ABFM ITE
ABFM ITE EXAM ACTUAL EXAM 2025 | 2 DIFFERENT EXAMS |
MOST TESTED 450 QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES | ALREADY GRADED A+ | LATEST VERSIONS
Terms in this set (200)
,A 67-year old male sees you for a Medicare ANSWER: A
annual wellness visit. He tells you that his No additional testing for stroke risk Carotid artery disease affects extra cranial
best friend had a stroke and he asks about carotid arteries and is caused by atherosclerosis.
his risk for stroke. He has a family history of
cardiovascular disease in his father, who This patient is asymptomatic and has no history of an ischemic stroke, neurology
had a myocardial infarction at age 65 and symptoms referable to the carotid arteries such as amaurosis fugal, or TIA. He has
died from a thrombotic stroke at age 71. risk factors for cardiovascular disease (age, male sex, hyperlipidemia_, but the
The patient exercises regularly and has a USPSTF recommends against specific screening asymptomatic carotid artery
BMI of 27 kg/m2. His only current medical stenosis (D recommendation) which a low prevalence in the general adult
condition is hyperlipidemia, and his population. Stroke is a leading cause of disability and death in the US, but
cholesterol level is at goal on rosuvastatin asymptomatic carotid artery stenosis causes a relatively small portion of strokes.
(Crestor), 10 mg daily. He also takes aspirin, Auscultation of the carotid arteries for bruits has been found to have poor accuracy
81 mg daily. His blood pressure 125/78 for detecting carotid stenosis and is not a reasonable screening approach.
mmHg. Appropriate modalities for detecting carotid stenosis include carotid duplex
ultrasonography, magnetic resonance angiography, and computed tomography, but
Based on US Preventive Services Task there are not recommended for screening asymptomatic patients.
Force guidelines, which one of the
following would be most appropriate at
this time?
A. No additional testing for stroke risk
B. Auscultation for carotid bruits
C. Carotid duplex ultrasonography
D. Magnetic resonance angiography
E. CT angiography of the carotid arteries
A 28 year old female presents for ANSWER: B
evaluation of nasal congestion, sneezing, Intranasal corticosteroid monotherapy
watery eyes, and postnasal drip. This has
been an intermittent issue for her every This patient has seasonal allergic rhinitis. A joint guideline statement from the
spring and she would like to manage it American Academy of Allergy, Asthma, and Immunology/American College of
more effectively. Allergy, Asthma and Immunology Joint Task Force on Practice Parameters
recommends that mono therapy with intranasal corticosteroids would be prescribed
Which one of the following treatments has initially in patients equal to or more than 12 years of age rather than combined
been shown to be the most effective and treatment with oral antihistamines because data has not shown an additional benefit
best tolerated first-line therapy for this to adding the antihistamine. Higher patient adherence and tolerance and fewer side
patient's condition? effects were seen with the mono therapy regimen. High quality evidence indicates
A. A leukotriene receptor agonist that intranasal corticosteroids were more effective than leukotriene receptor
B. Intranasal corticosteroid monotherapy antagonists. Inhaled corticosteroids and triamcinolone injections are not appropriate
C. Intranasal corticosteroids plus an oral first line options for the treatment of seasonal allergic rhinitis
antihistamine
D. Inhaled corticosteroids
E. Annual triamcinolone injections
,A 68 year old female presents with a 2 ANSWER: B
month history of watery diarrhea. She has Colonoscopy
not had any blood or pus in her stools, and
the stools are not oily. She has not had any In patients with chronic nonbloody diarrhea, the differential diagnosis includes
history of fever, chills, or weight loss, and microscopic (lymphocytic or collagenous) colitis. The mucosa appears normal on
has not traveled recently. She smokes one colonoscopy but a biopsy will show lymphocytic infiltration of the epithelium. The
pack of cigarettes per day. Her medications etiology is unknown but there are several risk factors to consider, including older
include ibuprofen, sertraline and age, female sex, and smoking status. Drugs with a high level of evidence causing
pantoprazole. A CBC, metabolic panel, microscopic colitis include NSAIDs, PPIs, sertraline, acarbose, aspirin, and
CRP, IgA anti tissue transglutaminase level, ticlopidine. C. diff should be suspected in individuals who have taken antibiotics in
total IgA level, and stool guaiac test are all the past 3 months. Fecal calprotectin is elevated in inflammatory diarrhea such as
normal. Crohn's disease or ulcerative colitis. A stool culture would be indicated if there is a
suspicion of an infectious bacterial diarrhea such as Shigella or Salmonella, but these
Which one of the following tests would be bacteria tend to cause bloody diarrhea. Checking for a parasitic infection should be
mostly likely to yield a diagnosis? considered for patients with a history of recent travel or exposure to unpurified
