ABFM ITE ALL 2027 SETS ANSWERS AND
QUESTIONS SET A+
✔✔Toe fractures - ✔✔Nondisplaced lesser toe fractures are generally treated with a
rigid-sole shoe or buddy taping to an adjacent toe. The great toe has an increased role
in weight bearing and balance, and fractures of this toe have a greater potential
morbidity. Because of this, these fractures are generally treated with a short leg walking
cast with a toe plate.
Those with intra-articular involvement should get a repeat radiograph after 1 week.
Intra-articular fractures with 25% or greater involvement of the joint surface should be
referred for surgical treatment.
✔✔Patients on Hydrochlorothiazide may develop hyponatraemia whilst on? -
✔✔Carbamazepine due to SIADH
✔✔Age-related macular degeneration (Amsler grid testing notes
distorted grid lines) - ✔✔Smoking is a modifiable risk factor and smokers should be
counselled to quit.
Not reversible but treatment can delay progression or stabilize the changes.
✔✔Nutrition route for severe acute pancreatitis - ✔✔Continuous enteral feeding (esp. in
first 48h)
- Help prevent infectious complications, such as infected necrosis, by maintaining the
gut mucosal barrier and preventing translocation of bacteria that may seed pancreatic
necrosis.
✔✔Bedbug bites - ✔✔Having multiple exposures on skin often not covered by clothing
would be typical of household fleas or bedbugs.
,✔✔Chiggers - ✔✔A chigger is the larval form of a mite, which is an eight-legged
arthropod. The larval form has only six legs, and tends to crawl into spaces near
constricted clothing and cause welts from their bite along the neckline, waistline, sock
line, or more rarely on the genitals.
✔✔Chronic kidney disease is defined as an estimated glomerular filtration rate (eGFR)
<60 mL/min/1.73 m2 for at least 3 months, or other evidence of kidney damage such as
albuminuria, abnormal imaging, or an abnormal biopsy. - ✔✔Current guidelines
recommend referral to a nephrologist if a patient's renal disease is either of unknown
aetiology, is deteriorating quickly (eGFR decreasing by >5 mL/min/1.73 m2 per year), or
is severe.
Thresholds used to define severe chronic kidney disease include an eGFR <30
mL/min/1.73 m2, a urine albumin to creatinine ratio >300 g/mg, persistent acidosis or
potassium imbalance, non-iron deficiency anaemia with a haemoglobin level <10 g/dL,
and evidence of secondary hyperparathyroidism.
✔✔Stage I sarcoidosis - ✔✔An asymptomatic patient with stage I sarcoidosis (bilateral
hilar lymphadenopathy on chest radiography) without suspected infection or malignancy
does not require an invasive tissue biopsy because the results would not affect the
recommended management, which is monitoring only. Treatment is not indicated
because spontaneous resolution of stage I sarcoidosis is common.
✔✔Annual failure rate of a combined oral contraceptive pill
is - ✔✔9%
✔✔Cognitive assessment test for delirium - ✔✔Confusion Assessment Method (CAM)
✔✔Benefits of Directly Observed Therapy - ✔✔Decrease both the acquisition and
transmission of drug-resistant tuberculosis and to increase treatment success in HIV-
positive patients.
- The use of DOT does not guarantee the ingestion of all doses of every medication, as
patients may miss appointments, may not actually swallow the pills, or may regurgitate
the medication, sometimes deliberately. Due to these limitations, the use of DOT does
not remove the need to monitor patients for signs of treatment failure.
✔✔Beyond short-term pain relief, local corticosteroid injection provides the best long-
term improvement for - ✔✔Trigger finger
✔✔The American Academy of Paediatrics recommends screening children 9-11yo for -
✔✔Dyslipidaemia
,✔✔If patient deemed at high risk of iron deficiency anaemia, universal screening should
be conducted at - ✔✔12 months of age and again at 15-30 months of age
✔✔At what age is HIV screening recommended in adolescents - ✔✔16-18 years of age
✔✔Cervical cancer screening in women 21-65yo - ✔✔The USPSTF recommends
screening for cervical cancer every 3 years with cervical cytology alone in women aged
21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening
every 3 years with cervical cytology alone, every 5 years with high-risk human
papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in
combination with cytology (cotesting).
✔✔Initial management of stable, regular, monomorphic
wide-complex tachycardia - ✔✔Adenosine
✔✔Screening for hepatitis C virus (HCV) with an anti-HCV antibody test is
recommended for all adults at high risk of infection, and one-time screening is
recommended in adults born between 1945 and 1965. - ✔✔If the anti-HCV antibody test
result is positive, current infection should be confirmed with a qualitative HCV RNA test.
✔✔Diagnosing ADHD in adults - ✔✔Requires symptoms that interfere with social,
academic, or occupational functioning and are present in more than one setting. DSM-5
states that a history of symptoms before age 12 is required for the diagnosis.
✔✔Calcium levels in Di George syndrome - ✔✔Low (hypocalcaemia)
✔✔GORD in infants - ✔✔Features of gastroesophageal reflux include a history of
recurrent pneumonia, a low growth curve, a family history of sudden infant death
syndrome, and normocytic anaemia.
