ABFM FINAL PAPER 2026 COMPREHENSIVE
QUESTIONS AND ACCURATE SOLUTIONS
◉ entry to balloon time for PCI!
Answer: 120 minutes
◉ time limit from onset of MI to balloon time
Answer: should get it done w/in 12 hours
◉ Absolute contraindications to Fibrinolysis
Answer: Previous hemorrhage stroke
Previous ischemic stroke (4.5hrs-3months prior)
Suspected aortic dissection
Active bleeding (except menstruation)
BP >180/110 (severe hypertension)
Streptokinase 6 months prior
◉ acute cholecystitis
Answer: Acute inflammation of the gallbladder wall
,◉ Patient with pulmonary HTN due to left heart failure, can they
have vasodilators (PDE5?)
Answer: NO! can make things worse
-maximize heart failure treatment!
◉ Sever's Diseaese
Answer: Calcaneal apophysitis, also called Sever's disease, is a
common cause of heel pain in young athletes, especially those who
participate in basketball, soccer, track, and other sports that involve
running. Typically the heel apophysis closes by age 15. Treatment
options include activity modification, the use of ice packs and/or
moist heat, stretching, analgesics, and orthotic devices. The use of
therapeutic ultrasound on the active bone growth plates in children
is contraindicated.
◉ in pressure ulcers what solutions to avoid, and what to use!
Answer: recommended that pressure ulcers not be cleaned with
povidone/iodine, Dakin's solution, hydrogen peroxide, wet-to-dry
dressings, or any solutions that may impede granulation tissue
formation. These sites should be cleaned with either saline or tap
water and covered with hydrocolloid, foam, or another nonadherent
dressing that promotes a moist environment.
◉ Chronic paraoxysmal hemicrania
,Answer: resembles cluster headache but has some important
differences. Like cluster headaches, these headaches are unilateral
and accompanied by conjunctival hyperemia and rhinorrhea.
However, these headaches are more frequent in women, and the
paroxysms occur many times each day. This type of headache falls
into a group of headaches that have been labeled indomethacin-
responsive headaches because they respond dramatically to
*indomethacin.*
◉ normal spirometry but low DLCO
Answer: chronic pulmonary embolus
◉ Antibiotic ppx for dental procedures
Answer: give amoxicillin only if prior endocarditis, prosthetic valve,
heart txp, or severe or repaired congenital heart
-if allergic to penicillin, then give clinda!!
◉ when to refer patient with CKD to nephrology
Answer: Current guidelines recommend referral to a nephrologist if
a patient's renal disease is either of unknown etiology, is
deteriorating quickly (eGFR decreasing by >5 mL/min/1.73 m2 per
year), or is severe. Thresholds used to define severe chronic kidney
disease include an eGFR <30 mL/min/1.73 m2, a urine albumin to
creatinine ratio >300 g/mg, persistent acidosis or potassium
, imbalance, non-iron deficiency anemia with a hemoglobin level <10
g/dL, and evidence of secondary hyperparathyroidism.
◉ Causes of peripheral neuropathy
Answer: common treatable causes of peripheral neuropathy, which
include *diabetes mellitus, hypothyroidism, and nutritional
deficiencies*. Additional causes of peripheral neuropathy include
*chronic liver disease and renal disease*. It is important to consider
medications as a possible cause, including *amiodarone, digoxin,
nitrofurantoin, and statins. Excessive alcohol* use is another
important consideration. In addition think *MGUS, and Multiple
Myeloma*
◉ Failure rates of contraception
Answer: The annual failure rate of combined oral contraceptive pills
with typical use is 9%. Typical failure rates for other contraceptive
methods are 0.2% for the levonorgestrel IUD, 6% for injectable
progestin, 18% for male condoms, and 22% for the withdrawal
method.
◉ mental status exam for acute changes like delerium
Answer: Confusion Assessment Method (CAM)
◉ to diagnose adult ADHD, symptoms must be present before what
age?
