ABFM ITE REAL EXAM COMPLETE 200 ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (CORRECT VERIFIED SOLUTIONS) LATEST
UPDATES |ALREADY GRADED A+ (BRAND NEW!!)
What is the criteria for chorioamnionitis? How would you treat? - ANSWER: Maternal
Fever >38 plus one of the following....
-Uterine tenderness
-Fetal tachycardia (>160bpm)
-Maternal leukocytosis
-Maternal tachycardia
-Foul-smelling amniotic fluid
Tx: Amp+ gent OR Clinda + Gent (if allergic to amp)
76 yo is brought by her daughter who is concerned about her mother's memory. 6
months ago, daughter took over mom's checkbook after she failed to pay bills. Her
mother seems unable to knit, something she enjoyed for years. She has difficulty
finding the words to complete a thought. Dx?
A. PT has dementia
B. Pt is delirious
C. The patient is depressed
D. The pt has mild cog impairment - ANSWER: The patient has dementia
-Progressive impairment
-Lead to loss of social and functional abilities
Greatest risk factor for developing dementia?
A. Family Hx
B. Phys Activity
C. Aging
D. Lack of mental exercise - ANSWER: Aging
What is Mild Cognitive Impairment? - ANSWER: -Complaint of memory impairment
-Objective memory loss
-Preserved general cog fnx
-Intact activities of daily living
-High risk of developing dementia
80 yo with 1yr becoming more sedentary w/difficulty completing ADLs, 2 falls.
Stepwise progression of deficits, can't manage finances, no change in
mood/personality. PMHx of diabetes, smoker, HTN. R grip is weaker vs L, no tremor.
1/5 on mini-cog test and the pt attempts to joke about not being able to perform
word recall.
A. Alzheimer's
B. Lewy Body
,C. Vascular
D. Frontotemporal - ANSWER: C. Vascular
-Hint is that it is stepwise progression
-Preserved personality, but emotional incontinence
69yo with rigidity, short-stepped gait, and masked facies. He also has become more
forgetful (mini-cog 2/5). Family thinks he sees things that aren't real.
What kind of dementia? - ANSWER: Lewy Body
-Dementia
-Parkinsonism + visual hallucinations
-Significant visuospatial deficits
64 yo brought in after exposing himself in public. He has also been urinating in the
kitchen sink and refuses to bathe. MMSE 26/30. Has some word-finding difficulties -
ANSWER: Frontotemporal
Key is this starts younger
First thing is behavioral issues
76 yo, difficulty walking and his "feet seem stuck together." Gait is widened, but arm
swing is maintained. Mild memory loss. Urge incontinence. - ANSWER: Normal
Pressure Hydrocephalus
-Key here is that the arm swing is maintained (less likely Parkinson's)
84 yo rapidly progressive dementia over 4 months. Has low-grade fever, very rigid,
and has myoclonic jerks when startled. EEG shows triphasic sharp wave complexes -
ANSWER: Creutzfeldt-Jakob Dz
-Rapid with myoclonus
-Tend to be younger, viral-like prions
Which is proven to be protective against dementia?
A. Estrogen
B. Educational attainment
C. Vit E
D Turmeric - ANSWER: Educational Attainment
USPSTF: Screening guideline for AAA - ANSWER: Men ages 65-75 one time who have
ever smoked
You identify a AAA in your pt. At what size should you refer for surgical intervention?
A. 3-3.5
B. 4-4.5
C. 5-5.5
D. 6-6.5 - ANSWER: 5-5.5
How often should you monitor a 3-3.9 cm AAA? - ANSWER: Every 36 months
,How often should you monitor a 4-4.9cm AAA? - ANSWER: Every 12 months
How often should you monitor a 5-5.4 cm AAA? - ANSWER: Every 6 months
Most common cause of AAA - ANSWER: Atherosclerosis
Most common cause of Aortic Dissection - ANSWER: HTN (2 lumen problem)
68 yo M presents with aching pain in both thighs after walking 1 block. Pain subsides
1-2 mins after he stops ambulating. The best initial test is:
A. ABI
B. Bil leg US
C. PVRs
D MRA of LE - ANSWER: A. ABI
What is a normal ABI? - ANSWER: 0.9-1.4
What if you have a very high ABI? - ANSWER: Noncompressible arteries (calcified
likely)
When obtaining ABI, AHA/ACC recommends obtaining the systolic BP in both arms
and using the higher of the readings. However, if a difference in systolic BP
>20mmHg between the arms, what is the most likely dx? - ANSWER: Subclavian
Artery Stenosis
What medication can be given to help with pain with claudication? - ANSWER:
Cilostazol
72 yo F comes with sudden, severe R leg pain from knees to toes. PMHx HTN, DB.