✔✔Which treatments for cough has evidence of efficacy and safety when used for
children from 1 to 2 years of age? - ✔✔Honey
✔✔Acute chest syndrome in Sickle Cell Disease - ✔✔Atypical pathogens predominates
(Mycoplasma and Chlamydophila).
Viral infections are also common, especially in children with ACS.
Other possible pathogens include Staphylococcus aureus, Streptococcus pneumoniae,
and Haemophilus influenzae.
Therefore, the use of a third-generation cephalosporin along with azithromycin is the
recommended antibiotic coverage.
, Also include supportive care with supplemental oxygen, intravenous fluids, pain control,
and incentive spirometry.
✔✔Absorption of levothyroxine is impaired by several gastrointestinal conditions -
✔✔Includes atrophic gastritis, chronic PPI use, and Helicobacter pylori infection.
✔✔Acute uncomplicated cystitis antibiotic choice - ✔✔Bactrim/Co-trimoxazole,
Nitrofurantoin, Fosfomycin
- Increasing resistance to fluoroquinolones has been seen and they are therefore less
likely to be
successful. Because of the association with tendon rupture they are also not considered
first-line treatment.
✔✔One of your patients recently went into atrial fibrillation and you order an
echocardiogram. The diameter of which structures best predicts the likelihood that sinus
rhythm will be maintained after successful cardioversion? - ✔✔Left atrium
✔✔Non-displaced mid-clavicular fracture - ✔✔Treated with just a sling for 2-6 weeks. A
sling is more comfortable and less irritating than a figure-of-eight bandage.
Passive range of motion of the shoulder is indicated as soon as the pain allows.
Physical therapy may be started at 4 weeks after the injury.
✔✔Treating reflux in infants - ✔✔Implementing body position changes while awake (on
side or prone), lower volume feedings if they are overfed, thickening agents, and
antiregurgitant formula.
It is recommended to avoid the use of medication in infants that have regurgitation that
is effortless, painless, and not affecting growth. When the infant is not growing well or
appears to be in pain, it would be appropriate to initiate pharmacotherapy with an acid
suppressing medication (4-week trial).
✔✔Justifiable breach of patient confidentiality - ✔✔1. Abuse of a vulnerable person
(child
or elderly)
2. A public health risk (communicable disease)
3. Substantial danger to the patient or others
✔✔Most appropriate maximum blood glucose goal in sepsis - ✔✔<180mg/dL
- Intensive management of glucose in critically ill adult
patients has been shown to increase mortality.
QUESTIONS SET A+
✔✔Toe fractures - ✔✔Nondisplaced lesser toe fractures are generally treated with a
rigid-sole shoe or buddy taping to an adjacent toe. The great toe has an increased role
in weight bearing and balance, and fractures of this toe have a greater potential
morbidity. Because of this, these fractures are generally treated with a short leg walking
cast with a toe plate.
Those with intra-articular involvement should get a repeat radiograph after 1 week.
Intra-articular fractures with 25% or greater involvement of the joint surface should be
referred for surgical treatment.
✔✔Patients on Hydrochlorothiazide may develop hyponatraemia whilst on? -
✔✔Carbamazepine due to SIADH
✔✔Age-related macular degeneration (Amsler grid testing notes
distorted grid lines) - ✔✔Smoking is a modifiable risk factor and smokers should be
counselled to quit.
Not reversible but treatment can delay progression or stabilize the changes.
✔✔Nutrition route for severe acute pancreatitis - ✔✔Continuous enteral feeding (esp. in
first 48h)
- Help prevent infectious complications, such as infected necrosis, by maintaining the
gut mucosal barrier and preventing translocation of bacteria that may seed pancreatic
necrosis.
✔✔Bedbug bites - ✔✔Having multiple exposures on skin often not covered by clothing
would be typical of household fleas or bedbugs.
,✔✔Chiggers - ✔✔A chigger is the larval form of a mite, which is an eight-legged
arthropod. The larval form has only six legs, and tends to crawl into spaces near
constricted clothing and cause welts from their bite along the neckline, waistline, sock
line, or more rarely on the genitals.
✔✔Chronic kidney disease is defined as an estimated glomerular filtration rate (eGFR)
<60 mL/min/1.73 m2 for at least 3 months, or other evidence of kidney damage such as
albuminuria, abnormal imaging, or an abnormal biopsy. - ✔✔Current guidelines
recommend referral to a nephrologist if a patient's renal disease is either of unknown
aetiology, is deteriorating quickly (eGFR decreasing by >5 mL/min/1.73 m2 per year), or
is severe.
Thresholds used to define severe chronic kidney disease include an eGFR <30
mL/min/1.73 m2, a urine albumin to creatinine ratio >300 g/mg, persistent acidosis or
potassium imbalance, non-iron deficiency anaemia with a haemoglobin level <10 g/dL,
and evidence of secondary hyperparathyroidism.
