ABFM ITE CORRECT FINALS ANSWERS AND
QUESTIONS SET A+
✔✔Treatment of life-threatening heat stroke - ✔✔Aggressive ice water immersion
✔✔Colonoscopy after 75 years old - ✔✔The decision to screen for colorectal cancer in
adults aged 76 to 85 years should be an individual one, taking into account the patient's
overall health and prior screening history. Adults in this age group who have never been
screened for colorectal cancer are more likely to benefit. Screening would be most
appropriate among adults who 1) are healthy enough to undergo treatment if colorectal
cancer is detected and 2) do not have comorbid conditions that would significantly limit
their life expectancy.
✔✔Peripheral blood film character in B12 deficiency - ✔✔Hypersegmented
polymorphonuclear WBCs
✔✔Biopsy proven coeliac disease monitoring after being on gluten-free diet - ✔✔IgA
Tissue Transglutaminase antibody
✔✔Hypokalaemia in DKA due to insulin causing K being pushed into cells -
✔✔Potassium replacement
✔✔Buprenorphine therapy should be initiated when patient is in mild to moderate
withdrawal from opioids - ✔✔Patents with opioids in their bloodstream or who are not in
the early stages of withdrawal, may experience acute withdrawal.
✔✔Pregnancy related dental disorders - ✔✔Cavities, gingivitis, loose teeth,
periodontitis, tooth erosion
✔✔What can help to delay definitive surgical therapy in carpal tunnel syndrome? -
✔✔Corticosteroid injections
,✔✔What to do after a tick bite to prevent Lyme disease? - ✔✔Doxycycline 200mg once
or Amoxicillin
- This is only recommended for tick attachment longer than 36 hours, or of unknown
duration.
✔✔At what grade level should health care materials be written? - ✔✔
✔✔At what age should a child's Hb be checked as recommended by the AAP? - ✔✔12
months
✔✔Antibiotic that increases risk of AAA rupture - ✔✔Fluoroquinolones (floxacins)
✔✔An otherwise healthy 55-year-old male who is visiting from Arizona presents to your
office with a 4-week history of intermittent fevers, night sweats, dry cough, weight loss,
and myalgia. The patient has no other recent history of travel. - ✔✔Valley Fever
(medical name coccidioidomycosis or "cocci" for short) is an infection in the lungs
caused by the fungus coccidioides spp., which grows in soils in areas of low rainfall,
high summer temperatures and moderate winter temperatures, such as: throughout
Arizona, the San Joaquin and Central Valleys of California, southern parts of Nevada,
New Mexico and western Texas, east-central Utah, south-eastern Washington, and the
semiarid and arid soils of Central and South America.
✔✔First-line pharmacotherapy for diabetic gastroparesis - ✔✔Metoclopramide,
Erythromycin
✔✔Expedited Partner Therapy (EPT) in STDs - ✔✔Treating the sex partners of patients
diagnosed with chlamydia or gonorrhea by providing prescriptions or medications to the
patient to take to his/her partner without the health care provider first examining the
partner.
✔✔Antibiotic time-out - ✔✔Occurs 48-72h after first administration, part of antibiotic
stewardship programme to ensure judicious use.
✔✔Prehn's sign - ✔✔Physical lifting of the testicles relieves the pain of epididymitis but
not pain caused by testicular torsion.
✔✔Treatment of epididymitis - ✔✔Bed rest, antibiotics (Levofloxacin), scrotal support,
and ice compresses.
✔✔A healthy 2-month-old female is brought to your office for a routine well baby
examination by both of her parents, who have no concerns. The parents refuse routine
recommended vaccines for their daughter because of their personal beliefs. You want to
incorporate patient-centeredness and are also concerned about improving the health of
,the population. You decide to follow the CDC recommendations by? - ✔✔Having the
parents sign a refusal to vaccinate form.
