ABFM ITE Study Guide 2026–2027 | American
Board of Family Medicine In-Training Exam
Questions & Answers
This document contains:
❖ ABFM ITE
❖ ABFM in training exam
❖ family medicine ITE study guide
❖ medicine board review
❖ ABFM exam prep 2026
❖ clinical exam prep family medicine
❖ ABFM review questions
https://www.stuvia.com/user/Registerednurse 1
, 1. A 67-year old male sees you for a Medicare annual wellness visit. He tells
you that his best friend had a stroke and he asks about his risk for stroke.
He has a family history of cardiovascular disease in his father, who had a
myocardial infarction at age 65 and died from a thrombotic stroke at age 71.
The patient exercises regularly and has a BMI of 27 kg/m2. His only current
medical condition is hyperlipidemia, and his cholesterol level is at goal on
rosuvastatin (Crestor), 10 mg daily. He also takes aspirin, 81 mg daily. His
blood pressure 125/78 mmHg.
Based on US Preventive Services Task 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: ANSWER : A
No additional testing for stroke risk Carotid artery disease attects extra cranial carotid arteries and is caused by
atherosclerosis.
This patient is asymptomatic and has no history of an ischemic stroke, neurology symptoms referable to the carotid
arteries such as amaurosis fugal, or TIA. He has risk factors for cardiovascular disease (age, male sex, hyperlipidemia_,
but the USPSTF recommends against specific screening asymptomatic carotid artery stenosis (D recommendation)
which a low prevalence in the general adult population. Stroke is a leading cause of disability and death in the US, but
asymptomatic carotid artery stenosis causes a relatively small portion of strokes. Auscultation of the carotid arteries
for bruits has been found to have poor accuracy for detecting carotid stenosis and is not a reasonable screening
approach. Appropriate modalities for detecting carotid stenosis include carotid duplex ultrasonography, magnetic
resonance angiography, and computed tomography, but there are not recommended for screening asymptomatic
patients.
2. A 28 year old female presents for evaluation of nasal congestion, sneezing,
watery eyes, and postnasal drip. This has been an intermittent issue for her
every spring and she would like to manage it more effectively.
https://www.stuvia.com/user/Registerednurse 2
, Which one of the following treatments has been shown to be the most effec-
tive and best tolerated first-line therapy for this patient's condition?
A. A leukotriene receptor agonist
B. Intranasal corticosteroid monotherapy
C. Intranasal corticosteroids plus an oral antihistamine
D. Inhaled corticosteroids
E. Annual triamcinolone injections: ANSWER : B
Intranasal corticosteroid monotherapy
This patient has seasonal allergic rhinitis. A joint guideline statement from the American Academy of Allergy, Asthma,
and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters
recommends that mono therapy with intranasal corticosteroids would be prescribed initially in patients equal to or
more than 12 years of age rather than combined treatment with oral antihistamines because data has not shown
an additional benefit to adding the antihistamine. Higher patient adherence and tolerance and fewer side ettects
were seen with the mono therapy regimen. High quality evidence indicates that intranasal corticosteroids were
more ettective than leukotriene receptor antagonists. Inhaled corticosteroids and triamcinolone injections are not
appropriate first line options for the treatment of seasonal allergic rhinitis
3. A 68 year old female presents with a 2 month history of watery diarrhea. She
has not had any blood or pus in her stools, and the stools are not oily. She
has not had any history of fever, chills, or weight loss, and has not traveled
recently. She smokes one pack of cigarettes per day. Her medications include
ibuprofen, sertraline and pantoprazole. A CBC, metabolic panel, CRP, IgA anti
tissue transglutaminase level, total IgA level, and stool guaiac test are all
normal.
Which one of the following tests would be mostly likely to yield a diagnosis?
A. C difficile toxin
B. Colonoscopy
C. Fecal calprotectin
D. A stool culture
E. Stool exam for ova and parasites: ANSWER : B
Colonoscopy
https://www.stuvia.com/user/Registerednurse 3
, ABFM ITE 2021
Study online at https://quizlet.com/_bw29e9
In patients with chronic nonbloody diarrhea, the ditterential diagnosis includes microscopic (lymphocytic or col-
lagenous) colitis. The mucosa appears normal on colonoscopy but a biopsy will show lymphocytic infiltration of the
epithelium. The etiology is unknown but there are several risk factors to consider, including older age, female sex,
and smoking status. Drugs with a high level of evidence causing microscopic colitis include NSAIDs, PPIs, sertraline,
acarbose, aspirin, and ticlopidine. C. ditt should be suspected in individuals who have taken antibiotics in the past 3
months. Fecal calprotectin is elevated in inflammatory diarrhea such as 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 bacteria tend to cause bloody diarrhea. Checking for a parasitic infection should be considered for patients
with a history of recent travel or exposure to unpurified water.
4. A 23 year old male with opioid use disorder requests buprenorphine thera-
py. He is still actively using immediate release oxycodone and he took a dose
2 hours ago.
This patient should begin buprenorphine induction
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: ANSWER : C
8-12 hours after his last opioid use
Buprenorphine is a partial opioid agonist. In order to reduce the risk of precipitated 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. Waiting until a patient goes through a full withdrawal increases the chances that the patient will
revert back to using opioids.
5. A 45 year old left hand dominant female presents to your office with a
lump on her hand. She first noticed the lump 2 weeks ago and thinks it has
gotten bigger. She does not recall any injury. She has not had any numbness,
weakness, or tingling. She has minimal discomfort when she presses on the
lump, and it does not affect her activity. On examination her left wrist is
neurovascularly intact.
