ABFM ITE EXAM AND PRACTICE EXAM NEWEST
2026 TEST BANK| AMERICAN BOARD OF FAMILY
MEDICINE IN-TRAINING EXAM PREP WITH
COMPLETE 650 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+
A 65-year-old male with type 2 diabetes mellitus, hypertension, and
obstructive sleep apnea sees you for follow-up. He does not use tobacco
or other drugs, and his alcohol consumption consists of two drinks per
day. His BMI is 31.0 kg/m2, and he just started a fitness program. The
patient tells you that his brother was recently diagnosed with atrial
fibrillation and he asks you if this increases his own risk.
Which one of the following factors would increase the risk of atrial
fibrillation in this patient?
A) Alcohol use
B) Treatment with lisinopril (Prinivil, Zestril)
C) Treatment with pioglitazone (Actos)
D) Use of a continuous positive airway pressure (CPAP) device
E) Physical stress - Correct Answer - A
Alcohol consumption greater than one drink/day has been associated
with atrial fibrillation. While not recommended to prevent atrial
fibrillation, pioglitazone and lisinopril have both been associated with
lower rates of atrial fibrillation compared to alternative therapies.
Treatment of obstructive sleep apnea, along with a regular fitness
regimen, has been associated with a decrease in the recurrence of atrial
fibrillation.
pg. 1
,You have diagnosed a 32-year-old female with moderate iron deficiency
anemia, presumed to be due to chronic menstrual blood loss. She has no
gastrointestinal or genitourinary symptoms, and no bruising or bleeding
other than menstrual bleeding. Her vital signs are normal and a physical
examination is unremarkable. You initiate a trial of oral iron therapy.
Which one of the following would be the best way to assess the patient's
response to oral iron?
A) A reticulocyte count in 1-2 weeks
B) A repeat hematocrit in 2 weeks
C) A peripheral smear to look for new RBCs in 4 weeks
D) A serum total iron binding capacity and ferritin level in 6 weeks -
Correct Answer - A
The reticulocyte count is the first and best indicator of iron absorption
and bone marrow response to oral iron therapy in the treatment of iron
deficiency anemia. An increase in reticulocytes is seen as early as 4
days, peaking at 7-10 days. The rate of production of new RBCs slows
thereafter due to a compensatory decrease in erythropoietin as more iron
becomes available. It typically takes 4-6 weeks before seeing recovery in
the hematocrit, and for the RBC count and indices to normalize.
However it is usually 4-6 months before iron stores are fully restored to
normal levels, so treatment should continue for at least that long.
You see an adult patient who has chronic urticaria and no other known
chronic conditions. He continues to experience hives after a 3-month
course of daily loratadine (Claritin).
Which one of the following would be the most appropriate addition to
his treatment regimen at this time?
A) A short course of oral corticosteroids
B) Cyclosporine
C) Ranitidine (Zantac)
pg. 2
,D) Narrow-band UV light treatment - Correct Answer - C
First- and second-generation H1 antihistamine receptor antagonists are
generally considered first-line treatment for chronic urticaria, and
approximately 60% of patients experience a satisfactory result. Second-
generation options such as loratadine have the added benefit of a lower
likelihood of side effects such as drowsiness. For those who fail to
achieve the desired result with monotherapy using an H1 antihistamine
receptor antagonist, the addition of an H2 antihistamine receptor
antagonist such as cimetidine or ranitidine is often beneficial. The
tricyclic antidepressant doxepin has strong H1 and H2 antihistamine
receptor antagonist effects and has been used as an off-label treatment
option in some studies. A short course of oral corticosteroids, narrow-
band UV light treatment, or cyclosporine can be used in the management
of recalcitrant chronic urticaria, but these are considered second- or
third-line adjunctive options.
A 62-year-old female with diabetes mellitus presents to your office with
left lower quadrant pain and guarding. She has a previous history of a
shellfish allergy that caused hives and swelling.
Further evaluation of this patient should include which one of the
following?
A) Ultrasonography of the abdomen
B) CT of the abdomen and pelvis with oral and intravenous (IV) contrast
C) Oral corticosteroids and antihistamines, then CT of the abdomen and
pelvis with oral and IV contrast
D) Intravenous corticosteroids and antihistamines, then CT of the
abdomen and pelvis with oral and IV contrast
E) Laparotomy - Correct Answer - B
Evaluation of this patient should include CT of the abdomen and pelvis
with oral and intravenous (IV) contrast. There is no reason to inquire
pg. 3
, about shellfish allergies prior to CT with IV contrast, because
premedication is not needed. There is no correlation between shellfish
allergies and allergic reactions to contrast. Patients with moderately
severe to severe reactions to IV contrast in the past would need
pretreatment with corticosteroids.
A 45-year-old female who works as a house cleaner presents with left
shoulder pain. On examination she has pain and relative weakness when
pushing toward the midline against resistance while the shoulder is
adducted and the elbow is bent to 90°. With the elbow still at 90° she is
unable to keep her left hand away from her body when you position her
hand behind her back.
This presentation is most consistent with an injury of which one of the
following tendons?
