ABFM KSA EXAM STUDY GUIDE 2026
COMPLETE TEST BANK WITH ANSWERS
◉ 2. A 28-year-old female presents for evaluation of nasal
congestion, sneezing, watery eyes, and postnasal drip. This has been
an intermittent issue for her every spring and she would like to
manage it more effectively.
Which one of the following treatments has been shown to be the
most effective and best tolerated
first-line therapy for this patient's condition?
A) A leukotriene receptor antagonist
B) Intranasal corticosteroid monotherapy
C) Intranasal corticosteroids plus an oral antihistamine
D) Inhaled corticosteroids
E) Annual triamcinolone injections
Answer: B
This patient has seasonal allergic rhinitis. A joint guideline
statement from the American Academy of
Allergy, Asthma, and Immunology/American College of Allergy,
Asthma, and Immunology Joint Task
Force on Practice Parameters recommends that monotherapy with
intranasal corticosteroids should be
,prescribed initially in patients 12 years of age rather than combined
treatment with oral antihistamines
because data has not shown an additional benefit to adding the
antihistamine. Higher patient adherence and
tolerance and fewer side effects were seen with the monotherapy
regimen. High-quality evidence indicates
that intranasal corticosteroids were more effective than leukotriene
receptor antagonists. Inhaled
corticosteroids and triamcinolone injections are not appropriate
first-line options for the treatment of
seasonal allergic rhinitis.
◉ 3. A 68-year-old female presents with a 2-month history of watery
diarrhea. She has not had any blood or pus in her stools, and the
stools are not oily. She has not had any history of fever, chills, or
weight loss, and has not traveled recently. She smokes one pack of
cigarettes per day.
Her medications include ibuprofen, sertraline (Zoloft), and
pantoprazole (Protonix). A CBC, metabolic panel, C-reactive protein
level, IgA anti-tissue transglutaminase level, total IgA level, and stool
guaiac test are all normal.
Which one of the following tests would be most likely to yield a
diagnosis?
A) Clostridioides (Clostridium) difficile toxin
,B) Colonoscopy
C) Fecal calprotectin
D) A stool culture
E) Stool examination for ova and parasites
Answer: B
In patients with chronic nonbloody diarrhea, the differential
diagnosis includes microscopic (lymphocytic
or collagenous) colitis. The mucosa appears normal on colonoscopy
but a biopsy will show lymphocytic
infiltration of the epithelium. The etiology of this is unknown but
there are several risk factors to consider,
including older age, female sex, and smoking status. Drugs with a
high level of evidence for causing
microscopic colitis include NSAIDs, proton pump inhibitors,
sertraline, acarbose, aspirin, and ticlopidine.
Clostridioides (Clostridium) difficile should be suspected in
individuals who have taken antibiotics in the past 3 months. Fecal
calprotectin is elevated in inflammatory diarrhea such as Crohn's
disease or ulcerative colitis. A stool culture would be indicated if
there is suspicion of an infectious bacterial diarrhea such as Shigella
or Salmonella, but these bacteria tend to cause bloody diarrhea.
Checking for a parasitic infection should be considered for patients
with a history of recent travel or exposure to unpurified water.
, ◉ 4. A 23-year-old male with opioid use disorder requests
buprenorphine therapy. He is still actively
using immediate-release oxycodone (Roxicodone) and he took a
dose 2 hours ago.
This patient should begin buprenorphine induction
A) now
B) in 2 hours
C) 8-12 hours after his last opioid use
D) 24 hours after his last opioid use
E) 1 week after his last opioid use
Answer: C
Buprenorphine is a partial opioid agonist. In order to reduce the risk
of precipitated withdrawal,
buprenorphine induction should begin once the patient is exhibiting
signs of mild to moderate withdrawal,
usually 8-12 hours after the last opioid use. Waiting until a patient
goes through full withdrawal increases
the chances that the patient will revert back to using opioids.
◉ 5. A 45-year-old left hand-dominant female presents to your office
with a lump on her hand. She first noticed the lump 2 weeks ago and
thinks it has gotten bigger. She does not recall any injury.
