ABFM IN-TRAINING EXAMINATION ACTUAL PRACTICE QUESTIONS WITH CORRECT ANSWERS AND EXPLANATION FROM PAGE 70 American Board of Family Medicine

ABFM IN-TRAINING EXAMINATION ACTUAL PRACTICE
QUESTIONS WITH CORRECT ANSWERS AND EXPLANATION
FROM PAGE 70 American Board of Family Medicine




1. A 67-year-old male sees you for a Medicare annual wellness visit. He tells you that his best
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friend had a stroke and he asks about his risk for stroke. He has no history of stroke,TIA, or
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neurologic symptoms. Hehasa family history ofcardiovasculardisease in his father, who had
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a myocardial infarction at age 65 and died from a thrombotic stroke at age 71. The patient
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exercises regularly and has a BMI of 27 kg/m2. His only current medical condition is
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hyperlipidemia, and his cholesterol level is at goal on rosuvastatin (Crestor), 10 mg daily.
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He also takes aspirin, 81 mg daily. His blood pressure is 125/78 mm Hg.
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BasedonU.S.PreventiveServicesTaskForceguidelines,whichoneofthefollowing would be
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most appropriate at this time?
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A) Noadditionaltestingforstrokerisk
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B) Auscultationforcarotidbruits 2
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C) Carotid duplex ultrasonography q2 q2




D) Magnetic resonance angiography q2 q2




E) CT angiography of the carotid arteries
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2. A 28-year-old female presents for evaluation of nasal congestion, sneezing, watery eyes, and
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postnasal drip. This has been an intermittent issue for her every spring and she would like
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to manage it more effectively.
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Which one of the following treatments has been shown to be the most effective and best tolerated
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first-line therapy for this patient’s condition?
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A) A leukotriene receptor antagonist
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B) Intranasal corticosteroid monotherapy q 2 q 2




C) Intranasal corticosteroids plus an oral antihistamine q 2 q 2 q 2 q 2 q 2




D) Inhaled corticosteroids q 2




E) Annualtriamcinolone injections q2 q2




3. A 68-year-old female presents with a 2-month history of watery diarrhea. She has not had any
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blood or pus in her stools, and the stools are not oily. She has not had any history of fever,
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chills, or weight loss, and has not traveled recently. She smokes one pack of cigarettes per
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day. Her medications include ibuprofen, sertraline (Zoloft), and pantoprazole (Protonix). A
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CBC, metabolicpanel, C-reactiveprotein level, IgAanti-tissue
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1

,transglutaminaselevel,totalIgAlevel,and stoolguaiac test are all normal. Which
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oneofthefollowingtestswouldbemostlikelytoyieldadiagnosis?
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A) Clostridioides(Clostridium) difficile toxin
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B) Colonoscopy
C) Fecal calprotectin
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D) A stool culture
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E) Stoolexaminationforova andparasites
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,4. A 23-year-old male with opioid use disorder requests buprenorphine therapy. He is still
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actively using immediate-release oxycodone (Roxicodone) and he took a dose 2 hours
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ago.
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This patient should begin buprenorphine induction
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A) now
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C) 8–12hoursafterhislastopioiduse 2
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D) 24hoursafterhislastopioiduse
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E) 1weekafterhislastopioiduse
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5. A 45-year-old left hand–dominant female presents to your office with a lump on her hand. She
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first noticed the lump 2 weeks ago and thinks it has gotten bigger. She does not recall any injury.
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She has not had any numbness, weakness, or tingling. She has minimal discomfort when
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she presses on the lump, and it does not affect her activity. On examination her left wrist is
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neurovolar wrist mass shownbelow.vascularly
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Whichoneofthefollowingmanagementoptions wouldyourecommend?
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A) Re-examinationifshedevelopsnumbness,weakness,orincreasedpain 2
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B) Immobilizationofthewristfor6weeksandthenre-examination 2
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C) Aspirationofthelesion 2
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D) Aspirationandinjectionof the lesion with acorticosteroid q2 q2 q2 q2 q2 q2 q2 q2




E) Referralforexcisionofthelesion 2
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6. A 57-year-old female with diabetes mellitus comes to your office for a routine follow-up. Her
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current medications include metformin (Glucophage), 1000 mg twice daily. She tells you that
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she does not exercise regularly and finds it difficult to follow a healthy diet. A hemoglobinA1c
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today is 7.5%. She does not want to add medications at this time, but she does want to get her
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hemoglobin A1c below 7%, which is the goal that was previously discussed.
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Whichoneofthefollowingwouldbethemosteffectivewaytoimproveglucosecontrolfor this
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patient?
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A) Discussthecomponentsof ahealthydiabetic dietandencouragehertofollowit more q2 q2 q2 q2 q2 2
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closely
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B) Discuss the importance ofregular exercise and encourage her to exercise 30–45 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2




minutes daily
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C) Recommendthatshecheckherglucose level1–3timesdailytohelpdetermine what 2
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adjustments need to be made
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D) Starther on an additional medication q2 q2 q2 q2 q2




E) Refer her to a diabetes educator for medical nutrition therapy
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