✔✔Stage I sarcoidosis - ✔✔An asymptomatic patient with stage I sarcoidosis (bilateral
hilar lymphadenopathy on chest radiography) without suspected infection or malignancy
does not require an invasive tissue biopsy because the results would not affect the
recommended management, which is monitoring only. Treatment is not indicated
because spontaneous resolution of stage I sarcoidosis is common.
✔✔Annual failure rate of a combined oral contraceptive pill
is - ✔✔9%
✔✔Cognitive assessment test for delirium - ✔✔Confusion Assessment Method (CAM)
✔✔Benefits of Directly Observed Therapy - ✔✔Decrease both the acquisition and
transmission of drug-resistant tuberculosis and to increase treatment success in HIV-
positive patients.
- The use of DOT does not guarantee the ingestion of all doses of every medication, as
patients may miss appointments, may not actually swallow the pills, or may regurgitate
the medication, sometimes deliberately. Due to these limitations, the use of DOT does
not remove the need to monitor patients for signs of treatment failure.
✔✔Beyond short-term pain relief, local corticosteroid injection provides the best long-
term improvement for - ✔✔Trigger finger
✔✔The American Academy of Paediatrics recommends screening children 9-11yo for -
✔✔Dyslipidaemia
,✔✔If patient deemed at high risk of iron deficiency anaemia, universal screening should
be conducted at - ✔✔12 months of age and again at 15-30 months of age
✔✔At what age is HIV screening recommended in adolescents - ✔✔16-18 years of age
✔✔Cervical cancer screening in women 21-65yo - ✔✔The USPSTF recommends
screening for cervical cancer every 3 years with cervical cytology alone in women aged
21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening
every 3 years with cervical cytology alone, every 5 years with high-risk human
papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in
combination with cytology (cotesting).
✔✔Initial management of stable, regular, monomorphic
wide-complex tachycardia - ✔✔Adenosine
✔✔Screening for hepatitis C virus (HCV) with an anti-HCV antibody test is
recommended for all adults at high risk of infection, and one-time screening is
recommended in adults born between 1945 and 1965. - ✔✔If the anti-HCV antibody test
result is positive, current infection should be confirmed with a qualitative HCV RNA test.
✔✔Diagnosing ADHD in adults - ✔✔Requires symptoms that interfere with social,
academic, or occupational functioning and are present in more than one setting. DSM-5
states that a history of symptoms before age 12 is required for the diagnosis.
✔✔Calcium levels in Di George syndrome - ✔✔Low (hypocalcaemia)
✔✔GORD in infants - ✔✔Features of gastroesophageal reflux include a history of
recurrent pneumonia, a low growth curve, a family history of sudden infant death
syndrome, and normocytic anaemia.
✔✔Which treatments for cough has evidence of efficacy and safety when used for
children from 1 to 2 years of age? - ✔✔Honey
✔✔Acute chest syndrome in Sickle Cell Disease - ✔✔Atypical pathogens predominates
(Mycoplasma and Chlamydophila).
Viral infections are also common, especially in children with ACS.
Other possible pathogens include Staphylococcus aureus, Streptococcus pneumoniae,
and Haemophilus influenzae.
Therefore, the use of a third-generation cephalosporin along with azithromycin is the
recommended antibiotic coverage.
, Also include supportive care with supplemental oxygen, intravenous fluids, pain control,
and incentive spirometry.
✔✔Absorption of levothyroxine is impaired by several gastrointestinal conditions -
✔✔Includes atrophic gastritis, chronic PPI use, and Helicobacter pylori infection.
✔✔Acute uncomplicated cystitis antibiotic choice - ✔✔Bactrim/Co-trimoxazole,
Nitrofurantoin, Fosfomycin
- Increasing resistance to fluoroquinolones has been seen and they are therefore less
likely to be
successful. Because of the association with tendon rupture they are also not considered
first-line treatment.
✔✔One of your patients recently went into atrial fibrillation and you order an
echocardiogram. The diameter of which structures best predicts the likelihood that sinus
rhythm will be maintained after successful cardioversion? - ✔✔Left atrium
✔✔Non-displaced mid-clavicular fracture - ✔✔Treated with just a sling for 2-6 weeks. A
sling is more comfortable and less irritating than a figure-of-eight bandage.
Passive range of motion of the shoulder is indicated as soon as the pain allows.
Physical therapy may be started at 4 weeks after the injury.
✔✔Treating reflux in infants - ✔✔Implementing body position changes while awake (on
side or prone), lower volume feedings if they are overfed, thickening agents, and
antiregurgitant formula.
It is recommended to avoid the use of medication in infants that have regurgitation that
is effortless, painless, and not affecting growth. When the infant is not growing well or
appears to be in pain, it would be appropriate to initiate pharmacotherapy with an acid
suppressing medication (4-week trial).
✔✔Justifiable breach of patient confidentiality - ✔✔1. Abuse of a vulnerable person
(child
or elderly)
2. A public health risk (communicable disease)
3. Substantial danger to the patient or others
✔✔Most appropriate maximum blood glucose goal in sepsis - ✔✔<180mg/dL
- Intensive management of glucose in critically ill adult
patients has been shown to increase mortality.
