ABFM KSA FINAL EXAM SCRIPT 2026
SOLVED QUESTIONS AND ANSWERS
◉ 21. A 30-year-old male is diagnosed with hereditary
hemochromatosis. Periodic therapeutic
phlebotomy may be appropriate to prevent
A) chronic liver disease
B) chronic renal disease
C) encephalopathy
D) myelofibrosis
E) Wilson disease
Answer: A
Hereditary hemochromatosis is a common inherited disorder of iron
metabolism. Iron deposits in the liver
may lead to chronic liver disease and hepatocellular cancer.
Screening for hereditary hemochromatosis
includes serum ferritin levels, a family history, and genetic testing.
Chronic renal disease, encephalopathy,
myelofibrosis, and Wilson disease (disorder of copper transport) do
not result from iron overload.
,◉ 22. A 14-year-old male is brought to your office by his parents,
who are concerned about his behavior. Recently he was caught
shoplifting video games. He started smoking cigarettes at age
10, and he has a history of truancy from school for the past 2 years.
His parents report that they have caught him starting fires outside of
their home, and he often teases the family dog, whom he has injured
on several occasions.
The most likely diagnosis is
A) antisocial personality disorder
B) attention-deficit/hyperactivity disorder (ADHD)
C) avoidant personality disorder
D) conduct disorder
E) substance abuse
Answer: D
Conduct disorder most commonly occurs during adolescence and
childhood. There are multiple criteria,
including aggression toward people and animals, theft, starting fires,
and truancy. It may be associated
with other disorders. Antisocial personality disorder, which is
usually diagnosed after age 18, involves a
disregard for the rights of others. Symptoms of attention-
deficit/hyperactivity disorder (ADHD) include
,inattention, impulsiveness, and hyperactivity. Avoidant personality
disorder is characterized by avoidance
of social situations and interactions with others. There is no
evidence of substance abuse in this patient's
history.
◉ 23. A 70-year-old female sees you for a Medicare annual wellness
visit. Her past medical history includes hypertension treated with
enalapril (Vasotec). She states that she "couldn't be better" and says
that she has no new symptoms or health concerns. She has a blood
pressure of 159/90mm Hg, a temperature of 36.7°C (98.1°F), a heart
rate of 76 beats/min, a respiratory rate of 17/min, and an oxygen
saturation of 98% on room air. On examination you note a new
harsh systolic murmur that is heard best at the second right
intercostal space and can also be heard over the right carotid artery.
A transthoracic echocardiogram reveals severe aortic stenosis.
Which one of the following should you recommend for this patient?
A) Antibiotic prophylaxis for dental procedures
B) Transesophageal echocardiography
C) Repeat echocardiography in 6 months
D) Referral for aortic valve replacement
Answer: C
This patient has severe aortic stenosis that is asymptomatic.
Watchful waiting is recommended for most asymptomatic patients.
, In asymptomatic patients with severe aortic stenosis, monitoring
with serial
echocardiography is recommended every 6-12 months. Antibiotic
prophylaxis is not indicated unless the
patient has undergone aortic valve replacement or has a history of
endocarditis. Transesophageal
echocardiography is not indicated in this situation. Aortic valve
replacement is indicated to decrease
mortality in patients with symptomatic aortic stenosis.
◉ 24. A 4-month-old female is brought to your office by her mother
for a well child visit. The mother tells you about some red patches on
the child's cheeks and legs that do not seem to bother the infant. She
says that the patches sometimes appear very irritated and improve
with occasional lotion use but keep coming back. The mother has
not noticed any signs of illness. An examination reveals a well
appearing infant with normal growth, development, and vital signs.
You note slightly rough erythematous patches on both cheeks and
her chin, as well as on her thighs.
Which one of the following would be most appropriate at this time?
