individual therapy such as self guided treatment, cognitive behavioral
therapy, focal psychodynamic psychotherapy, and interpersonal
psychotherapy
Question:
A 67-year-old female presents for an annual health maintenance examination.
She has a history of GERD, asthma, and hypothyroidism. Her last colonoscopy
revealed tubular adenomas. She has smoked 1 pack of cigarettes per day since
age 20. She does not have any current medical concerns.
Which one of the following would be most appropriate for this patient?
A) Urinalysis screening for bladder cancer
B) Stool DNA testing (Cologuard) for colon cancer
C) Cytology and HPV co-testing for cervical cancer
D) Annual EKG screening for coronary artery disease
E) Annual low-dose CT screening for lung cancer