✔✔Prepatellar bursitis is a common superficial bursitis caused by microtrauma from
repeated kneeling and crawling. Other terms for this include housemaid's knee, coal
miner's knee, and carpet layer's knee. It is usually associated with minimal to no pain. -
✔✔The proper management of prepatellar bursitis is conservative and includes ice,
compression wraps, padding, elevation, analgesics, and modification of activity. There
is little evidence that a corticosteroid injection is beneficial, even though it is often done.
If inflammatory bursitis is suspected, a corticosteroid injection may be helpful. Fluid
aspiration is indicated if septic bursitis is suspected. Surgery can be considered for
significant enlargement of a bursa if it interferes with function.
✔✔Absolute contraindication to fibrinolytic therapy - ✔✔A history of an ischemic stroke
within the past 3 months unless the stroke is diagnosed within 4½ hours.
✔✔Treatment of sudden SNHL likely idiopathic - ✔✔Oral Prednisolone (recommended
dosage is 1 mg/kg/day with a maximum dosage of 60 mg daily for 10-14 days)
✔✔Ottawa Ankle rules: negative i.e. ankle sprain - ✔✔Compression combined with
lace-up ankle support or an air cast, along with cryotherapy, is recommended and can
increase mobility. Early mobilization, including weight bearing as tolerated for daily
activities, is associated with better long-term outcomes than prolonged rest.
✔✔Risk factor for atrial fibrillation - ✔✔Alcohol use
✔✔Assessing response to oral iron therapy in iron deficiency anaemia - ✔✔Reticulocyte
count
✔✔Use of IV contrast in those with shellfish allergies - ✔✔No correlation
✔✔Shoulder pain with weak internal rotation - ✔✔Subscapularis
✔✔Shoulder pain with weak external rotation - ✔✔Infraspinatus, teres minor
✔✔Shoulder pain with weak abduction - ✔✔Supraspinatus, deltoid
✔✔First line imaging modality for acute abdominal pain in children -
✔✔Ultrasonography
✔✔First line anti-hypertensives in African-Caribbean patients - ✔✔Calcium-channel
blockers, Thiazides (e.g. Chlorthalidone)
✔✔Hospice care eligibility is based on - ✔✔Life expectancy (6 months or less)
, ✔✔Depression in adolescents (12-18yo) should be screened annually with PHQ-2 then
PHQ-A - ✔✔Psychotherapy
SSRIs: Fluoxetine, Citalopram
- Venlafaxine should be avoided in adolescents because it is associated with a
statistically increased risk of suicidal behavioupr or ideation.
✔✔GLP-1 receptor agonist that lowers risk of recurrent cardiovascular events -
✔✔Liraglutide
✔✔Sickle cell disease increases risk of stroke - ✔✔All sickle cell patients 2-16 years of
age should be screened with transcranial Doppler ultrasonography
✔✔Non-specific lower back pain - ✔✔Does not require imaging
- An initial plain film would be appropriate if there were a history of recent significant
trauma, or even a history of minor trauma in an elderly patient.
- Immediate MRI would be appropriate in the presence of other red flags
NSAIDs then skeletal muscle relaxant e.g. Cyclobenzaprine
A walking program is the best choice for long-term benefit because it is much more
affordable than physical therapy
✔✔Occupations causing silicosis - ✔✔Stone cutting, sand blasting, mining, and
quarrying
✔✔HOCM systolic murmur intensifies with Valsava's and is the most common primary
cardiomyopathy - ✔✔First-line treatment with beta-blockers, CCBs (non-dipines) if beta-
blockers not tolerated
✔✔BPSD of dementia can be treated (off-label) with antipsychotics - ✔✔Aripiprazole
produces small reductions in behavioral and psychological symptoms of dementia, and
it has the least adverse effects of the atypical antipsychotics.
Both typical and atypical antipsychotics increase the risk of mortality in patients with
dementia.
The typical antipsychotics are more commonly associated with extrapyramidal side
effects. Diabetes mellitus and agranulocytosis are associated with the atypical
antipsychotics, including Risperidone. Periodic monitoring of serum glucose levels and
CBCs is recommended.