A) Twice-daily application of a fragrance-free moisturizer with a
high lipid-to-water ratio
B) Twice-daily application of a low-potency topical corticosteroid
SOLVED QUESTIONS AND ANSWERS
◉ 21. A 30-year-old male is diagnosed with hereditary
hemochromatosis. Periodic therapeutic
phlebotomy may be appropriate to prevent
A) chronic liver disease
B) chronic renal disease
C) encephalopathy
D) myelofibrosis
E) Wilson disease
Answer: A
Hereditary hemochromatosis is a common inherited disorder of iron
metabolism. Iron deposits in the liver
may lead to chronic liver disease and hepatocellular cancer.
Screening for hereditary hemochromatosis
includes serum ferritin levels, a family history, and genetic testing.
Chronic renal disease, encephalopathy,
myelofibrosis, and Wilson disease (disorder of copper transport) do
not result from iron overload.
,◉ 22. A 14-year-old male is brought to your office by his parents,
who are concerned about his behavior. Recently he was caught
shoplifting video games. He started smoking cigarettes at age
10, and he has a history of truancy from school for the past 2 years.
His parents report that they have caught him starting fires outside of
their home, and he often teases the family dog, whom he has injured
on several occasions.
The most likely diagnosis is
A) antisocial personality disorder
B) attention-deficit/hyperactivity disorder (ADHD)
C) avoidant personality disorder
D) conduct disorder
E) substance abuse
Answer: D
Conduct disorder most commonly occurs during adolescence and
childhood. There are multiple criteria,
including aggression toward people and animals, theft, starting fires,
and truancy. It may be associated
with other disorders. Antisocial personality disorder, which is
usually diagnosed after age 18, involves a
disregard for the rights of others. Symptoms of attention-
deficit/hyperactivity disorder (ADHD) include
,inattention, impulsiveness, and hyperactivity. Avoidant personality
disorder is characterized by avoidance
of social situations and interactions with others. There is no
evidence of substance abuse in this patient's
history.
◉ 23. A 70-year-old female sees you for a Medicare annual wellness
visit. Her past medical history includes hypertension treated with
enalapril (Vasotec). She states that she "couldn't be better" and says
that she has no new symptoms or health concerns. She has a blood
pressure of 159/90mm Hg, a temperature of 36.7°C (98.1°F), a heart
rate of 76 beats/min, a respiratory rate of 17/min, and an oxygen
saturation of 98% on room air. On examination you note a new
harsh systolic murmur that is heard best at the second right
intercostal space and can also be heard over the right carotid artery.
A transthoracic echocardiogram reveals severe aortic stenosis.
Which one of the following should you recommend for this patient?
A) Antibiotic prophylaxis for dental procedures
B) Transesophageal echocardiography
C) Repeat echocardiography in 6 months
D) Referral for aortic valve replacement
Answer: C
This patient has severe aortic stenosis that is asymptomatic.
Watchful waiting is recommended for most asymptomatic patients.
, In asymptomatic patients with severe aortic stenosis, monitoring
with serial
echocardiography is recommended every 6-12 months. Antibiotic
prophylaxis is not indicated unless the
patient has undergone aortic valve replacement or has a history of
endocarditis. Transesophageal
echocardiography is not indicated in this situation. Aortic valve
replacement is indicated to decrease
mortality in patients with symptomatic aortic stenosis.
◉ 24. A 4-month-old female is brought to your office by her mother
for a well child visit. The mother tells you about some red patches on
the child's cheeks and legs that do not seem to bother the infant. She
says that the patches sometimes appear very irritated and improve
with occasional lotion use but keep coming back. The mother has
not noticed any signs of illness. An examination reveals a well
appearing infant with normal growth, development, and vital signs.
You note slightly rough erythematous patches on both cheeks and
her chin, as well as on her thighs.
Which one of the following would be most appropriate at this time?
A) Twice-daily application of a fragrance-free moisturizer with a
high lipid-to-water ratio
B) Twice-daily application of a low-potency topical corticosteroid
