ABFM KSA EXAM Q AND A 2026 STUDY
SHEET FULL SOLUTION VIEW AHEAD
◉ 60. The most common symptom of obstructive sleep apnea is
A) cough
B) excessive sleepiness
C) leg swelling
D) palpitations
E) weight gain
Answer: B
Obstructive sleep apnea (OSA) is the repetitive partial or complete
collapse of the upper airway during
sleep, resulting in episodic apnea or hypopnea lasting at least 10
seconds. OSA is common and affects 17%
of women and 34% of men. Risk factors include increased BMI, male
sex, postmenopausal state in
women, enlarged upper airway soft tissue, and craniofacial
abnormalities. The most common presenting symptom is excessive
sleepiness; patients may also present with fatigue and lack of energy.
Cough, leg swelling, palpitations, and weight gain are not among the
most common presenting symptoms of OSA. OSA increases the
incidence of heart failure, type 2 diabetes, hypertension, coronary
heart disease, stroke, atrial fibrillation, and death. OSA severity is
quantified using the apnea-hypopnea index. The diagnostic test of
,choice is laboratory-based polysomnography. Treatments include
behavioral measures (alcohol avoidance, weight loss, exercise, and
not sleeping in the supine position), medical devices (CPAP, oral
devices), and surgery.
◉ 61. A 56-year-old male who has heart failure with reduced
ejection fraction sees you for follow-up. He is stable but over the
past year has noted an increase in dyspnea with moderate activity.
His blood pressure is well controlled today. His current medications
include carvedilol (Coreg), losartan (Cozaar), and escitalopram
(Lexapro).
Which one of the following additions to his current medication
regimen has the best evidence for reducing his risk of mortality from
heart failure?
A) Aspirin
B) Atorvastatin (Lipitor)
C) Furosemide (Lasix)
D) Hydrochlorothiazide
E) Spironolactone (Aldactone)
Answer: E
This patient has symptomatic New York Heart Association class II
heart failure, and an escalation in
therapy is warranted. Both -blockers and aldosterone antagonists
have been shown to reduce mortality
,in patients with symptomatic heart failure (SOR A). Management of
associated cardiovascular disease such
as hyperlipidemia and hypertension is important to prevent disease
progression, but of the medications
listed (aspirin, atorvastatin, furosemide, hydrochlorothiazide, and
spironolactone) spironolactone is the best
choice to reduce heart failure-related mortality.
◉ 62. Chronic kidney disease is defined by abnormal kidney
structure or function lasting a minimum of
A) 2 months
B) 3 months
C) 6 months
D) 12 months
E) 24 months
Answer: B
Chronic kidney disease (CKD) is one of the most common chronic
disease states encountered by family
physicians, affecting 15% of the total U.S. adult population, and
substantially impacting health care costs as well as morbidity and
mortality. In the United States, diabetes mellitus and hypertension
are the most
common causes. CKD is defined by abnormal kidney structure or
function lasting greater than 3 months,
, with associated implications for health. Diagnostic criteria include a
persistent glomerular filtration rate
<60 mL/min/1.73 m2, albuminuria, urine sediment abnormalities,
renal imaging abnormalities, and serum
acid-base or electrolyte abnormalities.
◉ 63. A 55-year-old female with type 2 diabetes sees you because of
early satiety, nausea, vomiting, bloating, and postprandial fullness
that is sometimes accompanied by upper abdominal pain. Since
these symptoms have developed she has also noted increasing
difficulty with blood glucose control.
Which one of the following would be the best study for confirming
the most likely diagnosis?
A) Gastric emptying scintigraphy with a solid meal
B) Hepatobiliary scintigraphy (HIDA)
C) An upper gastrointestinal series with small-bowel follow-through
D) Abdominal ultrasonography
E) Abdominal CT
Answer: A
Gastroparesis is a complication of diabetes mellitus, and presents
with nausea, vomiting, early satiety,
bloating, postprandial fullness, and/or upper abdominal pain.