For patients who have been taking antipsychotics for >/= 3 months and whose
symptoms have stabilized, or for patients who have not responded to an adequate trial
QUESTIONS SET A+
✔✔Treatment of life-threatening heat stroke - ✔✔Aggressive ice water immersion
✔✔Colonoscopy after 75 years old - ✔✔The decision to screen for colorectal cancer in
adults aged 76 to 85 years should be an individual one, taking into account the patient's
overall health and prior screening history. Adults in this age group who have never been
screened for colorectal cancer are more likely to benefit. Screening would be most
appropriate among adults who 1) are healthy enough to undergo treatment if colorectal
cancer is detected and 2) do not have comorbid conditions that would significantly limit
their life expectancy.
✔✔Peripheral blood film character in B12 deficiency - ✔✔Hypersegmented
polymorphonuclear WBCs
✔✔Biopsy proven coeliac disease monitoring after being on gluten-free diet - ✔✔IgA
Tissue Transglutaminase antibody
✔✔Hypokalaemia in DKA due to insulin causing K being pushed into cells -
✔✔Potassium replacement
✔✔Buprenorphine therapy should be initiated when patient is in mild to moderate
withdrawal from opioids - ✔✔Patents with opioids in their bloodstream or who are not in
the early stages of withdrawal, may experience acute withdrawal.
✔✔Pregnancy related dental disorders - ✔✔Cavities, gingivitis, loose teeth,
periodontitis, tooth erosion
✔✔What can help to delay definitive surgical therapy in carpal tunnel syndrome? -
✔✔Corticosteroid injections
,✔✔What to do after a tick bite to prevent Lyme disease? - ✔✔Doxycycline 200mg once
or Amoxicillin
- This is only recommended for tick attachment longer than 36 hours, or of unknown
duration.
✔✔At what grade level should health care materials be written? - ✔✔
✔✔At what age should a child's Hb be checked as recommended by the AAP? - ✔✔12
months
✔✔Antibiotic that increases risk of AAA rupture - ✔✔Fluoroquinolones (floxacins)
✔✔An otherwise healthy 55-year-old male who is visiting from Arizona presents to your
office with a 4-week history of intermittent fevers, night sweats, dry cough, weight loss,
and myalgia. The patient has no other recent history of travel. - ✔✔Valley Fever
(medical name coccidioidomycosis or "cocci" for short) is an infection in the lungs
caused by the fungus coccidioides spp., which grows in soils in areas of low rainfall,
high summer temperatures and moderate winter temperatures, such as: throughout
Arizona, the San Joaquin and Central Valleys of California, southern parts of Nevada,
New Mexico and western Texas, east-central Utah, south-eastern Washington, and the
semiarid and arid soils of Central and South America.
✔✔First-line pharmacotherapy for diabetic gastroparesis - ✔✔Metoclopramide,
Erythromycin
✔✔Expedited Partner Therapy (EPT) in STDs - ✔✔Treating the sex partners of patients
diagnosed with chlamydia or gonorrhea by providing prescriptions or medications to the
patient to take to his/her partner without the health care provider first examining the
partner.
✔✔Antibiotic time-out - ✔✔Occurs 48-72h after first administration, part of antibiotic
stewardship programme to ensure judicious use.
✔✔Prehn's sign - ✔✔Physical lifting of the testicles relieves the pain of epididymitis but
not pain caused by testicular torsion.
✔✔Treatment of epididymitis - ✔✔Bed rest, antibiotics (Levofloxacin), scrotal support,
and ice compresses.
✔✔A healthy 2-month-old female is brought to your office for a routine well baby
examination by both of her parents, who have no concerns. The parents refuse routine
recommended vaccines for their daughter because of their personal beliefs. You want to
incorporate patient-centeredness and are also concerned about improving the health of
,the population. You decide to follow the CDC recommendations by? - ✔✔Having the
parents sign a refusal to vaccinate form.
✔✔Prepatellar bursitis is a common superficial bursitis caused by microtrauma from
repeated kneeling and crawling. Other terms for this include housemaid's knee, coal
miner's knee, and carpet layer's knee. It is usually associated with minimal to no pain. -
✔✔The proper management of prepatellar bursitis is conservative and includes ice,
compression wraps, padding, elevation, analgesics, and modification of activity. There
is little evidence that a corticosteroid injection is beneficial, even though it is often done.
