ABFM ITE EXAM V1 LATEST REAL QUESTIONS AND
CORRECT DETAILED ANSWERS (CORRECT VERIFIED
ANSWERS) A NEW UPDATED VERSION
1. A 56-year-old man with hypertension and type 2 diabetes has a urine albumin-
to-creatinine ratio of 240 mg/g and an estimated GFR of 68 mL/min/1.73 m².
Which medication is most appropriate to reduce the risk of kidney disease
progression?
A. Amlodipine
B. Lisinopril
C. Hydrochlorothiazide
D. Propranolol
Correct answer: B. Lisinopril
Rationale: ACE inhibitors reduce intraglomerular pressure and albuminuria,
slowing the progression of chronic kidney disease in patients with diabetes and
hypertension.
2. A 24-year-old woman presents with dysuria and urinary frequency without
fever, flank pain, or vaginal symptoms. Urinalysis shows pyuria. Which is an
appropriate first-line treatment for uncomplicated acute cystitis?
,A. Ciprofloxacin for 14 days
B. Amoxicillin for 3 days
C. Nitrofurantoin for 5 days
D. Intravenous ceftriaxone for 7 days
Correct answer: C. Nitrofurantoin for 5 days
Rationale: Nitrofurantoin for five days is a recommended first-line option for
uncomplicated cystitis in appropriate patients with adequate renal function. It is
not suitable for suspected pyelonephritis.
3. A 62-year-old man presents with crushing substernal chest pain, diaphoresis,
and ST-segment elevation in leads II, III, and aVF. What is the most appropriate
next step?
A. Arrange immediate reperfusion therapy
B. Schedule an outpatient stress test
C. Prescribe an oral proton pump inhibitor
D. Observe for 24 hours before deciding
Correct answer: A. Arrange immediate reperfusion therapy
Rationale: ST-segment elevation myocardial infarction requires urgent
reperfusion, preferably primary percutaneous coronary intervention when it can
be delivered promptly.
,4. A 45-year-old woman has fatigue, cold intolerance, constipation, and weight
gain. Her TSH is elevated and free T4 is low. What is the most likely diagnosis?
A. Graves disease
B. Central hypothyroidism
C. Subclinical hypothyroidism
D. Primary hypothyroidism
Correct answer: D. Primary hypothyroidism
Rationale: Primary thyroid gland failure produces low free T4 with compensatory
elevation of TSH.
5. A 3-year-old child presents with a barking cough, hoarseness, and inspiratory
stridor at rest. Which treatment is most appropriate?
A. Oral amoxicillin alone
B. Dexamethasone and nebulized epinephrine
C. Inhaled corticosteroid alone
D. Cough suppressant and discharge
Correct answer: B. Dexamethasone and nebulized epinephrine
Rationale: Stridor at rest indicates moderate to severe croup. Dexamethasone
reduces airway inflammation, while nebulized epinephrine provides rapid,
temporary improvement in airway obstruction.
, 6. A 29-year-old woman at 10 weeks of pregnancy has persistent vomiting, dry
mucous membranes, and ketonuria. Which is the most appropriate initial
management?
A. Begin a weight-loss diet
B. Restrict oral fluids
C. Administer intravenous fluids and correct electrolyte abnormalities
D. Prescribe an NSAID and reassess in one week
Correct answer: C. Administer intravenous fluids and correct electrolyte
abnormalities
Rationale: Severe vomiting with dehydration requires fluid resuscitation and
electrolyte assessment. Thiamine should be given before dextrose when
prolonged poor intake raises concern for deficiency.
7. A 67-year-old man with COPD has increased dyspnea, increased sputum
volume, and purulent sputum. His oxygen saturation is 89% on room air. Which
oxygen saturation target is generally appropriate during initial treatment?
A. 88–92%
B. 95–100%
C. 80–84%
D. Exactly 100%
CORRECT DETAILED ANSWERS (CORRECT VERIFIED
ANSWERS) A NEW UPDATED VERSION
1. A 56-year-old man with hypertension and type 2 diabetes has a urine albumin-
to-creatinine ratio of 240 mg/g and an estimated GFR of 68 mL/min/1.73 m².
Which medication is most appropriate to reduce the risk of kidney disease
progression?
A. Amlodipine
B. Lisinopril
C. Hydrochlorothiazide
D. Propranolol
Correct answer: B. Lisinopril
Rationale: ACE inhibitors reduce intraglomerular pressure and albuminuria,
slowing the progression of chronic kidney disease in patients with diabetes and
hypertension.
2. A 24-year-old woman presents with dysuria and urinary frequency without
fever, flank pain, or vaginal symptoms. Urinalysis shows pyuria. Which is an
appropriate first-line treatment for uncomplicated acute cystitis?
,A. Ciprofloxacin for 14 days
B. Amoxicillin for 3 days
C. Nitrofurantoin for 5 days
D. Intravenous ceftriaxone for 7 days
Correct answer: C. Nitrofurantoin for 5 days
Rationale: Nitrofurantoin for five days is a recommended first-line option for
uncomplicated cystitis in appropriate patients with adequate renal function. It is
not suitable for suspected pyelonephritis.
3. A 62-year-old man presents with crushing substernal chest pain, diaphoresis,
and ST-segment elevation in leads II, III, and aVF. What is the most appropriate
next step?
A. Arrange immediate reperfusion therapy
B. Schedule an outpatient stress test
C. Prescribe an oral proton pump inhibitor
D. Observe for 24 hours before deciding
Correct answer: A. Arrange immediate reperfusion therapy
Rationale: ST-segment elevation myocardial infarction requires urgent
reperfusion, preferably primary percutaneous coronary intervention when it can
be delivered promptly.
,4. A 45-year-old woman has fatigue, cold intolerance, constipation, and weight
gain. Her TSH is elevated and free T4 is low. What is the most likely diagnosis?
A. Graves disease
B. Central hypothyroidism
C. Subclinical hypothyroidism
D. Primary hypothyroidism
Correct answer: D. Primary hypothyroidism
Rationale: Primary thyroid gland failure produces low free T4 with compensatory
elevation of TSH.
5. A 3-year-old child presents with a barking cough, hoarseness, and inspiratory
stridor at rest. Which treatment is most appropriate?
A. Oral amoxicillin alone
B. Dexamethasone and nebulized epinephrine
C. Inhaled corticosteroid alone
D. Cough suppressant and discharge
Correct answer: B. Dexamethasone and nebulized epinephrine
Rationale: Stridor at rest indicates moderate to severe croup. Dexamethasone
reduces airway inflammation, while nebulized epinephrine provides rapid,
temporary improvement in airway obstruction.
, 6. A 29-year-old woman at 10 weeks of pregnancy has persistent vomiting, dry
mucous membranes, and ketonuria. Which is the most appropriate initial
management?
A. Begin a weight-loss diet
B. Restrict oral fluids
C. Administer intravenous fluids and correct electrolyte abnormalities
D. Prescribe an NSAID and reassess in one week
Correct answer: C. Administer intravenous fluids and correct electrolyte
abnormalities
Rationale: Severe vomiting with dehydration requires fluid resuscitation and
electrolyte assessment. Thiamine should be given before dextrose when
prolonged poor intake raises concern for deficiency.
7. A 67-year-old man with COPD has increased dyspnea, increased sputum
volume, and purulent sputum. His oxygen saturation is 89% on room air. Which
oxygen saturation target is generally appropriate during initial treatment?
A. 88–92%
B. 95–100%
C. 80–84%
D. Exactly 100%
