ABFM ITE 2025 EXAM Q&A | MOST FREQUENTLY
TESTED QUESTIONS WITH EXPLANATIONS
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 follow- ing 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: ANSWER: A
No additional testing for stroke risk Carotid artery disease attects extra cranial carotid arteries and is
caused by atherosclerosis.
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) which a low prevalence in the general adult population.
Stroke is a leading cause of disability and death in the US, but asymptomatic carotid artery stenosis
causes a relatively small portion of strokes. Auscultation of the carotid arteries for bruits has been found
to have poor accuracy for detecting carotid stenosis and is not a reasonable screening approach.
Appropriate modalities for detecting carotid stenosis include carotid duplex ultrasonography, magnetic
resonance angiography, and computed tomography, but there are not recommended for screening
asymptomatic patients.
2. A 28 year old female presents for evaluation of nasal congestion,
sneezing, watery eyes, and postnasal drip. This has been an
intermittent issue for her every spring and she would like to
manage it more effectively.
Which one of the following treatments has been shown to be the most
effective
,and best tolerated first-line therapy for this patient's condition?
A. A leukotriene receptor agonist
B. Intranasal corticosteroid monotherapy
C. Intranasal corticosteroids plus an oral antihistamine
D. Inhaled corticosteroids
E. Annual triamcinolone injections:
ANSWER: B Intranasal corticosteroid monotherapy
This patient has seasonal allergic rhinitis. A joint guideline statement from the American Academy of
Allergy, Asthma, and Immunology/American College of Allergy, Asthma and Immunology Joint Task
Force on Practice Parameters recommends that mono therapy with intranasal corticosteroids would be
prescribed initially in patients equal to or more than 12 years of age rather than combined treatment
with oral antihistamines because data has not shown an additional benefit to adding the antihistamine.
Higher patient adherence and tolerance and fewer side ettects were seen with the mono therapy
regimen. High quality evidence indicates that intranasal corticosteroids were more ettective than leukotriene
receptor antagonists. Inhaled corticosteroids and triamcinolone injections are not appropriate first line
options for the treatment of seasonal allergic rhinitis
3. A 68 year old female presents with a 2 month history of watery
diarrhea. She has not had any blood or pus in her stools, and the
stools are not oily. She has not had any history of fever, chills, or
weight loss, and has not traveled recently. She smokes one pack of
cigarettes per day. Her medications include ibuprofen, sertraline and
pantoprazole. A CBC, metabolic panel, CRP, IgA anti tissue
transglutaminase level, total IgA level, and stool guaiac test are
all normal.
Which one of the following tests would be mostly likely to yield a
diagnosis?
A. C difficile toxin
B. Colonoscopy
C. Fecal calprotectin
D. A stool culture
, E. Stool exam for ova and parasites:
ANSWER: B Colonoscopy
TESTED QUESTIONS WITH EXPLANATIONS
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 follow- ing 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: ANSWER: A
No additional testing for stroke risk Carotid artery disease attects extra cranial carotid arteries and is
caused by atherosclerosis.
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) which a low prevalence in the general adult population.
Stroke is a leading cause of disability and death in the US, but asymptomatic carotid artery stenosis
causes a relatively small portion of strokes. Auscultation of the carotid arteries for bruits has been found
to have poor accuracy for detecting carotid stenosis and is not a reasonable screening approach.
Appropriate modalities for detecting carotid stenosis include carotid duplex ultrasonography, magnetic
resonance angiography, and computed tomography, but there are not recommended for screening
asymptomatic patients.
2. A 28 year old female presents for evaluation of nasal congestion,
sneezing, watery eyes, and postnasal drip. This has been an
intermittent issue for her every spring and she would like to
manage it more effectively.
Which one of the following treatments has been shown to be the most
effective
,and best tolerated first-line therapy for this patient's condition?
A. A leukotriene receptor agonist
B. Intranasal corticosteroid monotherapy
C. Intranasal corticosteroids plus an oral antihistamine
D. Inhaled corticosteroids
E. Annual triamcinolone injections:
ANSWER: B Intranasal corticosteroid monotherapy
This patient has seasonal allergic rhinitis. A joint guideline statement from the American Academy of
Allergy, Asthma, and Immunology/American College of Allergy, Asthma and Immunology Joint Task
Force on Practice Parameters recommends that mono therapy with intranasal corticosteroids would be
prescribed initially in patients equal to or more than 12 years of age rather than combined treatment
with oral antihistamines because data has not shown an additional benefit to adding the antihistamine.
Higher patient adherence and tolerance and fewer side ettects were seen with the mono therapy
regimen. High quality evidence indicates that intranasal corticosteroids were more ettective than leukotriene
receptor antagonists. Inhaled corticosteroids and triamcinolone injections are not appropriate first line
options for the treatment of seasonal allergic rhinitis
3. A 68 year old female presents with a 2 month history of watery
diarrhea. She has not had any blood or pus in her stools, and the
stools are not oily. She has not had any history of fever, chills, or
weight loss, and has not traveled recently. She smokes one pack of
cigarettes per day. Her medications include ibuprofen, sertraline and
pantoprazole. A CBC, metabolic panel, CRP, IgA anti tissue
transglutaminase level, total IgA level, and stool guaiac test are
all normal.
Which one of the following tests would be mostly likely to yield a
diagnosis?
A. C difficile toxin
B. Colonoscopy
C. Fecal calprotectin
D. A stool culture
, E. Stool exam for ova and parasites:
ANSWER: B Colonoscopy
