ABFM ITE Exam Questions and Answers
Graded A+
1. A 68-year-old male presents to your office with a 2-day history of headache,
muscle aches, and chills. His wife adds that his temperature has been up to 104.1°F
and he seems confused sometimes. His symptoms have not improved with usual
care, including ibuprofen and increased fluid intake. He and his wife returned from
a cruise 10 days ago but don't recall anyone having a similar illness on the ship.
This morning he started to cough and his wife was concerned because she saw
some blood in his sputum. He also states that he experiences intermittent shortness
of breath and feels nauseated. His blood pressure is 100/70 mm Hg, heart rate
98/min, temperature 39.4°C (102.9°F), and oxygen saturation 95% on room air.
Which one of the following would be the preferred method to confirm your
suspected diagnosis of Legionnaires' disease?
A) Initiating azithromycin (Zithromax) to see if symptoms improve
B) A chest radiograph
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,C - Correct answer-ANSWER: E
A urine test for Legionella pneumophila antigen is the preferred method to confirm
Legionnaires' disease. This test is rapid and will only detect Legionella
pneumophila antigen. A sputum culture is the gold standard for the diagnosis of
Legionnaires' disease but it requires 48-72 hours. A chest radiograph does not
confirm the diagnosis but may show the extent of disease. Responding to antibiotic
treatment does not confirm a specific diagnosis.
2. Which one of the following factors related to pregnancy and delivery increases
the risk of developmental dysplasia of the hip in infants?
A) A large-for-gestational age infant
B) Twin birth
C) Breech presentation
D) Cesarean delivery
E) Premature birth - Correct answer-ANSWER: C
Risk factors for developmental dysplasia of the hip in infants include a breech
presentation in the third trimester, regardless of whether the delivery was cesarean
or vaginal. Other indications to evaluate an infant for this condition include a
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,positive family history, a history of previous clinical instability, parental concern, a
history of improper swaddling, and a suspicious or inconclusive physical
examination. Twin birth, a large-for-gestational age infant, and prematurity are not
considered risk factors.
3. A healthy 2-month-old female is brought to your office for a routine well baby
examination by both of her parents, who have no concerns. The parents refuse
routine recommended vaccines for their daughter because of their personal beliefs.
You want to incorporate patient-centeredness and are also concerned about
improving the health of the population. You decide to follow the CDC
recommendations by
A) accepting their decision without further action
B) not offering vaccines at future visits to preserve a positive doctor-patient
relationship
C) having the parents sign a refusal to vaccinate form
D) dismissing the family from the practice
E) pursuing a court order for vaccine administration since the child has no medical
exemptions - Correct answer-ANSWER: C
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, Experts recommend that a refusal to vaccinate form be signed by patients or
parents who refuse a recommended vaccine. This form should document that the
patient/parents were provided the vaccine information statement (SOR C). The
CDC recommends against dismissing a patient or family from a practice if they
refuse vaccination. Physicians should continue to discuss the benefits of
immunizations at subsequent visits, because some patients/parents may reconsider
their decision not to vaccinate.
4. A 50-year-old male carpet layer presents with swelling of his right knee
proximal to the patella. He does not have any history of direct trauma, fever, chills,
or changes in the overlying skin. On examination the site is swollen but minimally
tender, with no warmth or erythema.
Which one of the following would be most appropriate at this point?
A) Rest, ice, and compression
B) Aspiration of fluid for analysis
C) Injection of a corticosteroid
D) An oral corticosteroid taper
E) Referral to an orthopedic surgeon for resection - Correct answer-ANSWER: A
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
Graded A+
1. A 68-year-old male presents to your office with a 2-day history of headache,
muscle aches, and chills. His wife adds that his temperature has been up to 104.1°F
and he seems confused sometimes. His symptoms have not improved with usual
care, including ibuprofen and increased fluid intake. He and his wife returned from
a cruise 10 days ago but don't recall anyone having a similar illness on the ship.
This morning he started to cough and his wife was concerned because she saw
some blood in his sputum. He also states that he experiences intermittent shortness
of breath and feels nauseated. His blood pressure is 100/70 mm Hg, heart rate
98/min, temperature 39.4°C (102.9°F), and oxygen saturation 95% on room air.
Which one of the following would be the preferred method to confirm your
suspected diagnosis of Legionnaires' disease?
A) Initiating azithromycin (Zithromax) to see if symptoms improve
B) A chest radiograph
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,C - Correct answer-ANSWER: E
A urine test for Legionella pneumophila antigen is the preferred method to confirm
Legionnaires' disease. This test is rapid and will only detect Legionella
pneumophila antigen. A sputum culture is the gold standard for the diagnosis of
Legionnaires' disease but it requires 48-72 hours. A chest radiograph does not
confirm the diagnosis but may show the extent of disease. Responding to antibiotic
treatment does not confirm a specific diagnosis.
2. Which one of the following factors related to pregnancy and delivery increases
the risk of developmental dysplasia of the hip in infants?
A) A large-for-gestational age infant
B) Twin birth
C) Breech presentation
D) Cesarean delivery
E) Premature birth - Correct answer-ANSWER: C
Risk factors for developmental dysplasia of the hip in infants include a breech
presentation in the third trimester, regardless of whether the delivery was cesarean
or vaginal. Other indications to evaluate an infant for this condition include a
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,positive family history, a history of previous clinical instability, parental concern, a
history of improper swaddling, and a suspicious or inconclusive physical
examination. Twin birth, a large-for-gestational age infant, and prematurity are not
considered risk factors.
3. A healthy 2-month-old female is brought to your office for a routine well baby
examination by both of her parents, who have no concerns. The parents refuse
routine recommended vaccines for their daughter because of their personal beliefs.
You want to incorporate patient-centeredness and are also concerned about
improving the health of the population. You decide to follow the CDC
recommendations by
A) accepting their decision without further action
B) not offering vaccines at future visits to preserve a positive doctor-patient
relationship
C) having the parents sign a refusal to vaccinate form
D) dismissing the family from the practice
E) pursuing a court order for vaccine administration since the child has no medical
exemptions - Correct answer-ANSWER: C
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, Experts recommend that a refusal to vaccinate form be signed by patients or
parents who refuse a recommended vaccine. This form should document that the
patient/parents were provided the vaccine information statement (SOR C). The
CDC recommends against dismissing a patient or family from a practice if they
refuse vaccination. Physicians should continue to discuss the benefits of
immunizations at subsequent visits, because some patients/parents may reconsider
their decision not to vaccinate.
4. A 50-year-old male carpet layer presents with swelling of his right knee
proximal to the patella. He does not have any history of direct trauma, fever, chills,
or changes in the overlying skin. On examination the site is swollen but minimally
tender, with no warmth or erythema.
Which one of the following would be most appropriate at this point?
A) Rest, ice, and compression
B) Aspiration of fluid for analysis
C) Injection of a corticosteroid
D) An oral corticosteroid taper
E) Referral to an orthopedic surgeon for resection - Correct answer-ANSWER: A
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
