ABFM ITE Exam Final Test Paper Questions with Correct
Answers (Grade A+)
Question 1: what do asplenic patients do if they have fever and get in to see doctor for eval in 2
hours?
Answer: Amoxicillin, levofloxacin, and
moxifloxacin should be taken by asplenic patients with a new onset of fever if they cannot get to a medical
facility within 2 hours for evaluation. Fever should be reported immediately due to the lifelong significant risk
of sepsis. Unless otherwise contraindicated, asplenic patients should receive annual influenza immunization.
Pneumococcal polysaccharide vaccine (PPSV23) should be given twice, with the second dose given 5 years
after the first.
Question 2: chronic urticaria, what do you do if antihistamines don't work?
Answer: add H2 blockers (doxepin can be used off label, blocks antihistamine receptors) steroids UV therapy
2nd line therapies
Question 3: what can you use for sensoneural hearing loss short term to reduce long term sequelae
Answer: Prednisone!
greatest improvement in hearing tends to occur in the first 2 weeks, corticosteroid treatment should be started
immediately. The recommended dosage is 1 mg/kg/day with a maximum dosage of 60 mg daily for 10-14
days.
Question 4: if patient has shellfish allergy, do you wait or give steroids and epi for IV contrast?
Answer: NO! There is no correlation! Just do the damn CT!
Question 5: Rotator Cuff Muscles (SITS)
Answer: S = supraspinatus -
abduction (along with deltoid)
I = infraspinatus - external rotation t = teres minor - external rotation S = subscapularis - internal rotation
Question 6: sickle cell kids ages 2-16 should be screened for and with what?
Answer: Individuals with sickle cell disease are at increased risk for vascular disease, especially stroke. All
sickle cell patients 2-16 years of age should be screened with transcranial Doppler ultrasonography (SOR A).
Question 7: fetal alcohol syndrome
Answer: a medical condition in which
body deformation or facial development or mental ability of a fetus is impaired because the mother drank
alcohol while pregnant associated with clinodactyly, camptodactyly (flexion deformity of the fingers), other
flexion contractures, radioulnar synostosis, scoliosis, and spinal malformations. It is also associated with many
neurologic, behavioral, and cardiovascular abnormalities, as well as other types of abnormalities.
Page 1
, Question 8: Dix-Hallpike maneuver
Answer: Rapidly moving the pt from a
sitting position to the supine position with the head turned 45 degrees to the Right. After waiting apx. 20-30
sec, the pt is returned to the sitting position. If no *Nystagmus* is observed, the procedure is then repeated on
the Left side.
Question 9: preferred antidepressant in older patients
Answer: Escitalopram
(lexapro)
Question 10: herbal supplement with highest risk of drug interactions?
Answer: St. John's Wort
inducer of CYP3A4 and P-glycoprotein synthesis. Concurrent use of St. John's wort with drugs that are
metabolized with these systems should be avoided. These include cyclosporine, warfarin, theophylline, and
oral contraceptives.
Question 11: why recombinant zoster vaccine (shingrix) over live zoster vaccine (zostavax)
Answer: better efficacy
Question 12: Peak effect of opioids
Answer: oral 1 hr
IM - 10 min
Subq- 20-30 min
Question 13: when to start O2 on pts with COPD?
Answer: when PaO2 < 60
Question 14: antihypertensives that help with HTN associated with OSA
Answer: diuretics - but spironolactone does the best job
Question 15: highest cure rate for basal cell carcinoma?
Answer: Moh's surgery
Question 16: patients who no depression but have alcohol use disorder, what med is the best?
Answer: Acamprosate, zofran also may help
only use SSRI / SNRI if co-existing depression
Page 2
Answers (Grade A+)
Question 1: what do asplenic patients do if they have fever and get in to see doctor for eval in 2
hours?
Answer: Amoxicillin, levofloxacin, and
moxifloxacin should be taken by asplenic patients with a new onset of fever if they cannot get to a medical
facility within 2 hours for evaluation. Fever should be reported immediately due to the lifelong significant risk
of sepsis. Unless otherwise contraindicated, asplenic patients should receive annual influenza immunization.
Pneumococcal polysaccharide vaccine (PPSV23) should be given twice, with the second dose given 5 years
after the first.
Question 2: chronic urticaria, what do you do if antihistamines don't work?
Answer: add H2 blockers (doxepin can be used off label, blocks antihistamine receptors) steroids UV therapy
2nd line therapies
Question 3: what can you use for sensoneural hearing loss short term to reduce long term sequelae
Answer: Prednisone!
greatest improvement in hearing tends to occur in the first 2 weeks, corticosteroid treatment should be started
immediately. The recommended dosage is 1 mg/kg/day with a maximum dosage of 60 mg daily for 10-14
days.
Question 4: if patient has shellfish allergy, do you wait or give steroids and epi for IV contrast?
Answer: NO! There is no correlation! Just do the damn CT!
Question 5: Rotator Cuff Muscles (SITS)
Answer: S = supraspinatus -
abduction (along with deltoid)
I = infraspinatus - external rotation t = teres minor - external rotation S = subscapularis - internal rotation
Question 6: sickle cell kids ages 2-16 should be screened for and with what?
Answer: Individuals with sickle cell disease are at increased risk for vascular disease, especially stroke. All
sickle cell patients 2-16 years of age should be screened with transcranial Doppler ultrasonography (SOR A).
Question 7: fetal alcohol syndrome
Answer: a medical condition in which
body deformation or facial development or mental ability of a fetus is impaired because the mother drank
alcohol while pregnant associated with clinodactyly, camptodactyly (flexion deformity of the fingers), other
flexion contractures, radioulnar synostosis, scoliosis, and spinal malformations. It is also associated with many
neurologic, behavioral, and cardiovascular abnormalities, as well as other types of abnormalities.
Page 1
, Question 8: Dix-Hallpike maneuver
Answer: Rapidly moving the pt from a
sitting position to the supine position with the head turned 45 degrees to the Right. After waiting apx. 20-30
sec, the pt is returned to the sitting position. If no *Nystagmus* is observed, the procedure is then repeated on
the Left side.
Question 9: preferred antidepressant in older patients
Answer: Escitalopram
(lexapro)
Question 10: herbal supplement with highest risk of drug interactions?
Answer: St. John's Wort
inducer of CYP3A4 and P-glycoprotein synthesis. Concurrent use of St. John's wort with drugs that are
metabolized with these systems should be avoided. These include cyclosporine, warfarin, theophylline, and
oral contraceptives.
Question 11: why recombinant zoster vaccine (shingrix) over live zoster vaccine (zostavax)
Answer: better efficacy
Question 12: Peak effect of opioids
Answer: oral 1 hr
IM - 10 min
Subq- 20-30 min
Question 13: when to start O2 on pts with COPD?
Answer: when PaO2 < 60
Question 14: antihypertensives that help with HTN associated with OSA
Answer: diuretics - but spironolactone does the best job
Question 15: highest cure rate for basal cell carcinoma?
Answer: Moh's surgery
Question 16: patients who no depression but have alcohol use disorder, what med is the best?
Answer: Acamprosate, zofran also may help
only use SSRI / SNRI if co-existing depression
Page 2
