ABFM IN-TRAINING EXAMINATION ACTUAL PRACTICE QUESTIONS WITH CORRECT ANSWERS AND EXPLANATION FROM PAGE 70 American Board of Family Medicine

ABFM IN-TRAINING EXAMINATION ACTUAL PRACTICE
QUESTIONS WITH CORRECT ANSWERS AND EXPLANATION
FROM PAGE 70 American Board of Family Medicine




1. A 67-year-old male sees you for a Medicare annual wellness visit. He tells you that his best
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friend had a stroke and he asks about his risk for stroke. He has no history of stroke,TIA,or
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neurologic symptoms.Hehasafamily historyof cardiovasculardisease in his father, who had
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a myocardial infarction at age 65 and died from a thrombotic stroke at age 71. The patient
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exercises regularly and has a BMI of 27 kg/m2. His only current medical condition is
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hyperlipidemia, and his cholesterol level is at goal on rosuvastatin (Crestor), 10 mg daily.
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He also takes aspirin, 81 mg daily. His blood pressure is 125/78 mm Hg.
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BasedonU.S.PreventiveServicesTaskForceguidelines,whichoneofthefollowing would
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be most appropriate at this time?
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A) Noadditionaltestingfor strokerisk
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B) Auscultationfor carotidbruits w
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C) Carotid duplex ultrasonography w1 w1




D) Magnetic resonance angiography w1 w1




E) CT angiography of the carotid arteries
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2. A 28-year-old female presents for evaluation of nasal congestion, sneezing, watery eyes, and
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postnasal drip. This has been an intermittent issue for her every spring and she would like
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to manage it more effectively.
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Which one of the following treatments has been shown to be the most effective and best tolerated
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first-line therapy for this patient’s condition?
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A) A leukotriene receptor antagonist
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B) Intranasal corticosteroid monotherapy w 1 w 1




C) Intranasal corticosteroids plus an oral antihistamine w 1 w 1 w 1 w 1 w 1




D) Inhaled corticosteroids w 1




E) Annualtriamcinolone injections w1 w1




3. A 68-year-old female presents with a 2-month history of watery diarrhea. She has not had any
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blood or pus in her stools, and the stools are not oily. She has not had any history of fever,
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chills, or weight loss, and has not traveled recently. She smokes one pack of cigarettes per
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day. Her medications include ibuprofen, sertraline (Zoloft), and pantoprazole (Protonix). A
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CBC, metabolic panel, C-reactive protein level, IgA anti-tissue
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,transglutaminaselevel,totalIgAlevel,and stool guaiac test are all normal. Which
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oneofthefollowingtestswouldbemostlikelytoyieldadiagnosis?
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A) Clostridioides(Clostridium) difficile toxin
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B) Colonoscopy
C) Fecal calprotectin
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D) A stool culture
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E) Stoolexaminationfor ova andparasites
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,4. A 23-year-old male with opioid use disorder requests buprenorphine therapy. He is still
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actively using immediate-release oxycodone (Roxicodone) and he took a dose 2 hours
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ago.
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This patient should begin buprenorphine induction
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A) now
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C) 8–12hours afterhislastopioiduse w
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D) 24hoursafter hislastopioiduse
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E) 1weekafterhislastopioiduse
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5. A 45-year-old left hand–dominant female presents to your office with a lump on her hand. She
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first noticed the lump 2 weeks ago and thinks it has gotten bigger. She does not recall any injury.
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She has not had any numbness, weakness, or tingling. She has minimal discomfort when
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she presses on the lump, and it does not affect her activity. On examination her left wrist is
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neuro volar wrist mass shown below.vascularly
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Whichoneof thefollowingmanagementoptions wouldyourecommend?
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A) Re-examinationifshedevelopsnumbness,weakness,orincreasedpain w
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B) Immobilizationof the wristfor6weeksandthenre-examination 1
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C) Aspirationof thelesion w
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D) Aspirationandinjectionof the lesion with acorticosteroid w1 w1 w1 w1 w1 w1 w1 w1




E) Referralforexcisionofthelesion 1
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6. A 57-year-old female with diabetes mellitus comes to your office for a routine follow-up. Her
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current medications include metformin (Glucophage), 1000 mg twice daily. She tells you that
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she does not exercise regularly and finds it difficult to follow a healthy diet. A hemoglobin
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A1c today is 7.5%. She does not want to add medications at this time, but she does want to get
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her hemoglobin A1c below 7%, which is the goal that was previously discussed.
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Whichoneof thefollowingwouldbethemosteffectivewaytoimproveglucosecontrolfor this
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patient?
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A) Discussthecomponents of ahealthydiabetic diet andencourageherto followit more w1 w1 w1 w1 w1 w
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closely
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B) Discuss the importance of regular exercise and encourage her to exercise 30–45 w1 w1 w1 w1 w1 w1 w1 w1 w1 w1 w1




minutes daily
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C) Recommendthatshe checkherglucose level1–3timesdailytohelp determine what 1
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adjustments need to be made
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D) Starther on an additional medication w1 w1 w1 w1 w1




E) Refer her to a diabetes educator for medical nutrition therapy w1 w1 w1 w1 w1 w1 w1 w1 w1




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