A. C difficile toxin water.
B. Colonoscopy
C. Fecal calprotectin
D. A stool culture
E. Stool exam for ova and parasites
A 23 year old male with opioid use ANSWER: C
disorder requests buprenorphine therapy. 8-12 hours after his last opioid use
He is still actively using immediate release
oxycodone and he took a dose 2 hours Buprenorphine is a partial opioid agonist. In order to reduce the risk of precipitated
ago. withdrawal, buprenorphine induction should begin once the patient is exhibiting
signs of mild to moderate withdrawal, usually 8-12 hours after the last opioid use.
This patient should begin buprenorphine Waiting until a patient goes through a full withdrawal increases the chances that the
induction patient will revert back to using opioids.
A. Now
B. In 2 hours
C. 8-12 hours after his last opioid use
D. 24 hours after his last opioid use
E. 1 week after his last opioid use
A 45 year old left hand dominant female ANSWER: A. Re-examination if she develops numbness, weakness or increased pain
presents to your office with a lump on her
hand. She first noticed the lump 2 weeks This patient has a ganglion cyst, which is common and resolves spontaneously in
ago and thinks it has gotten bigger. She 50% of cases, and watchful waiting would be most appropriate at this time. Treatment
does not recall any injury. She has not had is indicated if the cyst is causing significant symptoms such as pain, numbness, or
any numbness, weakness, or tingling. She weakness, or for cosmetic symptoms. Aspiration of the lesion is the initial treatment,
has minimal discomfort when she presses although recurrence may occur in 85% of cases. Immobilizing the wrist with a splint
on the lump, and it does not affect her or brace is sometimes helpful in the short term if the patient is bothered by the
activity. On examination her left wrist is symptoms, but immobilization does not provide lasting relief and could cause
neurovascularly intact. muscle atrophy. Corticosteroid injections have not shown any benefit. Referral for
excision is appropriate if there has been no improvement. Patients should be advised
Which one of the following management that there is a 10%-15% recurrence rate even after excision.
options would you recommend?
A. Re-examination if she develops
numbness, weakness, or increased pain
B. Immobilization of the wrist for 6 weeks
and then re-examination
C. Aspiration of the lesion
D. Aspiration and injection of the lesion
with a corticosteroid
E. Referral for excision of the lesion
, A 57 year old female with diabetes mellitus ANSWER: E. Refer her to a diabetes educator for medical nutrition therapy
comes to your office for a routine follow
up. Her current medications include Counseling by a diabetic educator or a team of educators for medical nutrition
metformin 1000 mg twice daily. She tells therapy lowers HbA1c by 0.2-0.8 percentage points in patients with type 2 diabetes.
you that she does not exercise regularly While a healthy diabetic diet and regular exercise is important, simply reminding the
and finds it difficult to follow a healthy diet. patient of that fact is not likely to be as successful as comprehensive diabetic
HbA1c today is 7.5%. She does not want to education. According to the Society of General Internal Medicine in the Choosing
add medications at this time, but she does Wisely campaign, patients with type 2 diabetes who are not on insulin therapy should
want to het her HbA1c below 7%, which is not check their blood glucose level daily. An additional medication will likely
the goal that was previously discussed. decrease HbA1c, but this patient has expressed a desire to avoid additional
medication, is near goal, and is not currently managing her diabetes with adequate
Which one of the following would be the lifestyle changes, so it would be appropriate to respect her wishes and pursue
most effective way to improve glucose proven interventions that do not require medication.
control for this patient.
A. Discuss the components of a healthy
diabetic diet and encourage her to follow it
more closely.
B. Discuss the importance of regular
exercise and encourage her to exercise 30-
45 minutes daily.
C. Recommend that she check her glucose
level 1-3 times daily to help determine what
adjustments need to be made.
D. Start her on an additional medication
E. Refer her to a diabetes educator for
medical nutrition therapy.
