ABFM ITE (American Board of Family
Medicine In-Training Examination)
Complete Questions with Correct
Answers Download!!
"Sundowning" behaviour that includes nighttime disorientation and some mild agitation is characteristic
of - Answer -Delirium
2-day-old infant with flesh-colored papules over an erythematous base located on the face and trunk,
containing eosinophils. - Answer -Erythema toxicum neonatorum, which usually resolves in the
first week or two of life. Unknown cause.
A 30-year-old male is treated with topical medications for his papulopustular rosacea with only partial
improvement. The preferred antibiotic is - Answer -Doxycycline
A 35-year-old white male who has had T1DM for 20 years begins having episodes of hypoglycaemia. His
glucose levels had previously been stable and well controlled, and he has not recently changed his diet
or insulin regimen. What is the most likely cause of the hypoglycaemia? - Answer -Diabetic
nephropathy
A 48-year-old female is treated appropriately for MRSA bacteremia. An echocardiogram is negative for
endocarditis. There are no indwelling devices such as prosthetic heart valves or vascular grafts. -
Answer -Repeat blood cultures 2-4 days after the initial set and as needed thereafter.
A 5-year-old male is brought to your office after passing an intestinal worm. He lives on a farm with
cattle, pigs, and dogs. He has never travelled very far from home. He does not have any respiratory
symptoms or diarrhoea, but has experienced some abdominal bloating. - Answer -Ascaris
lumbricoides is a large roundworm that typically infects the ileum. Symptoms are variable but large
infections can lead to intestinal obstruction.
Pinworms are much smaller and typically present with anal pruritus.
Tapeworms can be large, but are flat and segmental in appearance, and are typically found in the stool as
segments called proglottids.
Hookworms are also round, but are typically 6-12 mm in length. They are a significant cause of anemia in
children globally.
,A copper T 380A intrauterine device (ParaGard) would be preferred over a levonorgestrel-releasing
intrauterine device (Mirena) in a patient with a history of - Answer -Severe cirrhosis or liver cancer
- Known association between oral contraceptive use and the growth of hepatocellular adenoma, and this
risk is thought to extend to other types of hormonal contraceptives
Breast cancer
A doctor and patient are discussing using a particular drug to treat the patient's uncontrolled
hypertension. Which potential effects of the drug is a patient-oriented outcome that should be discussed
during shared decision-making? - Answer -A decrease in all-cause mortality
A pathogen for community-acquired pneumonia in a patient who has
a history of a hotel stay or cruise ship travel within the past couple of weeks. - Answer -Legionella
A risk factor for uncomplicated cystitis - Answer -Frequent sexual intercourse
A U.S. hospital or birthing center seeking to be certified as "Baby Friendly" by the Baby-Friendly Hospital
Initiative - Answer -Providing no other food or fluids to breastfeeding infants without a medical
indication
A U.S. Preventive Services Task Force "D" recommendation indicates - Answer -Moderate or high
certainty that the service has no net benefit or that the harms outweigh the benefits
A useful adjunct to Buprenorphine in the treatment of opioid use disorder to help increase the rates of
abstinence and decrease stress-related opioid cravings - Answer -Clonidine (0.1-0.3 mg every 6-8
hours)
Absolute contraindication to fibrinolytic therapy - Answer -A history of an ischemic stroke within
the past 3 months unless the stroke is diagnosed within 4½ hours.
Absorption of levothyroxine is impaired by several gastrointestinal conditions - Answer -Includes
atrophic gastritis, chronic PPI use, and Helicobacter pylori infection.
According to DSM-5, what is the severity of anorexia nervosa based on? - Answer -BMI
According to state child abuse mandatory reporter laws, what is the
threshold that must be met for physicians to make a report to local child protective services or law
enforcement? - Answer -If they suspect that a child has experienced abuse or neglect
According to the Centers for Disease Control and Prevention, which vaccination would be recommended
for grandparents to protect their infant grandchild from illness? - Answer -Tdap
According to U.S. Preventive Services Task Force guidelines, patients who are overweight or obese
should be screened for diabetes mellitus beginning at age - Answer -40
,ACEi and ARB as anti-hypertensives with renoprotective effects - Answer -May tolerate a rise of
<30% in serum creatinine after initiation. Rises in serum creatinine of >30% from baseline increase the
risk of renal failure, adverse cardiac outcomes, and death.
ACEi causes angioedema due to increased bradykinin - Answer -Rx: Icatibant is a bradykinin
receptor type 2 blocker
Acne appearing at which one of the following ages should prompt detailed endocrine laboratory testing
for possible underlying systemic disease? - Answer -Mid-childhood i.e. 5yo
Activity order in a patient is admitted to the hospital for acute DVT of the lower extremity and started on
anticoagulation therapy - Answer -Early ambulation as tolerated
Acute bronchitis in adults is usually viral - Answer -Indications for a chest radiograph include:
bloody sputum, rusty-colored sputum, or dyspnoea; a pulse rate >100 beats/min; a respiratory rate
>24/min; or a temperature >37.8°C (100.0°F). A chest radiograph is also indicated if there are abnormal
findings on a chest examination such as fremitus, egophony, or focal consolidation.
