2025 ABFM QUESTIONS AND
CORRECT ANSWERS
A healthy 83-year-old female presents for an annual Medicare visit. Her blood pressure is 165/95 mm Hg on initial evaluation
today and 160/92 mm Hg on repeat measurement. She has no health complaints. The JNC 8 panel recommends which one of the
following as the goal blood pressure for this patient?
A) Less than 135/85 mm Hg
B) Less than 140/90 mm Hg
C) Less than 150/90 mm Hg
D) Less than 160/90 mmhg
E) Less than 160/100 mm Hg
ANSWER: C
In general, all patients with hypertension, regardless of age, benefit from treatment. Patients 80 years of age who are healthy
and functionally independent should be treated according to current recommendations for patients >65 years old. Available
guidelines recommend a target blood pressure of less than 150/90 mm Hg unless the patient is frail or has numerous
comorbidities. In these cases, the target blood pressure should be determined on a case-by-case basis (SOR B).
Actually:
The 2020 ISH guideline recommends an optimal target blood pressure of < 130/80 mm Hg for patients < 65 years of age, and a
target of < 140/90 mm Hg for patients ≥ 65 years of age if tolerated. The 2014 JNC 8 guideline recommends a general treatment
threshold and goal of < 140/90 mm Hg.
Blood Pressure goals according to AHA:
Hypertension and Coronary Artery Disease (CAD)
BP should be lowered if ≥140/90 mm Hg and treated to a target <130/80 mm Hg (<140/80 in elderly
patients).
Hypertension and Previous Stroke
BP should be lowered if ≥140/90 mm Hg and treated to a target <130/80 mm Hg (<140/80 in elderly
patients).
Hypertension and Heart Failure (HF)
BP should be lowered if ≥140/90 mm Hg and treated to a target <130/80 mm Hg but >120/70 mm Hg.
Hypertension and Chronic Kidney Disease (CKD)
BP should be lowered if ≥140/90 mm Hg and treated to a target <130/80 mm Hg (<140/80 in elderly
patients).
Hypertension and Chronic Obstructive Pulmonary Disease (COPD)
BP should be lowered if ≥140/90 mm Hg and treated to a target <130/80 mm Hg (<140/80 in elderly
patients).
, Diabetes
BP should be lowered if ≥140/90 mm Hg and treated to a target <130/80 mm Hg (<140/80 in elderly
patients).
A 55-year-old male is found to be in cardiac arrest. When the emts arrive, they note ventricular fibrillation on the monitor.
The patient began an antibiotic 3 days ago for a mild case of community-acquired pneumonia. Which one of the following
antibiotics is most commonly associated with this scenario?
A) Doxycycline
B) Amoxicillin
C) Cefuroxime (Ceftin)
D) Azithromycin (Zithromax)
ANSWER: D
The likelihood of azithromycin inducing an arrhythmia is small, but given its widespread use this possibility must be kept in
mind. The arrhythmia results from prolongation of the QT interval and is also more common in patients with a prior
cardiac history. The other three antibiotics have not been implicated in an increase in cardiac deaths.
. Supraventricular tachycardia may require treatment both acutely and over the long term. Which one of the following
medications is useful for both of these purposes?
A) Adenosine (Adenocard)
B) Amiodarone (Cordarone)
C) Esmolol (Brevibloc)
D) Procainamide
E) Verapamil (Calan, Verelan)
ANSWER: E
Calcium channel blockers such as verapamil or diltiazem can be used acutely to decrease heart rate and terminate
supraventricular tachycardia (SVT) and chronically to prevent SVT recurrence. Adenosine, amiodarone, esmolol,
and procainamide all can be used to treat SVT acutely, but they are not suitable for long-term therapy.
. A 64-year-old male with nonvalvular atrial fibrillation has received anticoagulation therapy with warfarin (Coumadin) for the
past 3 years but it has been difficult to maintain his INR in the therapeutic range. He has been afraid to transition to one of the
newer oral anticoagulants because of the lack of a reversal medication should he develop life-threatening bleeding. Which one
of the following now has a reversal agent?
A) Apixaban (Eliquis)
B) Dabigatran (Pradaxa)
C) Edoxaban (Savaysa)
D) Rivaroxaban (Xarelto)
ANSWER: B
Idarucizumab has been approved for the urgent reversal of the anticoagulant effect of dabigatran. The dose is two
consecutive 2.5-g infusions and the cost is $3500. Apixaban, edoxaban, and rivaroxaban—all factor Xa inhibitors—are not
affected by this medication and they do not currently have a reversal agent.