During a newborn examination the patient's ANSWER: C. Introducing peanut containing food when solids are started
mother asks what she can do to decrease
the risk of food allergies in her newborn Food allergy affects 4-6% of children in the US. IgE-mediated food allergy is the best
son. She tells you that there is no family understood, and symptoms can range from rhinorrhea to anaphylaxis. The two most
history of atopic dermatitis or asthma but common allergens are cow's milk and peanuts. The onset of symptoms is usually
she has a cousin with a peanut allergy. The within 2 hours of exposure and they resolve within several hours. The National
remainder of the examination is Institute of Allergy and Infectious Diseases in 2017 recommended that healthy infants
unremarkable. without known food allergy or who have mild to moderate eczema may be
introduced to peanut-containing foods with other solid foods. If the parents are
You tell her that food allergy risk can be concerned about a reaction, introduction of peanut-containing foods may be done
reduced by in the physician's office. Infants with severe eczema, egg allergy, or both should
A. breastfeeding for at least 1 year undergo peanut-specific IgE or skin prick testing. While breastfeeding may decrease
B. Using soy based formula instead of atopic disease, there is insufficient evidence that it reduces the likelihood of food
cow's milk based formula allergy, and using a soy based formula will not prevent food allergy. If there is a dog
C. introducing peanut-containing food in the home there is less risk of allergy to eggs. Children who are exposed to farm
when solids are started animals or who attend day care are less likely to develop atopic disease.
D. Avoiding all house pets
E. Avoiding a day care setting
Which one of the following ANSWER: D. Losartan
antihypertensive medications is LEAST
likely to exacerbate erectile dysfunction? Angiotensin receptor blockers (ARBs) such as losartan are least likely to cause or
A. Clonidine (Catapres) exacerbate erectile dysfunction. ARBs may have a favorable effect on erectile
B. Doxazosin (Cardura) dysfunction by inhibiting vasoconstriction activity of angiotensin. Clonidine, alpha
C. Hydrochlorothiazine blockers, hydrochlorothiazide, and beta-blockers are more likely to negatively affect
D. Losartan (Cozaar) erectile function.
E. Metoprolol
ABFM ITE EXAM ACTUAL EXAM 2025 | 2 DIFFERENT EXAMS |
MOST TESTED 450 QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES | ALREADY GRADED A+ | LATEST VERSIONS
Terms in this set (200)
,A 67-year old male sees you for a Medicare ANSWER: A
annual wellness visit. He tells you that his No additional testing for stroke risk Carotid artery disease affects extra cranial
best friend had a stroke and he asks about carotid arteries and is caused by atherosclerosis.
his risk for stroke. He has a family history of
cardiovascular disease in his father, who This patient is asymptomatic and has no history of an ischemic stroke, neurology
had a myocardial infarction at age 65 and symptoms referable to the carotid arteries such as amaurosis fugal, or TIA. He has
died from a thrombotic stroke at age 71. risk factors for cardiovascular disease (age, male sex, hyperlipidemia_, but the
The patient exercises regularly and has a USPSTF recommends against specific screening asymptomatic carotid artery
BMI of 27 kg/m2. His only current medical stenosis (D recommendation) which a low prevalence in the general adult
condition is hyperlipidemia, and his population. Stroke is a leading cause of disability and death in the US, but
cholesterol level is at goal on rosuvastatin asymptomatic carotid artery stenosis causes a relatively small portion of strokes.
(Crestor), 10 mg daily. He also takes aspirin, Auscultation of the carotid arteries for bruits has been found to have poor accuracy
81 mg daily. His blood pressure 125/78 for detecting carotid stenosis and is not a reasonable screening approach.
mmHg. Appropriate modalities for detecting carotid stenosis include carotid duplex
ultrasonography, magnetic resonance angiography, and computed tomography, but
Based on US Preventive Services Task there are not recommended for screening asymptomatic patients.
Force guidelines, which one of the
following would be most appropriate at
this time?
