Page 1 of 295
1
,Page 2 of 295
ABFM ITE EXAM 1
QUESTION: A 42-year-old male presents with a 10-day history of hoarseness. He also has a
2month history of reflux symptoms and has been taking antacids as needed. He does not take
any other medications. There is no history of fever, weight loss, night sweats, or appetite
changes. You note that the patient is hoarse, and a physical examination is normal, including
HEENT, cardiovascular, and pulmonary examinations. He is a member of a community choir that
rehearses twice a week.
In addition to voice rest, which one of the following would be most appropriate at this time?
A) Supportive care only
B) Azithromycin (Zithromax)
C) Omeprazole (Prilosec)
D) A course of prednisone - ANSWER-C
QUESTION: A 57-year-old male with a history of heart failure sees you for follow-up. He
describes symptoms of mild dyspnea on exertion with ordinary activities such as shopping or
yard work. An echocardiogram shows an ejection fraction of 37%.
According to the New York Heart Association criteria, this patient's heart failure would be
classified as which one of the following?
A) Class I
B) Class II
C) Class III
D) Class IV - ANSWER-B
QUESTION: A 40-year-old runner presents with pain in the left leg. He is training for a marathon
and has been increasing his running distance in recent weeks. He reports localized pain and
swelling at the midpoint of the shin over the past 4 weeks that begins after a run and lasts for a
2
,Page 3 of 295
few days, but now the swelling and tenderness have lasted for several days and there is severe
pain when he tries to run. You suspect a tibial stress fracture.
Which one of the following imaging modalities would be indicated initially?
A) A plain film
B) Ultrasonography
C) CT
D) MRI
E) Bone scintigraphy - ANSWER-A
QUESTION: A 24-year-old female presents with progressively worsening vulvar pain for 3 days.
On examination a 3×3-cm tender, fluctuant mass is noted on the right labia minora. She had a
similar episode of this problem last year.
Which one of the following would be the most appropriate management?
A) Expectant management
B) Fine-needle aspiration
C) Incision and drainage
D) Marsupialization
E) Excision under general anesthesia - ANSWER-D
QUESTION: Which one of the following should NOT be consumed during pregnancy due to a
potentially high mercury content?
A) Catfish
B) Crawfish, shrimp, and lobster
C) Flounder and haddock
D) Salmon and trout
E) Shark and swordfish - ANSWER-E
QUESTION: An 18-month-old female is brought to your office by her mother for evaluation of a
cough. The patient has had low-grade fevers and a runny nose for 2 days. She now has a cough
that is worse at night. On examination she has a temperature of 37.5°C (99.5°F), a pulse rate of
120 beats/min, a respiratory rate of 30/min, and an oxygen saturation of 92% on room air. She
is noted to have hoarseness, mild inspiratory stridor, and a barking cough. She does not have
drooling or a muffled voice.
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, Page 4 of 295
Which one of the following should be ordered to confirm the diagnosis?
A) No further testing
B) ACBC
C) A viral culture
D) Rapid antigen testing
E) A radiograph of the neck - ANSWER-A
A 42-year-old Asian male presents for follow-up of elevated blood pressure. He has no
additional chronic medical problems and is otherwise asymptomatic. An examination is
significant for a blood pressure of 162/95 mm Hg but is otherwise unremarkable.
all the labs are normal. (Claire's notes, ily)
According to the American College of Cardiology/American Heart Association 2017 guidelines,
which one of the following would be the most appropriate medication to initiate at this time?
A) Clonidine (Catapres), 0.1 mg twice daily
B) Hydralazine, 25 mg three times daily
C) Lisinopril/hydrochlorothiazide (Zestoretic), 10/12.5 mg daily
D) Metoprolol tartrate (Lopressor), 25 mg twice daily
E) Triamterene (Dyrenium), 50 mg daily - ANSWER-C
QUESTION: During rounds at the nursing home, you are informed that there are two residents
on the unit with laboratory-confirmed influenza. According to CDC guidelines, who should
receive chemoprophylaxis for influenza?
A) Only symptomatic residents on the same unit
B) Only symptomatic residents in the entire facility
C) All asymptomatic residents on the same unit
D) All residents of the facility regardless of symptoms
E) All staff regardless of symptoms - ANSWER-C
QUESTION: A 24-year-old female presents with a 2-day history of mild to moderate pelvic pain.
She has had two male sex partners in the last 6 months and uses oral contraceptives and
sometimes condoms. A physical examination reveals a temperature of 36.4°C (97.5°F) and
moderate cervical motion and uterine tenderness. Urine hCG and a urinalysis are negative.