COMPLETE TEST BANK WITH ANSWERS
◉ 2. A 28-year-old female presents for evaluation of nasal
congestion, sneezing, watery eyes, and postnasal drip. This has been
an intermittent issue for her every spring and she would like to
manage it more effectively.
Which one of the following treatments has been shown to be the
most effective and best tolerated
first-line therapy for this patient's condition?
A) A leukotriene receptor antagonist
B) Intranasal corticosteroid monotherapy
C) Intranasal corticosteroids plus an oral antihistamine
D) Inhaled corticosteroids
E) Annual triamcinolone injections
Answer: B
This patient has seasonal allergic rhinitis. A joint guideline
statement from the American Academy of
Allergy, Asthma, and Immunology/American College of Allergy,
Asthma, and Immunology Joint Task
Force on Practice Parameters recommends that monotherapy with
intranasal corticosteroids should be
,prescribed initially in patients 12 years of age rather than combined
treatment with oral antihistamines
because data has not shown an additional benefit to adding the
antihistamine. Higher patient adherence and
tolerance and fewer side effects were seen with the monotherapy
regimen. High-quality evidence indicates
that intranasal corticosteroids were more effective than leukotriene
receptor antagonists. Inhaled
corticosteroids and triamcinolone injections are not appropriate
first-line options for the treatment of
seasonal allergic rhinitis.
◉ 3. A 68-year-old female presents with a 2-month history of watery
diarrhea. She has not had any blood or pus in her stools, and the
stools are not oily. She has not had any history of fever, chills, or
weight loss, and has not traveled recently. She smokes one pack of
cigarettes per day.
Her medications include ibuprofen, sertraline (Zoloft), and
pantoprazole (Protonix). A CBC, metabolic panel, C-reactive protein
level, IgA anti-tissue transglutaminase level, total IgA level, and stool
guaiac test are all normal.
Which one of the following tests would be most likely to yield a
diagnosis?
A) Clostridioides (Clostridium) difficile toxin
,B) Colonoscopy
C) Fecal calprotectin
D) A stool culture
E) Stool examination for ova and parasites
Answer: B
In patients with chronic nonbloody diarrhea, the differential
diagnosis includes microscopic (lymphocytic
or collagenous) colitis. The mucosa appears normal on colonoscopy
but a biopsy will show lymphocytic
infiltration of the epithelium. The etiology of this is unknown but
there are several risk factors to consider,
including older age, female sex, and smoking status. Drugs with a
high level of evidence for causing
microscopic colitis include NSAIDs, proton pump inhibitors,
sertraline, acarbose, aspirin, and ticlopidine.
Clostridioides (Clostridium) difficile should be suspected in
individuals who have taken antibiotics in the past 3 months. Fecal
calprotectin is elevated in inflammatory diarrhea such as Crohn's
disease or ulcerative colitis. A stool culture would be indicated if
there is suspicion of an infectious bacterial diarrhea such as Shigella
or Salmonella, but these bacteria tend to cause bloody diarrhea.
Checking for a parasitic infection should be considered for patients
with a history of recent travel or exposure to unpurified water.
, ◉ 4. A 23-year-old male with opioid use disorder requests
buprenorphine therapy. He is still actively
using immediate-release oxycodone (Roxicodone) and he took a
dose 2 hours ago.
This patient should begin buprenorphine induction
A) now
B) in 2 hours
C) 8-12 hours after his last opioid use
D) 24 hours after his last opioid use
E) 1 week after his last opioid use
Answer: C
Buprenorphine is a partial opioid agonist. In order to reduce the risk
of precipitated withdrawal,
buprenorphine induction should begin once the patient is exhibiting
signs of mild to moderate withdrawal,
usually 8-12 hours after the last opioid use. Waiting until a patient
goes through full withdrawal increases
the chances that the patient will revert back to using opioids.
◉ 5. A 45-year-old left hand-dominant female presents to your office
with a lump on her hand. She first noticed the lump 2 weeks ago and
thinks it has gotten bigger. She does not recall any injury.