A) Deltoid
B) Infraspinatus
C) Subscapularis
D) Supraspinatus
E) Teres minor - Correct Answer - C
This patient's pain and weakness while pushing against resistance
reveals weakness on internal rotation of the shoulder, which suggests a
possible tear of the subscapularis tendon. The inability to keep her hand
away from her body when it is placed behind her back describes a
positive internal lag test, also suggesting involvement of the
subscapularis tendon. The infraspinatus and teres minor are involved in
external rotation rather than internal rotation. The supraspinatus and
deltoid are involved in abduction of the shoulder.
pg. 4
2026 TEST BANK| AMERICAN BOARD OF FAMILY
MEDICINE IN-TRAINING EXAM PREP WITH
COMPLETE 650 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+
A 65-year-old male with type 2 diabetes mellitus, hypertension, and
obstructive sleep apnea sees you for follow-up. He does not use tobacco
or other drugs, and his alcohol consumption consists of two drinks per
day. His BMI is 31.0 kg/m2, and he just started a fitness program. The
patient tells you that his brother was recently diagnosed with atrial
fibrillation and he asks you if this increases his own risk.
Which one of the following factors would increase the risk of atrial
fibrillation in this patient?
A) Alcohol use
B) Treatment with lisinopril (Prinivil, Zestril)
C) Treatment with pioglitazone (Actos)
D) Use of a continuous positive airway pressure (CPAP) device
E) Physical stress - Correct Answer - A
Alcohol consumption greater than one drink/day has been associated
with atrial fibrillation. While not recommended to prevent atrial
fibrillation, pioglitazone and lisinopril have both been associated with
lower rates of atrial fibrillation compared to alternative therapies.
Treatment of obstructive sleep apnea, along with a regular fitness
regimen, has been associated with a decrease in the recurrence of atrial
fibrillation.
pg. 1
,You have diagnosed a 32-year-old female with moderate iron deficiency
anemia, presumed to be due to chronic menstrual blood loss. She has no
gastrointestinal or genitourinary symptoms, and no bruising or bleeding
other than menstrual bleeding. Her vital signs are normal and a physical
examination is unremarkable. You initiate a trial of oral iron therapy.
Which one of the following would be the best way to assess the patient's
response to oral iron?
A) A reticulocyte count in 1-2 weeks
B) A repeat hematocrit in 2 weeks
C) A peripheral smear to look for new RBCs in 4 weeks
D) A serum total iron binding capacity and ferritin level in 6 weeks -
Correct Answer - A
The reticulocyte count is the first and best indicator of iron absorption
and bone marrow response to oral iron therapy in the treatment of iron
deficiency anemia. An increase in reticulocytes is seen as early as 4
days, peaking at 7-10 days. The rate of production of new RBCs slows
thereafter due to a compensatory decrease in erythropoietin as more iron
becomes available. It typically takes 4-6 weeks before seeing recovery in
the hematocrit, and for the RBC count and indices to normalize.
However it is usually 4-6 months before iron stores are fully restored to
normal levels, so treatment should continue for at least that long.
You see an adult patient who has chronic urticaria and no other known
chronic conditions. He continues to experience hives after a 3-month
course of daily loratadine (Claritin).
Which one of the following would be the most appropriate addition to
his treatment regimen at this time?
A) A short course of oral corticosteroids
B) Cyclosporine
C) Ranitidine (Zantac)
pg. 2
,D) Narrow-band UV light treatment - Correct Answer - C
First- and second-generation H1 antihistamine receptor antagonists are
generally considered first-line treatment for chronic urticaria, and
approximately 60% of patients experience a satisfactory result. Second-
generation options such as loratadine have the added benefit of a lower
likelihood of side effects such as drowsiness. For those who fail to
achieve the desired result with monotherapy using an H1 antihistamine
receptor antagonist, the addition of an H2 antihistamine receptor
antagonist such as cimetidine or ranitidine is often beneficial. The
tricyclic antidepressant doxepin has strong H1 and H2 antihistamine
receptor antagonist effects and has been used as an off-label treatment
option in some studies. A short course of oral corticosteroids, narrow-
band UV light treatment, or cyclosporine can be used in the management
of recalcitrant chronic urticaria, but these are considered second- or
third-line adjunctive options.
A 62-year-old female with diabetes mellitus presents to your office with
left lower quadrant pain and guarding. She has a previous history of a
shellfish allergy that caused hives and swelling.
Further evaluation of this patient should include which one of the
following?
A) Ultrasonography of the abdomen
B) CT of the abdomen and pelvis with oral and intravenous (IV) contrast
C) Oral corticosteroids and antihistamines, then CT of the abdomen and
pelvis with oral and IV contrast
D) Intravenous corticosteroids and antihistamines, then CT of the
abdomen and pelvis with oral and IV contrast
E) Laparotomy - Correct Answer - B
Evaluation of this patient should include CT of the abdomen and pelvis
with oral and intravenous (IV) contrast. There is no reason to inquire
pg. 3
, about shellfish allergies prior to CT with IV contrast, because
premedication is not needed. There is no correlation between shellfish
allergies and allergic reactions to contrast. Patients with moderately
severe to severe reactions to IV contrast in the past would need
pretreatment with corticosteroids.
A 45-year-old female who works as a house cleaner presents with left
shoulder pain. On examination she has pain and relative weakness when
pushing toward the midline against resistance while the shoulder is
adducted and the elbow is bent to 90°. With the elbow still at 90° she is
unable to keep her left hand away from her body when you position her
hand behind her back.
This presentation is most consistent with an injury of which one of the
following tendons?
A) Deltoid
B) Infraspinatus
C) Subscapularis
D) Supraspinatus
E) Teres minor - Correct Answer - C
This patient's pain and weakness while pushing against resistance
reveals weakness on internal rotation of the shoulder, which suggests a
possible tear of the subscapularis tendon. The inability to keep her hand
away from her body when it is placed behind her back describes a
positive internal lag test, also suggesting involvement of the
subscapularis tendon. The infraspinatus and teres minor are involved in
external rotation rather than internal rotation. The supraspinatus and
deltoid are involved in abduction of the shoulder.
pg. 4