4
1
,Page 2 of 295
ABFM ITE EXAM 1
QUESTION: A 42-year-old male presents with a 10-day history of hoarseness. He also has a
2month history of reflux symptoms and has been taking antacids as needed. He does not take
any other medications. There is no history of fever, weight loss, night sweats, or appetite
changes. You note that the patient is hoarse, and a physical examination is normal, including
HEENT, cardiovascular, and pulmonary examinations. He is a member of a community choir that
rehearses twice a week.
In addition to voice rest, which one of the following would be most appropriate at this time?
A) Supportive care only
B) Azithromycin (Zithromax)
C) Omeprazole (Prilosec)
D) A course of prednisone - ANSWER-C
QUESTION: A 57-year-old male with a history of heart failure sees you for follow-up. He
describes symptoms of mild dyspnea on exertion with ordinary activities such as shopping or
yard work. An echocardiogram shows an ejection fraction of 37%.
According to the New York Heart Association criteria, this patient's heart failure would be
classified as which one of the following?
A) Class I
B) Class II
C) Class III
D) Class IV - ANSWER-B
QUESTION: A 40-year-old runner presents with pain in the left leg. He is training for a marathon
and has been increasing his running distance in recent weeks. He reports localized pain and
swelling at the midpoint of the shin over the past 4 weeks that begins after a run and lasts for a
2
,Page 3 of 295
few days, but now the swelling and tenderness have lasted for several days and there is severe
pain when he tries to run. You suspect a tibial stress fracture.
Which one of the following imaging modalities would be indicated initially?
A) A plain film
B) Ultrasonography
C) CT
D) MRI
E) Bone scintigraphy - ANSWER-A
QUESTION: A 24-year-old female presents with progressively worsening vulvar pain for 3 days.
On examination a 3×3-cm tender, fluctuant mass is noted on the right labia minora. She had a
similar episode of this problem last year.
Which one of the following would be the most appropriate management?
A) Expectant management
B) Fine-needle aspiration
C) Incision and drainage
D) Marsupialization
E) Excision under general anesthesia - ANSWER-D
QUESTION: Which one of the following should NOT be consumed during pregnancy due to a
potentially high mercury content?
A) Catfish
B) Crawfish, shrimp, and lobster
C) Flounder and haddock
D) Salmon and trout
E) Shark and swordfish - ANSWER-E
QUESTION: An 18-month-old female is brought to your office by her mother for evaluation of a
cough. The patient has had low-grade fevers and a runny nose for 2 days. She now has a cough
that is worse at night. On examination she has a temperature of 37.5°C (99.5°F), a pulse rate of
120 beats/min, a respiratory rate of 30/min, and an oxygen saturation of 92% on room air. She
is noted to have hoarseness, mild inspiratory stridor, and a barking cough. She does not have
drooling or a muffled voice.
3
, Page 4 of 295
Which one of the following should be ordered to confirm the diagnosis?
A) No further testing
B) ACBC
C) A viral culture
D) Rapid antigen testing
E) A radiograph of the neck - ANSWER-A
A 42-year-old Asian male presents for follow-up of elevated blood pressure. He has no
additional chronic medical problems and is otherwise asymptomatic. An examination is
significant for a blood pressure of 162/95 mm Hg but is otherwise unremarkable.
all the labs are normal. (Claire's notes, ily)
According to the American College of Cardiology/American Heart Association 2017 guidelines,
which one of the following would be the most appropriate medication to initiate at this time?
A) Clonidine (Catapres), 0.1 mg twice daily
B) Hydralazine, 25 mg three times daily
C) Lisinopril/hydrochlorothiazide (Zestoretic), 10/12.5 mg daily
D) Metoprolol tartrate (Lopressor), 25 mg twice daily
E) Triamterene (Dyrenium), 50 mg daily - ANSWER-C
QUESTION: During rounds at the nursing home, you are informed that there are two residents
on the unit with laboratory-confirmed influenza. According to CDC guidelines, who should
receive chemoprophylaxis for influenza?
A) Only symptomatic residents on the same unit
B) Only symptomatic residents in the entire facility
C) All asymptomatic residents on the same unit
D) All residents of the facility regardless of symptoms
E) All staff regardless of symptoms - ANSWER-C
QUESTION: A 24-year-old female presents with a 2-day history of mild to moderate pelvic pain.
She has had two male sex partners in the last 6 months and uses oral contraceptives and
sometimes condoms. A physical examination reveals a temperature of 36.4°C (97.5°F) and
moderate cervical motion and uterine tenderness. Urine hCG and a urinalysis are negative.
4
