ABFM ITE Exam V1 (Latest 2026/ 2027 Update) Questions and
Answers with Rationales University of Washington
This ABFM ITE Exam Test Bank (2026/2027 Update) offers unique multiple-choice
questions with verified answers and detailed clinical rationales. It
comprehensively covers critical family medicine domains, including USPSTF
screening guidelines, cardiovascular, endocrine, and respiratory disorders. Ideal
for family medicine residents at top institutions like the University of Washington
and Duke University preparing to excel on their in-training examination.
Section 1: Preventive Medicine & USPSTF Guidelines (Questions 1–40)
1. A 67-year-old male sees you for a Medicare annual wellness visit. He tells
you that his best friend had a stroke and he asks about his risk for stroke.
He has a family history of cardiovascular disease in his father, who had a
myocardial infarction at age 65 and died from a thrombotic stroke at age 71.
The patient exercises regularly and has a BMI of 27 kg/m2. His only current
medical condition is hyperlipidemia, and his cholesterol level is at goal on
rosuvastatin (Crestor), 10 mg daily. He also takes aspirin, 81 mg daily. His
blood pressure 125/78 mmHg. Based on US Preventive Services Task Force
guidelines, which one of the following would be most appropriate at this
time?
A. No additional testing for stroke risk
B. Auscultation for carotid bruits
C. Carotid duplex ultrasonography
,D. Magnetic resonance angiography
E. CT angiography of the carotid arteries
A. No additional testing for stroke risk
Rationale: This patient is asymptomatic and has no history of an ischemic
stroke, neurology symptoms referable to the carotid arteries such as
amaurosis fugal, or TIA. He has risk factors for cardiovascular disease
(age, male sex, hyperlipidemia), but the USPSTF recommends against
specific screening asymptomatic carotid artery stenosis (D
recommendation). Auscultation of the carotid arteries for bruits has been
found to have poor accuracy. Appropriate modalities for detecting carotid
stenosis include carotid duplex ultrasonography, magnetic resonance
angiography, and computed tomography, but these are not recommended
for screening asymptomatic patients.
2. A 45-year-old male with no significant medical history presents for a
routine visit. According to the U.S. Preventive Services Task Force
(USPSTF), which screening should be prioritized for colorectal cancer?
A. Colonoscopy every 5 years
B. Fecal immunochemical test (FIT) annually
C. CT colonography every 10 years
D. Sigmoidoscopy every 10 years
B. Fecal immunochemical test (FIT) annually
Rationale: The USPSTF recommends screening for colorectal cancer in all
adults aged 45 to 75 years. While all options are acceptable screening
modalities, annual FIT is a non-invasive, high-sensitivity test that is often the
most practical first-line option for average-risk individuals in primary care.
,Colonoscopy is typically recommended every 10 years, not 5, for average-
risk patients without findings.
3. A 32-year-old female presents for a well-woman visit. She has a history
of one sexual partner, is in a monogamous relationship, and has never had
an abnormal Pap smear. According to current guidelines, when should she
next be screened for cervical cancer?
A. In 1 year
B. In 3 years
C. In 5 years
D. She does not require screening until age 40
B. In 3 years
Rationale: For women aged 21-29, cervical cancer screening with cytology
alone is recommended every 3 years. For women aged 30-65, screening
can be done every 3 years with cytology alone, every 5 years with HPV
testing alone, or every 5 years with co-testing.
4. A 68-year-old male with a 20-pack-year smoking history presents for a
wellness exam. He is asymptomatic. According to the USPSTF, which lung
cancer screening strategy is recommended?
A. Annual chest X-ray
B. Low-dose computed tomography (LDCT) annually
C. Sputum cytology every 2 years
D. No screening is recommended
B. Low-dose computed tomography (LDCT) annually
Rationale: The USPSTF recommends annual screening for lung cancer with
LDCT in adults aged 50 to 80 years who have a 20-pack-year smoking
, history and currently smoke or have quit within the past 15 years. This
patient meets the criteria.
5. A 45-year-old female asks about breast cancer screening. She has no
family history and is at average risk. What is the recommended screening
schedule according to the American Cancer Society?
A. Annual mammogram starting at age 40
B. Mammogram every 2 years starting at age 50
C. Annual mammogram starting at age 45
D. No screening until age 55
A. Annual mammogram starting at age 40
Rationale: The American Cancer Society recommends that women at
average risk of breast cancer should have the option to begin annual
mammography at age 40. Women aged 45 to 54 should get mammograms
annually.
6. A 50-year-old male with a BMI of 32 and a sedentary lifestyle is at risk
for type 2 diabetes. Which intervention has the strongest evidence for
preventing or delaying the onset of diabetes?
