ABFM KSA Pain Management Actual Exam
Questions and Answers with Rationales 2026/2027
| Family Medicine Board Exam | Pass Guarantee
ABFM Pain Management KSA Practice Exam
SECTION 1: PHARMACOLOGIC THERAPY
1. Which of the following is considered first-line pharmacologic therapy for
chronic neuropathic pain?
• A) Acetaminophen
• B) Duloxetine
• C) Morphine
• D) Ibuprofen
Answer: B
Rationale: Duloxetine, a serotonin-norepinephrine reuptake inhibitor (SNRI), is
effective for chronic neuropathic pain and is preferred due to its efficacy and safety
profile .
2. Which opioid receptor is primarily responsible for analgesia?
• A) Delta
• B) Kappa
• C) Sigma
, • D) Mu
Answer: D
Rationale: The mu-opioid receptor mediates most of the analgesic effects of
opioids .
3. Which of the following adjuvant medications is effective for neuropathic pain?
• A) Gabapentin
• B) Acetaminophen
• C) Prednisone
• D) Naproxen
Answer: A
Rationale: Gabapentin binds to calcium channels in the central nervous system,
reducing neuropathic pain. It is a first-line agent for neuropathic pain conditions .
4. A patient develops constipation while on chronic opioid therapy. The most
appropriate management is:
• A) Reduce opioid dose
• B) Prescribe a stimulant laxative
• C) Add another opioid
• D) Discontinue opioids
Answer: B
Rationale: Opioid-induced constipation is best managed with a stimulant laxative
or stool softener without reducing necessary analgesia .
5. Which non-opioid analgesic is associated with hepatotoxicity in overdose?
• A) Ibuprofen
• B) Naproxen
• C) Acetaminophen
, • D) Aspirin
Answer: C
Rationale: Acetaminophen overdose can cause severe liver injury due to
metabolite accumulation. The maximum daily dose should not exceed 4 grams in
healthy adults .
6. Which of the following is recommended for preventing NSAID-induced
gastrointestinal injury?
• A) High-dose NSAIDs
• B) Proton pump inhibitors (PPIs)
• C) H2 blockers
• D) Corticosteroids
Answer: B
Rationale: PPIs reduce gastric acid and protect against NSAID-induced ulcers in
high-risk patients .
7. Which of the following is a serious adverse effect of long-term NSAID use?
• A) Hypertension
• B) Gastrointestinal bleeding
• C) Hypoglycemia
• D) Renal stones
Answer: B
Rationale: Chronic NSAID use can cause gastric ulcers and gastrointestinal
bleeding due to COX-1 inhibition .
8. Which of the following is a risk factor for opioid misuse?
• A) Age >65
• B) History of substance use disorder
• C) Hypertension
Questions and Answers with Rationales 2026/2027
| Family Medicine Board Exam | Pass Guarantee
ABFM Pain Management KSA Practice Exam
SECTION 1: PHARMACOLOGIC THERAPY
1. Which of the following is considered first-line pharmacologic therapy for
chronic neuropathic pain?
• A) Acetaminophen
• B) Duloxetine
• C) Morphine
• D) Ibuprofen
Answer: B
Rationale: Duloxetine, a serotonin-norepinephrine reuptake inhibitor (SNRI), is
effective for chronic neuropathic pain and is preferred due to its efficacy and safety
profile .
2. Which opioid receptor is primarily responsible for analgesia?
• A) Delta
• B) Kappa
• C) Sigma
, • D) Mu
Answer: D
Rationale: The mu-opioid receptor mediates most of the analgesic effects of
opioids .
3. Which of the following adjuvant medications is effective for neuropathic pain?
• A) Gabapentin
• B) Acetaminophen
• C) Prednisone
• D) Naproxen
Answer: A
Rationale: Gabapentin binds to calcium channels in the central nervous system,
reducing neuropathic pain. It is a first-line agent for neuropathic pain conditions .
4. A patient develops constipation while on chronic opioid therapy. The most
appropriate management is:
• A) Reduce opioid dose
• B) Prescribe a stimulant laxative
• C) Add another opioid
• D) Discontinue opioids
Answer: B
Rationale: Opioid-induced constipation is best managed with a stimulant laxative
or stool softener without reducing necessary analgesia .
5. Which non-opioid analgesic is associated with hepatotoxicity in overdose?
• A) Ibuprofen
• B) Naproxen
• C) Acetaminophen
, • D) Aspirin
Answer: C
Rationale: Acetaminophen overdose can cause severe liver injury due to
metabolite accumulation. The maximum daily dose should not exceed 4 grams in
healthy adults .
6. Which of the following is recommended for preventing NSAID-induced
gastrointestinal injury?
• A) High-dose NSAIDs
• B) Proton pump inhibitors (PPIs)
• C) H2 blockers
• D) Corticosteroids
Answer: B
Rationale: PPIs reduce gastric acid and protect against NSAID-induced ulcers in
high-risk patients .
7. Which of the following is a serious adverse effect of long-term NSAID use?
• A) Hypertension
• B) Gastrointestinal bleeding
• C) Hypoglycemia
• D) Renal stones
Answer: B
Rationale: Chronic NSAID use can cause gastric ulcers and gastrointestinal
bleeding due to COX-1 inhibition .
8. Which of the following is a risk factor for opioid misuse?
• A) Age >65
• B) History of substance use disorder
• C) Hypertension