A 32-year-old male presents with an acute onset of chest pain. His EKG is shown on the page at right. Which one of the
following agents would be most appropriate to relieve this patient’s chest pain?
, A) Hydrocodone (Lortab)
B) Indomethacin (Indocin)
C) Nitroglycerin
D) Omeprazole (Prilosec)
E) Oxygen
ANSWER: B
Acute pericarditis is a common cause of chest pain in young adults. It presents with an acute to subacute onset of severe
retrosternal and left precordial chest pain that is characteristically alleviated by leaning forward or sitting up and worsened
with lying supine. Viral and idiopathic acute pericarditis are most common and occur at all ages, but are more common in
young adults. The pain, which is inflammatory in origin, typically responds to an NSAID such as indomethacin. High-dose aspirin
(2–4 g/day) has also been shown to be effective. Patients with pain resulting from myocardial ischemia would benefit from
nitroglycerin, while those with gastroesophageal reflux disease would benefit from a proton pump inhibitor such as
omeprazole. Hydrocodone can be used to relieve moderate to severe pain but lacks anti-inflammatory properties (SOR C).
42. A 56-year-old male is hospitalized for workup of a syncopal episode. He has a history of type 2 diabetes mellitus and
dyslipidemia, which are well controlled with metformin (Glucophage) and atorvastatin (Lipitor). In addition, he takes a daily
low- dose aspirin and a multivitamin. The cardiac examination reveals occasional skipped beats but the remainder of the
physical examination is normal. While hospitalized he has another syncopal episode. His clinical examination and EKG post
syncope are normal. A telemetry rhythm tracing captured during this syncopal episode is shown on the page at right. Which
one of the following is the most likely cause of his syncope?
A) Atrial fibrillation
B) Mobitz type I second degree atrioventricular block
C) Mobitz type II second degree atrioventricular block
D) Third degree atrioventricular block
ANSWER: D Third degree atrioventricular (AV) block is characterized by the inability of atrial impulses to reach the ventricles.
Hence, the EKG will show both atrial activity (P waves) and ventricular “escape” activity (QRS complexes) with no correlation
CORRECT ANSWERS
A healthy 83-year-old female presents for an annual Medicare visit. Her blood pressure is 165/95 mm Hg on initial evaluation
today and 160/92 mm Hg on repeat measurement. She has no health complaints. The JNC 8 panel recommends which one of the
following as the goal blood pressure for this patient?
A) Less than 135/85 mm Hg
B) Less than 140/90 mm Hg
C) Less than 150/90 mm Hg
D) Less than 160/90 mmhg
E) Less than 160/100 mm Hg
ANSWER: C
In general, all patients with hypertension, regardless of age, benefit from treatment. Patients 80 years of age who are healthy
and functionally independent should be treated according to current recommendations for patients >65 years old. Available
guidelines recommend a target blood pressure of less than 150/90 mm Hg unless the patient is frail or has numerous
comorbidities. In these cases, the target blood pressure should be determined on a case-by-case basis (SOR B).
Actually:
The 2020 ISH guideline recommends an optimal target blood pressure of < 130/80 mm Hg for patients < 65 years of age, and a
target of < 140/90 mm Hg for patients ≥ 65 years of age if tolerated. The 2014 JNC 8 guideline recommends a general treatment
threshold and goal of < 140/90 mm Hg.
Blood Pressure goals according to AHA:
Hypertension and Coronary Artery Disease (CAD)
BP should be lowered if ≥140/90 mm Hg and treated to a target <130/80 mm Hg (<140/80 in elderly
patients).
Hypertension and Previous Stroke
BP should be lowered if ≥140/90 mm Hg and treated to a target <130/80 mm Hg (<140/80 in elderly
patients).
Hypertension and Heart Failure (HF)
BP should be lowered if ≥140/90 mm Hg and treated to a target <130/80 mm Hg but >120/70 mm Hg.
Hypertension and Chronic Kidney Disease (CKD)
BP should be lowered if ≥140/90 mm Hg and treated to a target <130/80 mm Hg (<140/80 in elderly
patients).
Hypertension and Chronic Obstructive Pulmonary Disease (COPD)
BP should be lowered if ≥140/90 mm Hg and treated to a target <130/80 mm Hg (<140/80 in elderly
patients).