If inflammatory bursitis is suspected, a corticosteroid injection may be helpful. Fluid
aspiration is indicated if septic bursitis is suspected. Surgery can be considered for
significant enlargement of a bursa if it interferes with function.
✔✔Absolute contraindication to fibrinolytic therapy - ✔✔A history of an ischemic stroke
within the past 3 months unless the stroke is diagnosed within 4½ hours.
✔✔Treatment of sudden SNHL likely idiopathic - ✔✔Oral Prednisolone (recommended
dosage is 1 mg/kg/day with a maximum dosage of 60 mg daily for 10-14 days)
✔✔Ottawa Ankle rules: negative i.e. ankle sprain - ✔✔Compression combined with
lace-up ankle support or an air cast, along with cryotherapy, is recommended and can
increase mobility. Early mobilization, including weight bearing as tolerated for daily
activities, is associated with better long-term outcomes than prolonged rest.
✔✔Risk factor for atrial fibrillation - ✔✔Alcohol use
✔✔Assessing response to oral iron therapy in iron deficiency anaemia - ✔✔Reticulocyte
count
✔✔Use of IV contrast in those with shellfish allergies - ✔✔No correlation
✔✔Shoulder pain with weak internal rotation - ✔✔Subscapularis
✔✔Shoulder pain with weak external rotation - ✔✔Infraspinatus, teres minor
✔✔Shoulder pain with weak abduction - ✔✔Supraspinatus, deltoid
✔✔First line imaging modality for acute abdominal pain in children -
✔✔Ultrasonography
✔✔First line anti-hypertensives in African-Caribbean patients - ✔✔Calcium-channel
blockers, Thiazides (e.g. Chlorthalidone)
✔✔Hospice care eligibility is based on - ✔✔Life expectancy (6 months or less)
, ✔✔Depression in adolescents (12-18yo) should be screened annually with PHQ-2 then
PHQ-A - ✔✔Psychotherapy
SSRIs: Fluoxetine, Citalopram
- Venlafaxine should be avoided in adolescents because it is associated with a
statistically increased risk of suicidal behavioupr or ideation.
✔✔GLP-1 receptor agonist that lowers risk of recurrent cardiovascular events -
✔✔Liraglutide
✔✔Sickle cell disease increases risk of stroke - ✔✔All sickle cell patients 2-16 years of
age should be screened with transcranial Doppler ultrasonography
✔✔Non-specific lower back pain - ✔✔Does not require imaging
- An initial plain film would be appropriate if there were a history of recent significant
trauma, or even a history of minor trauma in an elderly patient.
- Immediate MRI would be appropriate in the presence of other red flags
NSAIDs then skeletal muscle relaxant e.g. Cyclobenzaprine
A walking program is the best choice for long-term benefit because it is much more
affordable than physical therapy
✔✔Occupations causing silicosis - ✔✔Stone cutting, sand blasting, mining, and
quarrying
✔✔HOCM systolic murmur intensifies with Valsava's and is the most common primary
cardiomyopathy - ✔✔First-line treatment with beta-blockers, CCBs (non-dipines) if beta-
blockers not tolerated
✔✔BPSD of dementia can be treated (off-label) with antipsychotics - ✔✔Aripiprazole
produces small reductions in behavioral and psychological symptoms of dementia, and
it has the least adverse effects of the atypical antipsychotics.
Both typical and atypical antipsychotics increase the risk of mortality in patients with
dementia.
The typical antipsychotics are more commonly associated with extrapyramidal side
effects. Diabetes mellitus and agranulocytosis are associated with the atypical
antipsychotics, including Risperidone. Periodic monitoring of serum glucose levels and
CBCs is recommended.
For patients who have been taking antipsychotics for >/= 3 months and whose
symptoms have stabilized, or for patients who have not responded to an adequate trial
