ABFM EXAM TEST COMPLETE QUESTIONS AND
CORRECT VERIFIED ANSWERS (PRACTICE TEST)
ALL PASSED EXAM 2024 UPDATE
Which abx exacerbate prolonged QT syndrome
macrolides (azithromycin, erythromycin, etc) - interferes with the delayed rectifier
potassium current, which results in the accumulation of potassium ions in cardiac
myocytes and thereby delays cardiac repolarization. This leads to prolongation of the
QT interval.
strongest evidence for treatment, screening, or prevention strategies
systematic reviews, meta-analyses, randomized controlled trials (RCTs) with consistent
findings, or a single high-quality RCT
asymptomatic microscopic hematuria (AMH) defined as
≥3 RBCs/hpf
Inhaled corticosteroids increase the risk of
bruising, candidal infection of the oropharynx, and pneumonia
insidious onset, NO fever or wheezing, conjunctivitis
lab: eosinophilia
initial management of PCOS
lifestyle modification
metformin - may improve abnormal menstruation
small bone fragment at the dorsal surface of the proximal distal phalanx
mallet fracture
tx of mallet fracture
splinting the distal interphalangeal (DIP) joint in
extension, 8 weeks
>30% of the intra-articular surface, referral to a hand or orthopedic surgeon can be
considered
Severe pain and skin changes outside the realm of cellulitis, including bullae and
deeper
discoloration
necrotizing skin
labs to monitor when on amiodarone
TSH
have baseline thyroid function tests (free T4, TSH) with follow-up testing every 6
months
term for painful period
dysmenorrhea
antipsychotic with risk of steven johnson syndrome
,carbamazepine
Lamotrigine - slowly inc dose to prevent SJS. started at a dosage of 25 mg daily and
titrated every 2 weeks until the goal dosage
is reached
JNC 8 panel - first line treatment for hypertension in non-blacks
ACE/ARBs, thiazide, CCB
polymyalgia rheumatica (PMR) s/s
age > 50, proximal muscle pain, inc ESR
other s/s = fever, weight loss, malaise
PMR labs
inc ESR and CRP = inflam
CK wnl
PMR tx and confirmation of dx
response to prednisone within 24-48 hours (since lab with inc ESR = inflam process ->
steroid should help)
PMR associated with what dz
temporal arteritis
glucose above normal drops sodium by how much?
1.6 points for 100mg above normal glucose
DLCO
extent to which oxygen passes from the air sacs of the lungs into the blood.
acute, sharp chest pain relieved only by leaning forward, EKG shows diffuse ST
elevations
acute pericarditis
common causes of pericarditis
connective tissue disease, autoreactivity, or uremia
empiric tx for pericarditis
colchicine or NSAID
weight classification 2-18 years
BMI
weight classification 0-2 years
weight-for-length ratio
overweight 0-2 years
weight-for-length ratio exceeds the 95th percentile for their sex
obese 0-2 years
none - term not used in under 2 years
underweight 2-18 years
BMI falls below the 5th percentile
healthy weight 2-18 years
BMI is between the 5th and 85th percentile
overweight 2-18 years
BMI is between the 85th and 94th percentile
obese 2-18 years
,BMI is in the 95th or greater percentile
severe or extreme overweight 2-18 years
BMI is at the 99th percentile or greater
what medication can cause proximal muscle weakness + elevated CK
Statin
PMR vs statin myopathy
both cause proximal weakness
CK elevated in statin myopathy and wnl in PMR
mcc CAP in infant and school aged kids + tx
Strep pneumo - amoxicillin
mcc CAP in adults + tx
Strep - amox
Hemophilus
Morexella - azithro
mcc OSA in children + tx
enlarged tonsils and adenoids -> Adenotonsillectomy is the primary treatment for most
non-obese children
criteria for diastolic HF
symptoms and signs consistent with heart failure (including dyspnea), a nondilated left
ventricle with a preserved ejection fraction (³50%), and evidence of structural heart
disease such as diastolic dysfunction on echocardiography
Slipped capital femoral epiphysis (SCFE) occurs most commonly during what age
group
adolescent growth spurt (11-13 years of age for girls, 13-15 years of age for boys)
Slipped capital femoral epiphysis (SCFE) presentation
pain in the groin or anterior thigh, but also may present with pain referred to the knee
Legg-Calvé-Perthes disease, also known as avascular or aseptic necrosis of the
femoral head age group
boys 4-8 years of age
Legg-Calvé-Perthes disease, also known as avascular or aseptic necrosis of the
femoral head presentation
hip (or knee) pain and limping is a prominent feature
lateral hip pain with point tenderness over the greater trochanter of the femur
Trochanteric bursitis
valgus stress test has 100% sensitivity and 75% specificity for
ulnar collateral ligament (UCL)
ulnar collateral ligament (UCL) presentation
pop followed by immediate pain and bruising around the medial elbow
ulnar collateral ligament (UCL) common in what sports
sports that require overhead throwing, such as baseball, javelin, and volleyball
common CAP pathogen seen in patient with COPD on steroids
pseudomonas
medication for treating alcohol withdrawal (SOR A) and preventing alcohol
withdrawal seizures
benzo
, reduce a lateral patellar dislocation
Medially directed pressure on the patella while extending the leg
contraindication to oral contraception
severe hypertension
patient on high dose morphine reports of diffuse pain away from the site of the
original pain
Opioid-induced hyperalgesia is characterized by a paradoxical increase in sensitivity to
pain and allodynia, a perception of pain in the absence of a painful stimulus
management of chronic pain who's developed opioid induced hyperalgesia
reducing the current opioid dosage, and occasionally eliminating the current opioid and
starting another opioid
when is copper IUD preferred over hormon IUD
Hormonal contraceptives in general should be avoided in women with severe liver
disease, as there is a known association between oral contraceptive use and the growth
of hepatocellular adenoma
Breast cancer is another contraindication
EKG abnormalities would dictate the use of a pharmacologic stress test as
opposed to an exercise stress test?