Acute Charcot neuroarthropathy, an inflammatory condition that occurs in obese patients with
peripheral neuropathy and ultimately leads to foot deformities (the classic rocker-bottom foot) and
resultant ulcerations and infections. - Answer -Radiography is an appropriate initial imaging
modality but the results are often interpreted as normal early in the disease process. MRI is the modality
of choice for a definitive diagnosis and may demonstrate periarticular bone marrow oedema, adjacent
soft-tissue oedema, joint effusion, and microtrabecular or stress fractures.
Rx: immobilization with total contact casting
Acute chest syndrome in Sickle Cell Disease - Answer -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.
, Acute laryngitis most often has a viral etiology - Answer -Symptomatic treatment is therefore most
appropriate
- PPIs such as omeprazole can be of benefit in treating chronic laryngitis caused by acid reflux
Acute MI management - Answer -Dual antiplatelet therapy and an anticoagulant (THROMBINS2)
Unless more than a 2-hour delay in percutaneous coronary intervention is expected, fibrinolytics should
not be administered.
Acute migraine not responding to NSAIDs - Answer -Metoclopramide is an effective treatment for
migraine beyond its antiemetic benefit and IV administration may be helpful for the patient unable to
tolerate oral medications.
Triptan medications would be another evidence-based choice for abortive therapy of migraine.
Acute parotitis, which is commonly caused by dehydration and can be diagnosed from the history and
examination - Answer -Empiric treatment with beta-lactams.
Administration of sialagogues such as lemon drops may be helpful, as well as parotid gland massage.
Acute salpingitis - Answer -Mucopurulent cervical discharge, tenderness with cervical motion, a
normal-size uterus, and left adnexal fullness.
- Acute, adnexal fullness = Gonorrhoea
IV Abx usually consists of a beta-lactam antibiotic (cefoxitin or ceftriaxone) plus doxycycline, or
gentamicin and clindamycin.
Ceftriaxone, 250 mg intramuscularly, is appropriate for
uncomplicated gonococcal infection.
Acute uncomplicated cystitis antibiotic choice - Answer -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.
Medicine In-Training Examination)
Complete Questions with Correct
Answers Download!!
"Sundowning" behaviour that includes nighttime disorientation and some mild agitation is characteristic
of - Answer -Delirium
2-day-old infant with flesh-colored papules over an erythematous base located on the face and trunk,
containing eosinophils. - Answer -Erythema toxicum neonatorum, which usually resolves in the
first week or two of life. Unknown cause.
A 30-year-old male is treated with topical medications for his papulopustular rosacea with only partial
improvement. The preferred antibiotic is - Answer -Doxycycline
A 35-year-old white male who has had T1DM for 20 years begins having episodes of hypoglycaemia. His
glucose levels had previously been stable and well controlled, and he has not recently changed his diet
or insulin regimen. What is the most likely cause of the hypoglycaemia? - Answer -Diabetic
nephropathy
A 48-year-old female is treated appropriately for MRSA bacteremia. An echocardiogram is negative for
endocarditis. There are no indwelling devices such as prosthetic heart valves or vascular grafts. -
Answer -Repeat blood cultures 2-4 days after the initial set and as needed thereafter.
A 5-year-old male is brought to your office after passing an intestinal worm. He lives on a farm with
cattle, pigs, and dogs. He has never travelled very far from home. He does not have any respiratory
symptoms or diarrhoea, but has experienced some abdominal bloating. - Answer -Ascaris
lumbricoides is a large roundworm that typically infects the ileum. Symptoms are variable but large
infections can lead to intestinal obstruction.
Pinworms are much smaller and typically present with anal pruritus.
Tapeworms can be large, but are flat and segmental in appearance, and are typically found in the stool as
segments called proglottids.
Hookworms are also round, but are typically 6-12 mm in length. They are a significant cause of anemia in
children globally.
