American Board of Family Medicine Exam
Questions and Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant Download Pdf
1. An 82-year-old woman presents with progressive memory loss
over the past year. She is independent in all activities of daily
living. Which of the following is the most likely diagnosis?
A. Alzheimer’s disease
B. Vascular dementia
C. Frontotemporal dementia
D. Normal aging
Alzheimer’s disease is the most common cause of progressive
memory loss in older adults, especially with preserved functional
independence early in the disease.
2. Which of the following vaccines is specifically recommended
annually for adults aged 65 years and older?
A. Tdap
B. Influenza
C. MMR
D. Varicella
Annual influenza vaccination is recommended for all adults 65 and
older due to increased morbidity and mortality risk.
3. A 78-year-old man presents with unintentional weight loss,
fatigue, and mild anemia. Initial laboratory evaluation shows
microcytic anemia. What is the most appropriate next step?
A. Colonoscopy
B. Bone marrow biopsy
C. Iron studies and evaluation for gastrointestinal bleeding
, D. Vitamin B12 supplementation
Microcytic anemia in older adults is often due to iron deficiency,
commonly from gastrointestinal blood loss, and should be
investigated first.
4. Which of the following medications is most strongly associated
with orthostatic hypotension in older adults?
A. Acetaminophen
B. Alpha-blockers
C. SSRIs
D. Metformin
Alpha-blockers, often used for hypertension or benign prostatic
hyperplasia, can cause significant orthostatic hypotension in the
elderly.
5. A 75-year-old woman has osteoarthritis of her knees and reports
persistent pain despite acetaminophen. Which is the next
appropriate pharmacologic treatment?
A. Opioids
B. NSAIDs, with caution
C. Corticosteroids orally
D. Tramadol only
NSAIDs can be used for osteoarthritis pain in older adults if there
are no contraindications, but risks such as GI bleeding and renal
impairment must be considered.
6. Which of the following is the most appropriate screening tool for
malnutrition in older adults?
A. PHQ-9
B. Mini-Cog
C. Mini Nutritional Assessment (MNA)
D. MMSE
, The Mini Nutritional Assessment (MNA) is validated for identifying
older adults at risk for malnutrition.
7. A 79-year-old man has frequent falls at home. Which of the
following is the most effective single intervention to prevent
further falls?
A. Vitamin D supplementation alone
B. Multifactorial risk assessment with exercise and home
modification
C. Hip protectors only
D. Routine benzodiazepine use
Fall prevention is most effective when multiple risk factors are
addressed, including strength and balance training and home
safety modifications.
8. Which of the following cognitive assessment tools is quickest and
most practical in primary care for screening dementia?
A. MMSE
B. Montreal Cognitive Assessment (MoCA)
C. Mini-Cog
D. CAM
The Mini-Cog is brief, practical, and effective for cognitive
screening in primary care settings.
9. A 76-year-old patient presents with urinary incontinence only
when coughing or sneezing. Which is the most likely diagnosis?
A. Urge incontinence
B. Overflow incontinence
C. Functional incontinence
D. Stress incontinence
Stress incontinence is leakage of urine with increased intra-
abdominal pressure, common in older women.
Questions and Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant Download Pdf
1. An 82-year-old woman presents with progressive memory loss
over the past year. She is independent in all activities of daily
living. Which of the following is the most likely diagnosis?
A. Alzheimer’s disease
B. Vascular dementia
C. Frontotemporal dementia
D. Normal aging
Alzheimer’s disease is the most common cause of progressive
memory loss in older adults, especially with preserved functional
independence early in the disease.
2. Which of the following vaccines is specifically recommended
annually for adults aged 65 years and older?
A. Tdap
B. Influenza
C. MMR
D. Varicella
Annual influenza vaccination is recommended for all adults 65 and
older due to increased morbidity and mortality risk.
3. A 78-year-old man presents with unintentional weight loss,
fatigue, and mild anemia. Initial laboratory evaluation shows
microcytic anemia. What is the most appropriate next step?
A. Colonoscopy
B. Bone marrow biopsy
C. Iron studies and evaluation for gastrointestinal bleeding
, D. Vitamin B12 supplementation
Microcytic anemia in older adults is often due to iron deficiency,
commonly from gastrointestinal blood loss, and should be
investigated first.
4. Which of the following medications is most strongly associated
with orthostatic hypotension in older adults?
A. Acetaminophen
B. Alpha-blockers
C. SSRIs
D. Metformin
Alpha-blockers, often used for hypertension or benign prostatic
hyperplasia, can cause significant orthostatic hypotension in the
elderly.
5. A 75-year-old woman has osteoarthritis of her knees and reports
persistent pain despite acetaminophen. Which is the next
appropriate pharmacologic treatment?
A. Opioids
B. NSAIDs, with caution
C. Corticosteroids orally
D. Tramadol only
NSAIDs can be used for osteoarthritis pain in older adults if there
are no contraindications, but risks such as GI bleeding and renal
impairment must be considered.
6. Which of the following is the most appropriate screening tool for
malnutrition in older adults?
A. PHQ-9
B. Mini-Cog
C. Mini Nutritional Assessment (MNA)
D. MMSE
, The Mini Nutritional Assessment (MNA) is validated for identifying
older adults at risk for malnutrition.
7. A 79-year-old man has frequent falls at home. Which of the
following is the most effective single intervention to prevent
further falls?
A. Vitamin D supplementation alone
B. Multifactorial risk assessment with exercise and home
modification
C. Hip protectors only
D. Routine benzodiazepine use
Fall prevention is most effective when multiple risk factors are
addressed, including strength and balance training and home
safety modifications.
8. Which of the following cognitive assessment tools is quickest and
most practical in primary care for screening dementia?
A. MMSE
B. Montreal Cognitive Assessment (MoCA)
C. Mini-Cog
D. CAM
The Mini-Cog is brief, practical, and effective for cognitive
screening in primary care settings.
9. A 76-year-old patient presents with urinary incontinence only
when coughing or sneezing. Which is the most likely diagnosis?
A. Urge incontinence
B. Overflow incontinence
C. Functional incontinence
D. Stress incontinence
Stress incontinence is leakage of urine with increased intra-
abdominal pressure, common in older women.