Gastric emptying scintigraphy with a solid
SHEET FULL SOLUTION VIEW AHEAD
◉ 60. The most common symptom of obstructive sleep apnea is
A) cough
B) excessive sleepiness
C) leg swelling
D) palpitations
E) weight gain
Answer: B
Obstructive sleep apnea (OSA) is the repetitive partial or complete
collapse of the upper airway during
sleep, resulting in episodic apnea or hypopnea lasting at least 10
seconds. OSA is common and affects 17%
of women and 34% of men. Risk factors include increased BMI, male
sex, postmenopausal state in
women, enlarged upper airway soft tissue, and craniofacial
abnormalities. The most common presenting symptom is excessive
sleepiness; patients may also present with fatigue and lack of energy.
Cough, leg swelling, palpitations, and weight gain are not among the
most common presenting symptoms of OSA. OSA increases the
incidence of heart failure, type 2 diabetes, hypertension, coronary
heart disease, stroke, atrial fibrillation, and death. OSA severity is
quantified using the apnea-hypopnea index. The diagnostic test of
,choice is laboratory-based polysomnography. Treatments include
behavioral measures (alcohol avoidance, weight loss, exercise, and
not sleeping in the supine position), medical devices (CPAP, oral
devices), and surgery.
◉ 61. A 56-year-old male who has heart failure with reduced
ejection fraction sees you for follow-up. He is stable but over the
past year has noted an increase in dyspnea with moderate activity.
His blood pressure is well controlled today. His current medications
include carvedilol (Coreg), losartan (Cozaar), and escitalopram
(Lexapro).
Which one of the following additions to his current medication
regimen has the best evidence for reducing his risk of mortality from
heart failure?
A) Aspirin
B) Atorvastatin (Lipitor)
C) Furosemide (Lasix)
D) Hydrochlorothiazide
E) Spironolactone (Aldactone)
Answer: E
This patient has symptomatic New York Heart Association class II
heart failure, and an escalation in
therapy is warranted. Both -blockers and aldosterone antagonists
have been shown to reduce mortality
,in patients with symptomatic heart failure (SOR A). Management of
associated cardiovascular disease such
as hyperlipidemia and hypertension is important to prevent disease
progression, but of the medications
listed (aspirin, atorvastatin, furosemide, hydrochlorothiazide, and
spironolactone) spironolactone is the best
choice to reduce heart failure-related mortality.
◉ 62. Chronic kidney disease is defined by abnormal kidney
structure or function lasting a minimum of
A) 2 months
B) 3 months
C) 6 months
D) 12 months
E) 24 months
Answer: B
Chronic kidney disease (CKD) is one of the most common chronic
disease states encountered by family
physicians, affecting 15% of the total U.S. adult population, and
substantially impacting health care costs as well as morbidity and
mortality. In the United States, diabetes mellitus and hypertension
are the most
common causes. CKD is defined by abnormal kidney structure or
function lasting greater than 3 months,
, with associated implications for health. Diagnostic criteria include a
persistent glomerular filtration rate
<60 mL/min/1.73 m2, albuminuria, urine sediment abnormalities,
renal imaging abnormalities, and serum
acid-base or electrolyte abnormalities.
◉ 63. A 55-year-old female with type 2 diabetes sees you because of
early satiety, nausea, vomiting, bloating, and postprandial fullness
that is sometimes accompanied by upper abdominal pain. Since
these symptoms have developed she has also noted increasing
difficulty with blood glucose control.
Which one of the following would be the best study for confirming
the most likely diagnosis?
A) Gastric emptying scintigraphy with a solid meal
B) Hepatobiliary scintigraphy (HIDA)
C) An upper gastrointestinal series with small-bowel follow-through
D) Abdominal ultrasonography
E) Abdominal CT
Answer: A
Gastroparesis is a complication of diabetes mellitus, and presents
with nausea, vomiting, early satiety,
bloating, postprandial fullness, and/or upper abdominal pain.
Gastric emptying scintigraphy with a solid