,A copper T 380A intrauterine device (ParaGard) would be preferred over a levonorgestrel-releasing
intrauterine device (Mirena) in a patient with a history of - Answer -Severe cirrhosis or liver cancer
- Known association between oral contraceptive use and the growth of hepatocellular adenoma, and this
risk is thought to extend to other types of hormonal contraceptives
Breast cancer
A doctor and patient are discussing using a particular drug to treat the patient's uncontrolled
hypertension. Which potential effects of the drug is a patient-oriented outcome that should be discussed
during shared decision-making? - Answer -A decrease in all-cause mortality
A pathogen for community-acquired pneumonia in a patient who has
a history of a hotel stay or cruise ship travel within the past couple of weeks. - Answer -Legionella
A risk factor for uncomplicated cystitis - Answer -Frequent sexual intercourse
A U.S. hospital or birthing center seeking to be certified as "Baby Friendly" by the Baby-Friendly Hospital
Initiative - Answer -Providing no other food or fluids to breastfeeding infants without a medical
indication
A U.S. Preventive Services Task Force "D" recommendation indicates - Answer -Moderate or high
certainty that the service has no net benefit or that the harms outweigh the benefits
A useful adjunct to Buprenorphine in the treatment of opioid use disorder to help increase the rates of
abstinence and decrease stress-related opioid cravings - Answer -Clonidine (0.1-0.3 mg every 6-8
hours)
Absolute contraindication to fibrinolytic therapy - Answer -A history of an ischemic stroke within
the past 3 months unless the stroke is diagnosed within 4½ hours.
Absorption of levothyroxine is impaired by several gastrointestinal conditions - Answer -Includes
atrophic gastritis, chronic PPI use, and Helicobacter pylori infection.
According to DSM-5, what is the severity of anorexia nervosa based on? - Answer -BMI
According to state child abuse mandatory reporter laws, what is the
threshold that must be met for physicians to make a report to local child protective services or law
enforcement? - Answer -If they suspect that a child has experienced abuse or neglect
According to the Centers for Disease Control and Prevention, which vaccination would be recommended
for grandparents to protect their infant grandchild from illness? - Answer -Tdap
According to U.S. Preventive Services Task Force guidelines, patients who are overweight or obese
should be screened for diabetes mellitus beginning at age - Answer -40
,ACEi and ARB as anti-hypertensives with renoprotective effects - Answer -May tolerate a rise of
<30% in serum creatinine after initiation. Rises in serum creatinine of >30% from baseline increase the
risk of renal failure, adverse cardiac outcomes, and death.
ACEi causes angioedema due to increased bradykinin - Answer -Rx: Icatibant is a bradykinin
receptor type 2 blocker
Acne appearing at which one of the following ages should prompt detailed endocrine laboratory testing
for possible underlying systemic disease? - Answer -Mid-childhood i.e. 5yo
Activity order in a patient is admitted to the hospital for acute DVT of the lower extremity and started on
anticoagulation therapy - Answer -Early ambulation as tolerated
Acute bronchitis in adults is usually viral - Answer -Indications for a chest radiograph include:
bloody sputum, rusty-colored sputum, or dyspnoea; a pulse rate >100 beats/min; a respiratory rate
>24/min; or a temperature >37.8°C (100.0°F). A chest radiograph is also indicated if there are abnormal
findings on a chest examination such as fremitus, egophony, or focal consolidation.
Acute Charcot neuroarthropathy, an inflammatory condition that occurs in obese patients with
peripheral neuropathy and ultimately leads to foot deformities (the classic rocker-bottom foot) and
resultant ulcerations and infections. - Answer -Radiography is an appropriate initial imaging
modality but the results are often interpreted as normal early in the disease process. MRI is the modality
of choice for a definitive diagnosis and may demonstrate periarticular bone marrow oedema, adjacent
soft-tissue oedema, joint effusion, and microtrabecular or stress fractures.
Rx: immobilization with total contact casting
Acute chest syndrome in Sickle Cell Disease - Answer -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.
, Acute laryngitis most often has a viral etiology - Answer -Symptomatic treatment is therefore most
appropriate
- PPIs such as omeprazole can be of benefit in treating chronic laryngitis caused by acid reflux
Acute MI management - Answer -Dual antiplatelet therapy and an anticoagulant (THROMBINS2)
Unless more than a 2-hour delay in percutaneous coronary intervention is expected, fibrinolytics should
not be administered.
Acute migraine not responding to NSAIDs - Answer -Metoclopramide is an effective treatment for
migraine beyond its antiemetic benefit and IV administration may be helpful for the patient unable to
tolerate oral medications.
Triptan medications would be another evidence-based choice for abortive therapy of migraine.
Acute parotitis, which is commonly caused by dehydration and can be diagnosed from the history and
examination - Answer -Empiric treatment with beta-lactams.
Administration of sialagogues such as lemon drops may be helpful, as well as parotid gland massage.
Acute salpingitis - Answer -Mucopurulent cervical discharge, tenderness with cervical motion, a
normal-size uterus, and left adnexal fullness.
- Acute, adnexal fullness = Gonorrhoea
IV Abx usually consists of a beta-lactam antibiotic (cefoxitin or ceftriaxone) plus doxycycline, or
gentamicin and clindamycin.
Ceftriaxone, 250 mg intramuscularly, is appropriate for
uncomplicated gonococcal infection.
Acute uncomplicated cystitis antibiotic choice - Answer -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.
