NEWEST FAMILY MEDICINE
CERTIFICATION EXAM FOR THE
AMERICAN BOARD OF FAMILY MEDICINE
(ABMS) | Q&A WITH RATIONALES
1. A 55-year-old patient with hypertension and type 2
diabetes has a blood pressure of 145/88 mmHg in the
office. According to the 2017 ACC/AHA guidelines,
this patient’s blood pressure is classified as:
A) Normal
B) Elevated
C) Stage 1 hypertension
D) Stage 2 hypertension
Correct answer: C
Rationale: Stage 1 hypertension is SBP 130-139 or
DBP 80-89 mmHg. This patient has diabetes and
hypertension, target BP <130/80.
2. A 65-year-old patient with hypertension is
prescribed a thiazide diuretic. Which laboratory
abnormality should be monitored?
A) Hypernatremia
,B) Hypokalemia, hyponatremia, hypercalcemia,
hyperglycemia, hyperuricemia
C) Hyperkalemia
D) Hypocalcemia
Correct answer: B
Rationale: Thiazide diuretics cause hypokalemia,
hyponatremia, hypercalcemia, hyperglycemia, and
hyperuricemia.
3. A 60-year-old patient with type 2 diabetes has a
hemoglobin A1c of 8.5% on metformin 2000 mg/day.
The next best add-on medication with cardiovascular
benefit is:
A) Sulfonylurea
B) DPP-4 inhibitor
C) SGLT2 inhibitor (empagliflozin, canagliflozin) or
GLP-1 receptor agonist (liraglutide, semaglutide) –
proven cardiovascular and renal benefit
D) Insulin glargine
Correct answer: C
Rationale: SGLT2 inhibitors and GLP-1 agonists
reduce major adverse cardiovascular events and
progression of chronic kidney disease in patients
with established CVD or high risk.
,4. The most common cause of chronic cough in a
nonsmoking adult with normal chest X-ray and no
ACE inhibitor use is:
A) Asthma (cough-variant), gastroesophageal reflux
disease (GERD), or upper airway cough syndrome
(postnasal drip)
B) Lung cancer
C) Bronchiectasis
D) Heart failure
Correct answer: A
Rationale: UACS (postnasal drip), asthma (cough-
variant), and GERD account for >90% of chronic
cough cases.
5. A 70-year-old patient presents with acute onset of
right lower quadrant pain, fever, and leukocytosis.
CT scan shows diverticulitis with a 2 cm abscess. The
most appropriate management is:
A) Oral antibiotics and discharge
B) Percutaneous drainage plus IV antibiotics
C) Emergent surgery
D) Observation
, Correct answer: B
Rationale: Hinchey II diverticulitis (abscess >3 cm)
requires percutaneous drainage; 2 cm may be
treated with antibiotics alone, but many guidelines
drain >3-4 cm.
6. A 45-year-old patient has a screening colonoscopy.
Three tubular adenomas are found (one 8 mm, two 5
mm). The appropriate surveillance interval is:
A) 10 years
B) 5 years
C) 3 years (high-risk: ≥3 adenomas, adenoma ≥1 cm,
villous histology, or high-grade dysplasia)
D) 1 year
Correct answer: C
Rationale: High-risk adenoma features (≥3 adenomas,
size ≥1 cm, villous histology, high-grade dysplasia)
require 3-year surveillance.
7. A 55-year-old patient with osteoarthritis of the
knee has moderate pain despite acetaminophen and
topical NSAIDs. The next step is:
A) Oral NSAIDs (ibuprofen, naproxen) – short-term
B) Opioids
CERTIFICATION EXAM FOR THE
AMERICAN BOARD OF FAMILY MEDICINE
(ABMS) | Q&A WITH RATIONALES
1. A 55-year-old patient with hypertension and type 2
diabetes has a blood pressure of 145/88 mmHg in the
office. According to the 2017 ACC/AHA guidelines,
this patient’s blood pressure is classified as:
A) Normal
B) Elevated
C) Stage 1 hypertension
D) Stage 2 hypertension
Correct answer: C
Rationale: Stage 1 hypertension is SBP 130-139 or
DBP 80-89 mmHg. This patient has diabetes and
hypertension, target BP <130/80.
2. A 65-year-old patient with hypertension is
prescribed a thiazide diuretic. Which laboratory
abnormality should be monitored?
A) Hypernatremia
,B) Hypokalemia, hyponatremia, hypercalcemia,
hyperglycemia, hyperuricemia
C) Hyperkalemia
D) Hypocalcemia
Correct answer: B
Rationale: Thiazide diuretics cause hypokalemia,
hyponatremia, hypercalcemia, hyperglycemia, and
hyperuricemia.
3. A 60-year-old patient with type 2 diabetes has a
hemoglobin A1c of 8.5% on metformin 2000 mg/day.
The next best add-on medication with cardiovascular
benefit is:
A) Sulfonylurea
B) DPP-4 inhibitor
C) SGLT2 inhibitor (empagliflozin, canagliflozin) or
GLP-1 receptor agonist (liraglutide, semaglutide) –
proven cardiovascular and renal benefit
D) Insulin glargine
Correct answer: C
Rationale: SGLT2 inhibitors and GLP-1 agonists
reduce major adverse cardiovascular events and
progression of chronic kidney disease in patients
with established CVD or high risk.
,4. The most common cause of chronic cough in a
nonsmoking adult with normal chest X-ray and no
ACE inhibitor use is:
A) Asthma (cough-variant), gastroesophageal reflux
disease (GERD), or upper airway cough syndrome
(postnasal drip)
B) Lung cancer
C) Bronchiectasis
D) Heart failure
Correct answer: A
Rationale: UACS (postnasal drip), asthma (cough-
variant), and GERD account for >90% of chronic
cough cases.
5. A 70-year-old patient presents with acute onset of
right lower quadrant pain, fever, and leukocytosis.
CT scan shows diverticulitis with a 2 cm abscess. The
most appropriate management is:
A) Oral antibiotics and discharge
B) Percutaneous drainage plus IV antibiotics
C) Emergent surgery
D) Observation
, Correct answer: B
Rationale: Hinchey II diverticulitis (abscess >3 cm)
requires percutaneous drainage; 2 cm may be
treated with antibiotics alone, but many guidelines
drain >3-4 cm.
6. A 45-year-old patient has a screening colonoscopy.
Three tubular adenomas are found (one 8 mm, two 5
mm). The appropriate surveillance interval is:
A) 10 years
B) 5 years
C) 3 years (high-risk: ≥3 adenomas, adenoma ≥1 cm,
villous histology, or high-grade dysplasia)
D) 1 year
Correct answer: C
Rationale: High-risk adenoma features (≥3 adenomas,
size ≥1 cm, villous histology, high-grade dysplasia)
require 3-year surveillance.
7. A 55-year-old patient with osteoarthritis of the
knee has moderate pain despite acetaminophen and
topical NSAIDs. The next step is:
A) Oral NSAIDs (ibuprofen, naproxen) – short-term
B) Opioids
