Family Medicine Board Review ABFM ITE Exam Questions with Complete Solutions

Family Medicine Board Review ABFM ITE Exam Questions with Complete Solutions A 42-year-old Asian male presents for follow-up of elevated blood pressure. He has no additional chronic medical problems and is otherwise asymptomatic. An examination is significant for a blood pressure of 162/95 mm Hg but is otherwise unremarkable. Laboratory Findings unremarkable Urine microalbumin negative According to the American College of Cardiology/American Heart Association 2017 guidelines, which one of the following would be the most appropriate medication to initiate at this time? A) Clonidine (Catapres), 0.1 mg twice daily B) Hydralazine, 25 mg three times daily C) Lisinopril/hydrochlorothiazide (Zestoretic), 10/12.5 mg daily D) Metoprolol tartrate (Lopressor), 25 mg twice daily E) Triamterene (Dyrenium), 50 mg daily - Correct Answer ANSWER: C This patient has hypertension and according to both JNC 8 and American College of Cardiology/American Heart Association 2017 guidelines, antihypertensive treatment should be initiated. For the general non-African-American population, monotherapy with an ACE inhibitor, an angiotensin receptor blocker, a calcium channel blocker, or a thiazide diuretic would be appropriate for initial management. It is also appropriate to initiate combination antihypertensive therapy as an initial management strategy, although patients should not take an ACE inhibitor and an angiotensin receptor blocker simultaneously. Studies have shown that blood pressure control is achieved faster with the initiation of combination therapy compared to monotherapy, without an increase in morbidity. Lisinopril/hydrochlorothiazide would be an appropriate choice in this patient. -Blockers, vasodilators, -blockers, and potassium-sparing diuretics are not recommended as initial choices for the treatment of hypertension. During rounds at the nursing home, you are informed that there are two residents on the unit with laboratory-confirmed influenza. According to CDC guidelines, who should receive chemoprophylaxis for influenza? A) Only symptomatic residents on the same unit B) Only symptomatic residents in the entire facility C) All asymptomatic residents on the same unit D) All residents of the facility regardless of symptoms E) All staff regardless of symptoms - Correct Answer ANSWER: C In long-term care facilities, an influenza outbreak is defined as two laboratory-confirmed cases of influenza within 72 hours in patients on the same unit. The CDC recommends chemoprophylaxis for all asymptomatic residents of the affected unit. Any resident exhibiting symptoms of influenza should b