LBBB - makes the EKG uninterpretable during an exercise stress test, and can also
interfere with nuclear imaging performed during the test. It is associated with transient
positive defects in the anteroseptal and septal regions in the absence of a lesion within
the left anterior descending coronary artery.
When is GI ppx indicated
Only critically ill patients who meet specific criteria should receive this therapy. One
indication for stress ulcer prophylaxis is prolonged mechanical ventilation for more than
48 hours.
Long term ppi associated with
long-term proton pump inhibitor therapy has been associated with complications such
as Clostridium difficile diarrhea and community-acquired pneumonia
Patholneumonic for slipped
greater limitation of internal rotation when the hip is flexed to 90°
How is the purpura from ITP different from vasculitic causes such as
meningococcal infection, disseminated intravascular coagulation, or Henoch-
Schönlein purpura
ITP is macular = smaller and flat vs the other ones are palpable/raised
ITP vs HUS/TTP
HUS/TTP = anemia, neurologic changes, fever, and renal failure
What lab should be tested for patients on carbamazepine and why
CBC - side effect of agranulocytosis
What lab should be tested for patients on imipramine and why
EKG 2/2 cardiac tox
How many days of thrombo ppx is recommended for patients going for ortho
surgery
At least 35 days outpatient
CORRECT VERIFIED ANSWERS (PRACTICE TEST)
ALL PASSED EXAM 2024 UPDATE
Which abx exacerbate prolonged QT syndrome
macrolides (azithromycin, erythromycin, etc) - interferes with the delayed rectifier
potassium current, which results in the accumulation of potassium ions in cardiac
myocytes and thereby delays cardiac repolarization. This leads to prolongation of the
QT interval.
strongest evidence for treatment, screening, or prevention strategies
systematic reviews, meta-analyses, randomized controlled trials (RCTs) with consistent
findings, or a single high-quality RCT
asymptomatic microscopic hematuria (AMH) defined as
≥3 RBCs/hpf
Inhaled corticosteroids increase the risk of
bruising, candidal infection of the oropharynx, and pneumonia
insidious onset, NO fever or wheezing, conjunctivitis
lab: eosinophilia
initial management of PCOS
lifestyle modification
metformin - may improve abnormal menstruation
small bone fragment at the dorsal surface of the proximal distal phalanx
mallet fracture
tx of mallet fracture
splinting the distal interphalangeal (DIP) joint in
extension, 8 weeks
>30% of the intra-articular surface, referral to a hand or orthopedic surgeon can be
considered
Severe pain and skin changes outside the realm of cellulitis, including bullae and
deeper
discoloration
necrotizing skin
labs to monitor when on amiodarone
TSH
have baseline thyroid function tests (free T4, TSH) with follow-up testing every 6
months
term for painful period
dysmenorrhea
antipsychotic with risk of steven johnson syndrome
,carbamazepine
Lamotrigine - slowly inc dose to prevent SJS. started at a dosage of 25 mg daily and
titrated every 2 weeks until the goal dosage
is reached
JNC 8 panel - first line treatment for hypertension in non-blacks
ACE/ARBs, thiazide, CCB
polymyalgia rheumatica (PMR) s/s
age > 50, proximal muscle pain, inc ESR
other s/s = fever, weight loss, malaise
PMR labs
inc ESR and CRP = inflam
CK wnl
PMR tx and confirmation of dx
response to prednisone within 24-48 hours (since lab with inc ESR = inflam process ->
steroid should help)
PMR associated with what dz
temporal arteritis
glucose above normal drops sodium by how much?