A. No additional testing for stroke risk
B. Auscultation for carotid bruits
C. Carotid duplex ultrasonography
D. Magnetic resonance angiography
E. CT angiography of the carotid arteries
A 28 year old female presents for ANSWER: B
evaluation of nasal congestion, sneezing, Intranasal corticosteroid monotherapy
watery eyes, and postnasal drip. This has
been an intermittent issue for her every This patient has seasonal allergic rhinitis. A joint guideline statement from the
spring and she would like to manage it American Academy of Allergy, Asthma, and Immunology/American College of
more effectively. Allergy, Asthma and Immunology Joint Task Force on Practice Parameters
recommends that mono therapy with intranasal corticosteroids would be prescribed
Which one of the following treatments has initially in patients equal to or more than 12 years of age rather than combined
been shown to be the most effective and treatment with oral antihistamines because data has not shown an additional benefit
best tolerated first-line therapy for this to adding the antihistamine. Higher patient adherence and tolerance and fewer side
patient's condition? effects were seen with the mono therapy regimen. High quality evidence indicates
A. A leukotriene receptor agonist that intranasal corticosteroids were more effective than leukotriene receptor
B. Intranasal corticosteroid monotherapy antagonists. Inhaled corticosteroids and triamcinolone injections are not appropriate
C. Intranasal corticosteroids plus an oral first line options for the treatment of seasonal allergic rhinitis
antihistamine
D. Inhaled corticosteroids
E. Annual triamcinolone injections
,A 68 year old female presents with a 2 ANSWER: B
month history of watery diarrhea. She has Colonoscopy
not had any blood or pus in her stools, and
the stools are not oily. She has not had any In patients with chronic nonbloody diarrhea, the differential diagnosis includes
history of fever, chills, or weight loss, and microscopic (lymphocytic or collagenous) colitis. The mucosa appears normal on
has not traveled recently. She smokes one colonoscopy but a biopsy will show lymphocytic infiltration of the epithelium. The
pack of cigarettes per day. Her medications etiology is unknown but there are several risk factors to consider, including older
include ibuprofen, sertraline and age, female sex, and smoking status. Drugs with a high level of evidence causing
pantoprazole. A CBC, metabolic panel, microscopic colitis include NSAIDs, PPIs, sertraline, acarbose, aspirin, and
CRP, IgA anti tissue transglutaminase level, ticlopidine. C. diff should be suspected in individuals who have taken antibiotics in
total IgA level, and stool guaiac test are all the past 3 months. Fecal calprotectin is elevated in inflammatory diarrhea such as
normal. Crohn's disease or ulcerative colitis. A stool culture would be indicated if there is a
suspicion of an infectious bacterial diarrhea such as Shigella or Salmonella, but these
Which one of the following tests would be bacteria tend to cause bloody diarrhea. Checking for a parasitic infection should be
mostly likely to yield a diagnosis? considered for patients with a history of recent travel or exposure to unpurified
A. C difficile toxin water.
B. Colonoscopy
C. Fecal calprotectin
D. A stool culture
E. Stool exam for ova and parasites
A 23 year old male with opioid use ANSWER: C
disorder requests buprenorphine therapy. 8-12 hours after his last opioid use
He is still actively using immediate release
oxycodone and he took a dose 2 hours Buprenorphine is a partial opioid agonist. In order to reduce the risk of precipitated
ago. withdrawal, buprenorphine induction should begin once the patient is exhibiting
signs of mild to moderate withdrawal, usually 8-12 hours after the last opioid use.
This patient should begin buprenorphine Waiting until a patient goes through a full withdrawal increases the chances that the
induction patient will revert back to using opioids.
A. Now
B. In 2 hours
C. 8-12 hours after his last opioid use
D. 24 hours after his last opioid use
E. 1 week after his last opioid use
A 45 year old left hand dominant female ANSWER: A. Re-examination if she develops numbness, weakness or increased pain
presents to your office with a lump on her
hand. She first noticed the lump 2 weeks This patient has a ganglion cyst, which is common and resolves spontaneously in
ago and thinks it has gotten bigger. She 50% of cases, and watchful waiting would be most appropriate at this time. Treatment
does not recall any injury. She has not had is indicated if the cyst is causing significant symptoms such as pain, numbness, or
any numbness, weakness, or tingling. She weakness, or for cosmetic symptoms. Aspiration of the lesion is the initial treatment,
has minimal discomfort when she presses although recurrence may occur in 85% of cases. Immobilizing the wrist with a splint
on the lump, and it does not affect her or brace is sometimes helpful in the short term if the patient is bothered by the
activity. On examination her left wrist is symptoms, but immobilization does not provide lasting relief and could cause
neurovascularly intact. muscle atrophy. Corticosteroid injections have not shown any benefit. Referral for
excision is appropriate if there has been no improvement. Patients should be advised
Which one of the following management that there is a 10%-15% recurrence rate even after excision.
options would you recommend?