QUESTIONS AND ACCURATE SOLUTIONS
◉ entry to balloon time for PCI!
Answer: 120 minutes
◉ time limit from onset of MI to balloon time
Answer: should get it done w/in 12 hours
◉ Absolute contraindications to Fibrinolysis
Answer: Previous hemorrhage stroke
Previous ischemic stroke (4.5hrs-3months prior)
Suspected aortic dissection
Active bleeding (except menstruation)
BP >180/110 (severe hypertension)
Streptokinase 6 months prior
◉ acute cholecystitis
Answer: Acute inflammation of the gallbladder wall
,◉ Patient with pulmonary HTN due to left heart failure, can they
have vasodilators (PDE5?)
Answer: NO! can make things worse
-maximize heart failure treatment!
◉ Sever's Diseaese
Answer: Calcaneal apophysitis, also called Sever's disease, is a
common cause of heel pain in young athletes, especially those who
participate in basketball, soccer, track, and other sports that involve
running. Typically the heel apophysis closes by age 15. Treatment
options include activity modification, the use of ice packs and/or
moist heat, stretching, analgesics, and orthotic devices. The use of
therapeutic ultrasound on the active bone growth plates in children
is contraindicated.
◉ in pressure ulcers what solutions to avoid, and what to use!
Answer: recommended that pressure ulcers not be cleaned with
povidone/iodine, Dakin's solution, hydrogen peroxide, wet-to-dry
dressings, or any solutions that may impede granulation tissue
formation. These sites should be cleaned with either saline or tap
water and covered with hydrocolloid, foam, or another nonadherent
dressing that promotes a moist environment.
◉ Chronic paraoxysmal hemicrania
,Answer: resembles cluster headache but has some important
differences. Like cluster headaches, these headaches are unilateral
and accompanied by conjunctival hyperemia and rhinorrhea.
However, these headaches are more frequent in women, and the
paroxysms occur many times each day. This type of headache falls
into a group of headaches that have been labeled indomethacin-
responsive headaches because they respond dramatically to
*indomethacin.*
◉ normal spirometry but low DLCO
Answer: chronic pulmonary embolus
◉ Antibiotic ppx for dental procedures
Answer: give amoxicillin only if prior endocarditis, prosthetic valve,
heart txp, or severe or repaired congenital heart
-if allergic to penicillin, then give clinda!!
◉ when to refer patient with CKD to nephrology
Answer: Current guidelines recommend referral to a nephrologist if
a patient's renal disease is either of unknown etiology, is
deteriorating quickly (eGFR decreasing by >5 mL/min/1.73 m2 per
year), or is severe. Thresholds used to define severe chronic kidney
disease include an eGFR <30 mL/min/1.73 m2, a urine albumin to
creatinine ratio >300 g/mg, persistent acidosis or potassium
, imbalance, non-iron deficiency anemia with a hemoglobin level <10
g/dL, and evidence of secondary hyperparathyroidism.
◉ Causes of peripheral neuropathy
Answer: common treatable causes of peripheral neuropathy, which
include *diabetes mellitus, hypothyroidism, and nutritional
deficiencies*. Additional causes of peripheral neuropathy include
*chronic liver disease and renal disease*. It is important to consider
medications as a possible cause, including *amiodarone, digoxin,
nitrofurantoin, and statins. Excessive alcohol* use is another
important consideration. In addition think *MGUS, and Multiple
Myeloma*
◉ Failure rates of contraception
Answer: The annual failure rate of combined oral contraceptive pills
with typical use is 9%. Typical failure rates for other contraceptive
methods are 0.2% for the levonorgestrel IUD, 6% for injectable
progestin, 18% for male condoms, and 22% for the withdrawal
method.
◉ mental status exam for acute changes like delerium
Answer: Confusion Assessment Method (CAM)
◉ to diagnose adult ADHD, symptoms must be present before what
age?
