Page 1 of 321
ABFM ITE EXAM VERSION A, B, C AND STUDY
GUIDE COMPLETE 670+ QUESTIONS AND CORRECT
DETAILED ANSWERS – LATEST UPDATE THIS YEAR
JUST RELEASED
ABFM ITE EXAM A
QUESTION: An 87-year-old female comes to your office for an annual health maintenance visit.
She appears cachectic and tells you that for the past 6 months she has had a decreased
appetite and generalized muscle weakness. The patient is alert and oriented to person and
place. She has a 10% weight loss, dry mucous membranes, and tenting of the skin on the
extensor surface of her hands. While inflating the blood pressure cuff on her right arm you
observe carpopedal spasms.
Which one of the following is the most likely electrolyte disturbance?
A) Hypercalcemia
B) Hypocalcemia
C) Hypokalemia
D) Hypernatremia
E) Hyponatremia - ANSWER-B
QUESTION: A 24-year old female presents to your office with a 3-month history of difficulty
sleeping. She says that she struggles to fall asleep and wakes up multiple times at night at least
three times a week. She tries to go to bed at 10:00 p.m. and wakes up at 6:30 a.m. to start her
day. She lies awake for an hour in bed before falling asleep and spends up to 2 hours awake in
the middle of the night trying to fall back asleep. Lately she has been feeling fatigued and
having difficulty concentrating at work. You conduct a full history and physical examination and
tell her to return in 2 weeks with a sleep diary. At this follow-up visit you see from her diary
that she is sleeping an average of 51⁄2 hours per night.
Which one of the following would be the most appropriate recommendation?
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A) Set her alarm for 5:30 a.m.
B) Add a mid-afternoon nap
C) Move her bedtime to 9:00 p.m.
D) Move her bedtime to 12:30 a.m.
E) Stay up for a - ANSWER-D
QUESTION: A 45-year-old female presents to the emergency department with a 1-week history
of facial swelling and progressive dyspnea with exertion. She was diagnosed 1 week ago with
non-Hodgkin's lymphoma but her medical history is otherwise unremarkable. A chest
radiograph is shown below.
After hospital admission, which one of the following would be the most appropriate next step
in the management of this condition?
A) Intravenous antibiotics
B) Urgent chemotherapy and radiation
C) Urgent chemotherapy and plasmapheresis
D) Urgent echocardiography
E) Urgent bronchoscopy - ANSWER-B
QUESTION: A nonverbal 22-year-old male with intellectual disability is brought to your office by
the staff of the group home where he lives. They report that the patient has been functioning at
his baseline until this morning when he was found to have loud breathing. No other history is
available at the time of this visit.
On examination he has a temperature of 37.3°C (99.1°F), a blood pressure of 124/82 mm Hg, a
pulse rate of 100 beats/min, and a respiratory rate of 16/min. The patient appears to be in mild
distress and a high-pitched whistling, crowing sound on inspiration is heard as you walk in the
room.
Which one of the following would be the most appropriate next step for this patient?
A) Oral antibiotics
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,Page 3 of 321
B) Oral corticosteroids
C) Nebulized albuterol
D) Nebulized epinephrine
E) Urgent evaluation in the emergency department - ANSWER-E
QUESTION: A 16-year-old female presents with chronic acne on her nose, forehead, and chin
consisting of a few comedones and a few mildly inflamed papules and pustules. She says it is
minimally improved after 12 weeks of daily adapalene 0.1% gel. There are no scars or cysts. The
patient would like to try to achieve better control.
Which one of the following would you recommend at this time?
A) Continue adapalene 0.1% gel for 12 more weeks
B) Add clindamycin (Cleocin T) 1% gel for up to 12 weeks
C) Add clindamycin 1% gel for maintenance
D) Stop adapalene 0.1% gel and start clindamycin 1% gel for maintenance
E) Stop adapalene 0.1% gel and start erythromycin 2% gel for maintenance - ANSWER-B
QUESTION: A 32-year-old female who is one of your longtime patients calls you because of a
24-hour history of painful urination with urinary frequency and urgency. She is otherwise
healthy and does not have any fever, chills, back pain, or vaginal discharge. She uses an oral
contraceptive pill and states that her last menstrual period was normal and occurred last week.
Which one of the following would be most appropriate at this time?
A) Empiric antibiotic treatment
B) A urinalysis
C) A urine culture
D) Plain abdominal radiographs
E) Pelvic ultrasonography - ANSWER-A
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, Page 4 of 321
QUESTION: A 70-year-old female develops thrombocytopenia during a prolonged
hospitalization for endocarditis. Her current medications include scheduled unfractionated
heparin injections for venous thromboembolism prophylaxis. You suspect heparin-induced
thrombocytopenia (HIT).
Assuming that her thrombocytopenia is caused by HIT, which one of the following is the most
likely complication?
