MEDICINE CERTIFICATED EXAM FOR THE
AMERICAN BOARD OF FAMILY MEDICINE
(ABMS) | Q&A WITH RATIONALES
1. A 16-year-old male basketball player lands on
another player's foot and inverts his ankle. He has
swelling over the lateral ankle and cannot bear
weight. Ottawa ankle rules indicate radiographs.
What is the most important view to assess for a fifth
metatarsal base fracture?
A) Anteroposterior (AP)
B) Lateral
C) Oblique
D) Mortise
Correct answer: C
Rationale: The oblique view best visualizes the base
of the fifth metatarsal (tuberosity avulsion fracture).
AP and lateral may miss it.
2. A 22-year-old female soccer player has anterior
knee pain that worsens with running, squatting, and
prolonged sitting. Exam shows tenderness at the
,inferior pole of the patella. What is the most likely
diagnosis?
A) Patellofemoral pain syndrome
B) Osgood-Schlatter disease
C) Sinding-Larsen-Johansson syndrome
D) Patellar tendinopathy
Correct answer: C
Rationale: Sinding-Larsen-Johansson is traction
apophysitis at the inferior pole of the patella (patellar
tendon origin). Osgood-Schlatter is at tibial
tuberosity.
3. A 45-year-old recreational tennis player reports
lateral elbow pain that worsens with gripping and
extending the wrist. Exam shows tenderness 1 cm
distal to the lateral epicondyle and pain with resisted
wrist extension. What is first-line non-surgical
treatment?
A) Corticosteroid injection
B) Counterforce brace and eccentric strengthening
C) Surgical release
D) Platelet-rich plasma injection
Correct answer: B
,Rationale: Lateral epicondylitis (tennis elbow) first-
line: activity modification, counterforce brace,
physical therapy (eccentric wrist extensions).
Corticosteroid injections provide short-term relief but
higher recurrence.
4. A 19-year-old male football player sustains a direct
blow to the anterior shoulder while tackling. He
presents with arm held internally rotated and
abducted, with a flattened deltoid contour. What is
the most likely diagnosis?
A) Anterior shoulder dislocation
B) Posterior shoulder dislocation
C) Acromioclavicular separation
D) Clavicle fracture
Correct answer: A
Rationale: Anterior dislocation (95% of shoulder
dislocations) presents with arm in external rotation
and abduction, loss of deltoid contour. Posterior
dislocation presents with internal rotation.
5. A 30-year-old runner reports medial tibial pain that
improves with warm-up but returns after running.
Exam shows diffuse tenderness along the
, posteromedial tibia. Radiographs are normal. What is
the most likely diagnosis?
A) Tibial stress fracture
B) Medial tibial stress syndrome (shin splints)
C) Chronic exertional compartment syndrome
D) Popliteal artery entrapment
Correct answer: B
Rationale: Medial tibial stress syndrome (shin splints)
presents with diffuse tenderness along
posteromedial tibia, pain with activity that improves
after warm-up. Stress fracture has focal tenderness.
6. A 17-year-old female gymnast has insidious onset
of low back pain that worsens with hyperextension
(backbend). Exam shows pain with single-leg
hyperextension (stork test). What is the most
appropriate initial imaging?
A) Lumbar spine X-ray with oblique views
B) MRI lumbar spine
C) CT lumbar spine
D) Bone scan
Correct answer: A