, Diabetes
BP should be lowered if ≥140/90 mm Hg and treated to a target <130/80 mm Hg (<140/80 in elderly
patients).
A 55-year-old male is found to be in cardiac arrest. When the emts arrive, they note ventricular fibrillation on the monitor.
The patient began an antibiotic 3 days ago for a mild case of community-acquired pneumonia. Which one of the following
antibiotics is most commonly associated with this scenario?
A) Doxycycline
B) Amoxicillin
C) Cefuroxime (Ceftin)
D) Azithromycin (Zithromax)
ANSWER: D
The likelihood of azithromycin inducing an arrhythmia is small, but given its widespread use this possibility must be kept in
mind. The arrhythmia results from prolongation of the QT interval and is also more common in patients with a prior
cardiac history. The other three antibiotics have not been implicated in an increase in cardiac deaths.
. Supraventricular tachycardia may require treatment both acutely and over the long term. Which one of the following
medications is useful for both of these purposes?
A) Adenosine (Adenocard)
B) Amiodarone (Cordarone)
C) Esmolol (Brevibloc)
D) Procainamide
E) Verapamil (Calan, Verelan)
ANSWER: E
Calcium channel blockers such as verapamil or diltiazem can be used acutely to decrease heart rate and terminate
supraventricular tachycardia (SVT) and chronically to prevent SVT recurrence. Adenosine, amiodarone, esmolol,
and procainamide all can be used to treat SVT acutely, but they are not suitable for long-term therapy.
. A 64-year-old male with nonvalvular atrial fibrillation has received anticoagulation therapy with warfarin (Coumadin) for the
past 3 years but it has been difficult to maintain his INR in the therapeutic range. He has been afraid to transition to one of the
newer oral anticoagulants because of the lack of a reversal medication should he develop life-threatening bleeding. Which one
of the following now has a reversal agent?
A) Apixaban (Eliquis)
B) Dabigatran (Pradaxa)
C) Edoxaban (Savaysa)
D) Rivaroxaban (Xarelto)
ANSWER: B
Idarucizumab has been approved for the urgent reversal of the anticoagulant effect of dabigatran. The dose is two
consecutive 2.5-g infusions and the cost is $3500. Apixaban, edoxaban, and rivaroxaban—all factor Xa inhibitors—are not
affected by this medication and they do not currently have a reversal agent.
A 32-year-old male presents with an acute onset of chest pain. His EKG is shown on the page at right. Which one of the
following agents would be most appropriate to relieve this patient’s chest pain?
, A) Hydrocodone (Lortab)
B) Indomethacin (Indocin)
C) Nitroglycerin
D) Omeprazole (Prilosec)
E) Oxygen
ANSWER: B
Acute pericarditis is a common cause of chest pain in young adults. It presents with an acute to subacute onset of severe
retrosternal and left precordial chest pain that is characteristically alleviated by leaning forward or sitting up and worsened
with lying supine. Viral and idiopathic acute pericarditis are most common and occur at all ages, but are more common in
young adults. The pain, which is inflammatory in origin, typically responds to an NSAID such as indomethacin. High-dose aspirin
(2–4 g/day) has also been shown to be effective. Patients with pain resulting from myocardial ischemia would benefit from
nitroglycerin, while those with gastroesophageal reflux disease would benefit from a proton pump inhibitor such as
omeprazole. Hydrocodone can be used to relieve moderate to severe pain but lacks anti-inflammatory properties (SOR C).
42. A 56-year-old male is hospitalized for workup of a syncopal episode. He has a history of type 2 diabetes mellitus and
dyslipidemia, which are well controlled with metformin (Glucophage) and atorvastatin (Lipitor). In addition, he takes a daily
low- dose aspirin and a multivitamin. The cardiac examination reveals occasional skipped beats but the remainder of the
physical examination is normal. While hospitalized he has another syncopal episode. His clinical examination and EKG post
syncope are normal. A telemetry rhythm tracing captured during this syncopal episode is shown on the page at right. Which
one of the following is the most likely cause of his syncope?
A) Atrial fibrillation
B) Mobitz type I second degree atrioventricular block
C) Mobitz type II second degree atrioventricular block
D) Third degree atrioventricular block
ANSWER: D Third degree atrioventricular (AV) block is characterized by the inability of atrial impulses to reach the ventricles.
Hence, the EKG will show both atrial activity (P waves) and ventricular “escape” activity (QRS complexes) with no correlation