A) Anaphylaxis
B) Disseminated intravascular coagulation
C) Hemorrhage
D) Sepsis
E) Thrombosis - ANSWER-E
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.
all the labs are normal. (Claire's notes, ily)
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 - ANSWER-C
4
ABFM ITE EXAM VERSION A, B, C AND STUDY
GUIDE COMPLETE 670+ QUESTIONS AND CORRECT
DETAILED ANSWERS – LATEST UPDATE THIS YEAR
JUST RELEASED
ABFM ITE EXAM A
QUESTION: An 87-year-old female comes to your office for an annual health maintenance visit.
She appears cachectic and tells you that for the past 6 months she has had a decreased
appetite and generalized muscle weakness. The patient is alert and oriented to person and
place. She has a 10% weight loss, dry mucous membranes, and tenting of the skin on the
extensor surface of her hands. While inflating the blood pressure cuff on her right arm you
observe carpopedal spasms.
Which one of the following is the most likely electrolyte disturbance?
A) Hypercalcemia
B) Hypocalcemia
C) Hypokalemia
D) Hypernatremia
E) Hyponatremia - ANSWER-B
QUESTION: A 24-year old female presents to your office with a 3-month history of difficulty
sleeping. She says that she struggles to fall asleep and wakes up multiple times at night at least
three times a week. She tries to go to bed at 10:00 p.m. and wakes up at 6:30 a.m. to start her
day. She lies awake for an hour in bed before falling asleep and spends up to 2 hours awake in
the middle of the night trying to fall back asleep. Lately she has been feeling fatigued and
having difficulty concentrating at work. You conduct a full history and physical examination and
tell her to return in 2 weeks with a sleep diary. At this follow-up visit you see from her diary
that she is sleeping an average of 51⁄2 hours per night.
Which one of the following would be the most appropriate recommendation?
1
,Page 2 of 321
A) Set her alarm for 5:30 a.m.
B) Add a mid-afternoon nap
C) Move her bedtime to 9:00 p.m.
D) Move her bedtime to 12:30 a.m.
E) Stay up for a - ANSWER-D
QUESTION: A 45-year-old female presents to the emergency department with a 1-week history
of facial swelling and progressive dyspnea with exertion. She was diagnosed 1 week ago with
non-Hodgkin's lymphoma but her medical history is otherwise unremarkable. A chest
radiograph is shown below.
After hospital admission, which one of the following would be the most appropriate next step
in the management of this condition?
A) Intravenous antibiotics
B) Urgent chemotherapy and radiation
C) Urgent chemotherapy and plasmapheresis
D) Urgent echocardiography
E) Urgent bronchoscopy - ANSWER-B
QUESTION: A nonverbal 22-year-old male with intellectual disability is brought to your office by
the staff of the group home where he lives. They report that the patient has been functioning at
his baseline until this morning when he was found to have loud breathing. No other history is
available at the time of this visit.
On examination he has a temperature of 37.3°C (99.1°F), a blood pressure of 124/82 mm Hg, a
pulse rate of 100 beats/min, and a respiratory rate of 16/min. The patient appears to be in mild
distress and a high-pitched whistling, crowing sound on inspiration is heard as you walk in the
room.
Which one of the following would be the most appropriate next step for this patient?
A) Oral antibiotics
2
,Page 3 of 321
B) Oral corticosteroids
C) Nebulized albuterol
D) Nebulized epinephrine
E) Urgent evaluation in the emergency department - ANSWER-E
QUESTION: A 16-year-old female presents with chronic acne on her nose, forehead, and chin
consisting of a few comedones and a few mildly inflamed papules and pustules. She says it is
minimally improved after 12 weeks of daily adapalene 0.1% gel. There are no scars or cysts. The
patient would like to try to achieve better control.
Which one of the following would you recommend at this time?
A) Continue adapalene 0.1% gel for 12 more weeks
B) Add clindamycin (Cleocin T) 1% gel for up to 12 weeks
C) Add clindamycin 1% gel for maintenance
D) Stop adapalene 0.1% gel and start clindamycin 1% gel for maintenance
E) Stop adapalene 0.1% gel and start erythromycin 2% gel for maintenance - ANSWER-B
QUESTION: A 32-year-old female who is one of your longtime patients calls you because of a
24-hour history of painful urination with urinary frequency and urgency. She is otherwise
healthy and does not have any fever, chills, back pain, or vaginal discharge. She uses an oral
contraceptive pill and states that her last menstrual period was normal and occurred last week.
Which one of the following would be most appropriate at this time?
A) Empiric antibiotic treatment
B) A urinalysis
C) A urine culture
D) Plain abdominal radiographs
E) Pelvic ultrasonography - ANSWER-A
3
, Page 4 of 321
QUESTION: A 70-year-old female develops thrombocytopenia during a prolonged
hospitalization for endocarditis. Her current medications include scheduled unfractionated
heparin injections for venous thromboembolism prophylaxis. You suspect heparin-induced
thrombocytopenia (HIT).
Assuming that her thrombocytopenia is caused by HIT, which one of the following is the most
likely complication?
A) Anaphylaxis
B) Disseminated intravascular coagulation
C) Hemorrhage
D) Sepsis
E) Thrombosis - ANSWER-E
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.
all the labs are normal. (Claire's notes, ily)
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 - ANSWER-C
4