A. Metformin 850 mg twice daily
B. Intensive lifestyle intervention focusing on diet and exercise
C. Annual HbA1c screening
D. Pioglitazone 30 mg daily
B. Intensive lifestyle intervention focusing on diet and exercise
Rationale: The Diabetes Prevention Program (DPP) demonstrated that
intensive lifestyle intervention (goal of 7% weight loss and 150 minutes of
Answers with Rationales University of Washington
This ABFM ITE Exam Test Bank (2026/2027 Update) offers unique multiple-choice
questions with verified answers and detailed clinical rationales. It
comprehensively covers critical family medicine domains, including USPSTF
screening guidelines, cardiovascular, endocrine, and respiratory disorders. Ideal
for family medicine residents at top institutions like the University of Washington
and Duke University preparing to excel on their in-training examination.
Section 1: Preventive Medicine & USPSTF Guidelines (Questions 1–40)
1. A 67-year-old male sees you for a Medicare annual wellness visit. He tells
you that his best friend had a stroke and he asks about his risk for stroke.
He has a family history of cardiovascular disease in his father, who had a
myocardial infarction at age 65 and died from a thrombotic stroke at age 71.
The patient exercises regularly and has a BMI of 27 kg/m2. His only current
medical condition is hyperlipidemia, and his cholesterol level is at goal on
rosuvastatin (Crestor), 10 mg daily. He also takes aspirin, 81 mg daily. His
blood pressure 125/78 mmHg. Based on US Preventive Services Task Force
guidelines, which one of the following would be most appropriate at this
time?
A. No additional testing for stroke risk
B. Auscultation for carotid bruits
C. Carotid duplex ultrasonography
,D. Magnetic resonance angiography
E. CT angiography of the carotid arteries
A. No additional testing for stroke risk
Rationale: This patient is asymptomatic and has no history of an ischemic
stroke, neurology symptoms referable to the carotid arteries such as
amaurosis fugal, or TIA. He has risk factors for cardiovascular disease
(age, male sex, hyperlipidemia), but the USPSTF recommends against
specific screening asymptomatic carotid artery stenosis (D
recommendation). Auscultation of the carotid arteries for bruits has been
found to have poor accuracy. Appropriate modalities for detecting carotid
stenosis include carotid duplex ultrasonography, magnetic resonance
angiography, and computed tomography, but these are not recommended
for screening asymptomatic patients.
2. A 45-year-old male with no significant medical history presents for a
routine visit. According to the U.S. Preventive Services Task Force
(USPSTF), which screening should be prioritized for colorectal cancer?
A. Colonoscopy every 5 years
B. Fecal immunochemical test (FIT) annually
C. CT colonography every 10 years
D. Sigmoidoscopy every 10 years
B. Fecal immunochemical test (FIT) annually
Rationale: The USPSTF recommends screening for colorectal cancer in all
adults aged 45 to 75 years. While all options are acceptable screening
modalities, annual FIT is a non-invasive, high-sensitivity test that is often the
most practical first-line option for average-risk individuals in primary care.
,Colonoscopy is typically recommended every 10 years, not 5, for average-
risk patients without findings.
3. A 32-year-old female presents for a well-woman visit. She has a history
of one sexual partner, is in a monogamous relationship, and has never had
an abnormal Pap smear. According to current guidelines, when should she
next be screened for cervical cancer?
A. In 1 year
B. In 3 years
C. In 5 years
D. She does not require screening until age 40
B. In 3 years
Rationale: For women aged 21-29, cervical cancer screening with cytology
alone is recommended every 3 years. For women aged 30-65, screening
can be done every 3 years with cytology alone, every 5 years with HPV
testing alone, or every 5 years with co-testing.
4. A 68-year-old male with a 20-pack-year smoking history presents for a
wellness exam. He is asymptomatic. According to the USPSTF, which lung
cancer screening strategy is recommended?
A. Annual chest X-ray
B. Low-dose computed tomography (LDCT) annually
C. Sputum cytology every 2 years
D. No screening is recommended
B. Low-dose computed tomography (LDCT) annually
Rationale: The USPSTF recommends annual screening for lung cancer with
LDCT in adults aged 50 to 80 years who have a 20-pack-year smoking
, history and currently smoke or have quit within the past 15 years. This
patient meets the criteria.
5. A 45-year-old female asks about breast cancer screening. She has no
family history and is at average risk. What is the recommended screening
schedule according to the American Cancer Society?
A. Annual mammogram starting at age 40
B. Mammogram every 2 years starting at age 50
C. Annual mammogram starting at age 45
D. No screening until age 55
A. Annual mammogram starting at age 40
Rationale: The American Cancer Society recommends that women at
average risk of breast cancer should have the option to begin annual
mammography at age 40. Women aged 45 to 54 should get mammograms
annually.
6. A 50-year-old male with a BMI of 32 and a sedentary lifestyle is at risk
for type 2 diabetes. Which intervention has the strongest evidence for
preventing or delaying the onset of diabetes?
A. Metformin 850 mg twice daily
B. Intensive lifestyle intervention focusing on diet and exercise
C. Annual HbA1c screening
D. Pioglitazone 30 mg daily
B. Intensive lifestyle intervention focusing on diet and exercise
Rationale: The Diabetes Prevention Program (DPP) demonstrated that
intensive lifestyle intervention (goal of 7% weight loss and 150 minutes of