A. Re-examination if she develops
numbness, weakness, or increased pain
B. Immobilization of the wrist for 6 weeks
and then re-examination
C. Aspiration of the lesion
D. Aspiration and injection of the lesion
with a corticosteroid
E. Referral for excision of the lesion
, A 57 year old female with diabetes mellitus ANSWER: E. Refer her to a diabetes educator for medical nutrition therapy
comes to your office for a routine follow
up. Her current medications include Counseling by a diabetic educator or a team of educators for medical nutrition
metformin 1000 mg twice daily. She tells therapy lowers HbA1c by 0.2-0.8 percentage points in patients with type 2 diabetes.
you that she does not exercise regularly While a healthy diabetic diet and regular exercise is important, simply reminding the
and finds it difficult to follow a healthy diet. patient of that fact is not likely to be as successful as comprehensive diabetic
HbA1c today is 7.5%. She does not want to education. According to the Society of General Internal Medicine in the Choosing
add medications at this time, but she does Wisely campaign, patients with type 2 diabetes who are not on insulin therapy should
want to het her HbA1c below 7%, which is not check their blood glucose level daily. An additional medication will likely
the goal that was previously discussed. decrease HbA1c, but this patient has expressed a desire to avoid additional
medication, is near goal, and is not currently managing her diabetes with adequate
Which one of the following would be the lifestyle changes, so it would be appropriate to respect her wishes and pursue
most effective way to improve glucose proven interventions that do not require medication.
control for this patient.
A. Discuss the components of a healthy
diabetic diet and encourage her to follow it
more closely.
B. Discuss the importance of regular
exercise and encourage her to exercise 30-
45 minutes daily.
C. Recommend that she check her glucose
level 1-3 times daily to help determine what
adjustments need to be made.
D. Start her on an additional medication
E. Refer her to a diabetes educator for
medical nutrition therapy.
During a newborn examination the patient's ANSWER: C. Introducing peanut containing food when solids are started
mother asks what she can do to decrease
the risk of food allergies in her newborn Food allergy affects 4-6% of children in the US. IgE-mediated food allergy is the best
son. She tells you that there is no family understood, and symptoms can range from rhinorrhea to anaphylaxis. The two most
history of atopic dermatitis or asthma but common allergens are cow's milk and peanuts. The onset of symptoms is usually
she has a cousin with a peanut allergy. The within 2 hours of exposure and they resolve within several hours. The National
remainder of the examination is Institute of Allergy and Infectious Diseases in 2017 recommended that healthy infants
unremarkable. without known food allergy or who have mild to moderate eczema may be
introduced to peanut-containing foods with other solid foods. If the parents are
You tell her that food allergy risk can be concerned about a reaction, introduction of peanut-containing foods may be done
reduced by in the physician's office. Infants with severe eczema, egg allergy, or both should
A. breastfeeding for at least 1 year undergo peanut-specific IgE or skin prick testing. While breastfeeding may decrease
B. Using soy based formula instead of atopic disease, there is insufficient evidence that it reduces the likelihood of food
cow's milk based formula allergy, and using a soy based formula will not prevent food allergy. If there is a dog
C. introducing peanut-containing food in the home there is less risk of allergy to eggs. Children who are exposed to farm
when solids are started animals or who attend day care are less likely to develop atopic disease.
D. Avoiding all house pets
E. Avoiding a day care setting
Which one of the following ANSWER: D. Losartan
antihypertensive medications is LEAST
likely to exacerbate erectile dysfunction? Angiotensin receptor blockers (ARBs) such as losartan are least likely to cause or
A. Clonidine (Catapres) exacerbate erectile dysfunction. ARBs may have a favorable effect on erectile
B. Doxazosin (Cardura) dysfunction by inhibiting vasoconstriction activity of angiotensin. Clonidine, alpha
C. Hydrochlorothiazine blockers, hydrochlorothiazide, and beta-blockers are more likely to negatively affect
D. Losartan (Cozaar) erectile function.
E. Metoprolol