1.6 points for 100mg above normal glucose
DLCO
extent to which oxygen passes from the air sacs of the lungs into the blood.
acute, sharp chest pain relieved only by leaning forward, EKG shows diffuse ST
elevations
acute pericarditis
common causes of pericarditis
connective tissue disease, autoreactivity, or uremia
empiric tx for pericarditis
colchicine or NSAID
weight classification 2-18 years
BMI
weight classification 0-2 years
weight-for-length ratio
overweight 0-2 years
weight-for-length ratio exceeds the 95th percentile for their sex
obese 0-2 years
none - term not used in under 2 years
underweight 2-18 years
BMI falls below the 5th percentile
healthy weight 2-18 years
BMI is between the 5th and 85th percentile
overweight 2-18 years
BMI is between the 85th and 94th percentile
obese 2-18 years
,BMI is in the 95th or greater percentile
severe or extreme overweight 2-18 years
BMI is at the 99th percentile or greater
what medication can cause proximal muscle weakness + elevated CK
Statin
PMR vs statin myopathy
both cause proximal weakness
CK elevated in statin myopathy and wnl in PMR
mcc CAP in infant and school aged kids + tx
Strep pneumo - amoxicillin
mcc CAP in adults + tx
Strep - amox
Hemophilus
Morexella - azithro
mcc OSA in children + tx
enlarged tonsils and adenoids -> Adenotonsillectomy is the primary treatment for most
non-obese children
criteria for diastolic HF
symptoms and signs consistent with heart failure (including dyspnea), a nondilated left
ventricle with a preserved ejection fraction (³50%), and evidence of structural heart
disease such as diastolic dysfunction on echocardiography
Slipped capital femoral epiphysis (SCFE) occurs most commonly during what age
group
adolescent growth spurt (11-13 years of age for girls, 13-15 years of age for boys)
Slipped capital femoral epiphysis (SCFE) presentation
pain in the groin or anterior thigh, but also may present with pain referred to the knee
Legg-Calvé-Perthes disease, also known as avascular or aseptic necrosis of the
femoral head age group
boys 4-8 years of age
Legg-Calvé-Perthes disease, also known as avascular or aseptic necrosis of the
femoral head presentation
hip (or knee) pain and limping is a prominent feature
lateral hip pain with point tenderness over the greater trochanter of the femur
Trochanteric bursitis
valgus stress test has 100% sensitivity and 75% specificity for
ulnar collateral ligament (UCL)
ulnar collateral ligament (UCL) presentation
pop followed by immediate pain and bruising around the medial elbow
ulnar collateral ligament (UCL) common in what sports
sports that require overhead throwing, such as baseball, javelin, and volleyball
common CAP pathogen seen in patient with COPD on steroids
pseudomonas
medication for treating alcohol withdrawal (SOR A) and preventing alcohol
withdrawal seizures
benzo
, reduce a lateral patellar dislocation
Medially directed pressure on the patella while extending the leg
contraindication to oral contraception
severe hypertension
patient on high dose morphine reports of diffuse pain away from the site of the
original pain
Opioid-induced hyperalgesia is characterized by a paradoxical increase in sensitivity to
pain and allodynia, a perception of pain in the absence of a painful stimulus
management of chronic pain who's developed opioid induced hyperalgesia
reducing the current opioid dosage, and occasionally eliminating the current opioid and
starting another opioid
when is copper IUD preferred over hormon IUD
Hormonal contraceptives in general should be avoided in women with severe liver
disease, as there is a known association between oral contraceptive use and the growth
of hepatocellular adenoma
Breast cancer is another contraindication
EKG abnormalities would dictate the use of a pharmacologic stress test as
opposed to an exercise stress test?
LBBB - makes the EKG uninterpretable during an exercise stress test, and can also
interfere with nuclear imaging performed during the test. It is associated with transient
positive defects in the anteroseptal and septal regions in the absence of a lesion within
the left anterior descending coronary artery.
When is GI ppx indicated
Only critically ill patients who meet specific criteria should receive this therapy. One
indication for stress ulcer prophylaxis is prolonged mechanical ventilation for more than
48 hours.
Long term ppi associated with
long-term proton pump inhibitor therapy has been associated with complications such
as Clostridium difficile diarrhea and community-acquired pneumonia
Patholneumonic for slipped
greater limitation of internal rotation when the hip is flexed to 90°
How is the purpura from ITP different from vasculitic causes such as
meningococcal infection, disseminated intravascular coagulation, or Henoch-
Schönlein purpura
ITP is macular = smaller and flat vs the other ones are palpable/raised
ITP vs HUS/TTP
HUS/TTP = anemia, neurologic changes, fever, and renal failure
What lab should be tested for patients on carbamazepine and why
CBC - side effect of agranulocytosis
What lab should be tested for patients on imipramine and why
EKG 2/2 cardiac tox
How many days of thrombo ppx is recommended for patients going for ortho
surgery
At least 35 days outpatient