Board of Family Medicine In-Training Exam
Questions & Answers
This document contains:
❖ ABFM ITE
❖ ABFM in training exam
❖ family medicine ITE study guide
❖ medicine board review
❖ ABFM exam prep 2026
❖ clinical exam prep family medicine
❖ ABFM review questions
https://www.stuvia.com/user/Registerednurse 1
, 1. A 67-year old male sees you for a Medicare annual wellness visit. He tells
you that his best friend had a stroke and he asks about his risk for stroke.
He has a family history of cardiovascular disease in his father, who had a
myocardial infarction at age 65 and died from a thrombotic stroke at age 71.
The patient exercises regularly and has a BMI of 27 kg/m2. His only current
medical condition is hyperlipidemia, and his cholesterol level is at goal on
rosuvastatin (Crestor), 10 mg daily. He also takes aspirin, 81 mg daily. His
blood pressure 125/78 mmHg.
Based on US Preventive Services Task 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: ANSWER : A
No additional testing for stroke risk Carotid artery disease attects extra cranial carotid arteries and is caused by
atherosclerosis.
This patient is asymptomatic and has no history of an ischemic stroke, neurology symptoms referable to the carotid
arteries such as amaurosis fugal, or TIA. He has risk factors for cardiovascular disease (age, male sex, hyperlipidemia_,
but the USPSTF recommends against specific screening asymptomatic carotid artery stenosis (D recommendation)
which a low prevalence in the general adult population. Stroke is a leading cause of disability and death in the US, but
asymptomatic carotid artery stenosis causes a relatively small portion of strokes. Auscultation of the carotid arteries
for bruits has been found to have poor accuracy for detecting carotid stenosis and is not a reasonable screening
approach. Appropriate modalities for detecting carotid stenosis include carotid duplex ultrasonography, magnetic
resonance angiography, and computed tomography, but there are not recommended for screening asymptomatic
patients.
2. A 28 year old female presents for evaluation of nasal congestion, sneezing,
watery eyes, and postnasal drip. This has been an intermittent issue for her
every spring and she would like to manage it more effectively.
https://www.stuvia.com/user/Registerednurse 2
, Which one of the following treatments has been shown to be the most effec-
tive and best tolerated first-line therapy for this patient's condition?
A. A leukotriene receptor agonist
B. Intranasal corticosteroid monotherapy
C. Intranasal corticosteroids plus an oral antihistamine
D. Inhaled corticosteroids
E. Annual triamcinolone injections: ANSWER : B
Intranasal corticosteroid monotherapy
This patient has seasonal allergic rhinitis. A joint guideline statement from the American Academy of Allergy, Asthma,
and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters
recommends that mono therapy with intranasal corticosteroids would be prescribed initially in patients equal to or
more than 12 years of age rather than combined treatment with oral antihistamines because data has not shown
an additional benefit to adding the antihistamine. Higher patient adherence and tolerance and fewer side ettects
were seen with the mono therapy regimen. High quality evidence indicates that intranasal corticosteroids were
more ettective than leukotriene receptor antagonists. Inhaled corticosteroids and triamcinolone injections are not
appropriate first line options for the treatment of seasonal allergic rhinitis
3. A 68 year old female presents with a 2 month history of watery diarrhea. She
has not had any blood or pus in her stools, and the stools are not oily. She
has not had any history of fever, chills, or weight loss, and has not traveled
recently. She smokes one pack of cigarettes per day. Her medications include
ibuprofen, sertraline and pantoprazole. A CBC, metabolic panel, CRP, IgA anti
tissue transglutaminase level, total IgA level, and stool guaiac test are all
normal.
Which one of the following tests would be mostly likely to yield a diagnosis?
A. C difficile toxin
B. Colonoscopy
C. Fecal calprotectin
D. A stool culture
E. Stool exam for ova and parasites: ANSWER : B
Colonoscopy
https://www.stuvia.com/user/Registerednurse 3
, ABFM ITE 2021
Study online at https://quizlet.com/_bw29e9
In patients with chronic nonbloody diarrhea, the ditterential diagnosis includes microscopic (lymphocytic or col-
lagenous) colitis. The mucosa appears normal on colonoscopy but a biopsy will show lymphocytic infiltration of the
epithelium. The etiology is unknown but there are several risk factors to consider, including older age, female sex,
and smoking status. Drugs with a high level of evidence causing microscopic colitis include NSAIDs, PPIs, sertraline,
acarbose, aspirin, and ticlopidine. C. ditt should be suspected in individuals who have taken antibiotics in the past 3
months. Fecal calprotectin is elevated in inflammatory diarrhea such as 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 bacteria tend to cause bloody diarrhea. Checking for a parasitic infection should be considered for patients
with a history of recent travel or exposure to unpurified water.
4. A 23 year old male with opioid use disorder requests buprenorphine thera-
py. He is still actively using immediate release oxycodone and he took a dose
2 hours ago.
This patient should begin buprenorphine induction
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: ANSWER : C
8-12 hours after his last opioid use
Buprenorphine is a partial opioid agonist. In order to reduce the risk of precipitated 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. Waiting until a patient goes through a full withdrawal increases the chances that the patient will
revert back to using opioids.
5. A 45 year old left hand dominant female presents to your office with a
lump on her hand. She first noticed the lump 2 weeks ago and thinks it has
gotten bigger. She does not recall any injury. She has not had any numbness,
weakness, or tingling. She has minimal discomfort when she presses on the
lump, and it does not affect her activity. On examination her left wrist is
neurovascularly intact.