Vitals 160/90, pulse 120 and irregular, afebrile. R leg is cool to touch, pale in color,
you're unable to obtain a posterior tibial or dorsalis pedis pulse. At this point, you
should
A. Start heparin and immediately consult vasc sx
B. Immediately obtain US of the lower extremity
C. Immediately obtain an echo
D. Immediately obtain an AA US - ANSWER: A. Start heparin and immediately consult
vasc sx
What are the 5 Ps of acute arterial occlusion? - ANSWER: Pain
Pallor
Paresthesia
Pulselessness
Paralysis
TX: Heparin and consult vascular
, What is the most common source of acute arterial occlusion? - ANSWER:
Thromboembolism from the heart! Think A Fib
76 yo M with Hx of HTN, HLD, and smoking presents with with blue painful toes in
the setting of intact pulses. The most likely diagnosis is
A. Acute Gout
B. Raynaud's
C. Cellulitis
D. Blue Toe Syndrome - ANSWER: Blue Toe Syndrome
Raynaud's secondary disease association - ANSWER: Scleroderma/Sclerosis
SLE
What is GDMT for HFrEF? - ANSWER: RAAS Inhibitor (ARNI or ACE)
BB (carvedilol, metoprolol succ)
MRAs (spironolactone)
SGLT2 Inhibitor (empagliflozin)
How to treat LOW RISK, stable angina - ANSWER: Stable Angina: pain only with
exertion, alleviated at rest
LOW RISK: Not LAD or multivessel disease (seen on stress)
Tx: ASA, statin, BB/CCB. No PCI!!
What is the appropriate first line test for hyperaldosteronism? - ANSWER: -
Aldosterone/renin ratio
-Hypokalemia, HTN
Benign Esophageal Varices Treatment
A. Propanolol
B. Octreotide
C. Ligation
D. Repeat EGD 1-2yr
E. Nothing - ANSWER: Repeat EGD in 1-2 years
Mod risk? (Red whale sign or moderate size) = propanolol or ligation
High Risk/Bleeding = Octreotide
(From ITE 2022 #3)
What are the indications for dental antibiotic prophylaxis? - ANSWER: -Infective
endocarditis
-Valve replacement
-Hx of congenital heart defect
(From ITE 2022)
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (CORRECT VERIFIED SOLUTIONS) LATEST
UPDATES |ALREADY GRADED A+ (BRAND NEW!!)
What is the criteria for chorioamnionitis? How would you treat? - ANSWER: Maternal
Fever >38 plus one of the following....
-Uterine tenderness
-Fetal tachycardia (>160bpm)
-Maternal leukocytosis
-Maternal tachycardia
-Foul-smelling amniotic fluid
Tx: Amp+ gent OR Clinda + Gent (if allergic to amp)
76 yo is brought by her daughter who is concerned about her mother's memory. 6
months ago, daughter took over mom's checkbook after she failed to pay bills. Her
mother seems unable to knit, something she enjoyed for years. She has difficulty
finding the words to complete a thought. Dx?
A. PT has dementia
B. Pt is delirious
C. The patient is depressed
D. The pt has mild cog impairment - ANSWER: The patient has dementia
-Progressive impairment
-Lead to loss of social and functional abilities
Greatest risk factor for developing dementia?
A. Family Hx
B. Phys Activity
C. Aging
D. Lack of mental exercise - ANSWER: Aging
What is Mild Cognitive Impairment? - ANSWER: -Complaint of memory impairment
-Objective memory loss
-Preserved general cog fnx
-Intact activities of daily living
-High risk of developing dementia
80 yo with 1yr becoming more sedentary w/difficulty completing ADLs, 2 falls.
Stepwise progression of deficits, can't manage finances, no change in
mood/personality. PMHx of diabetes, smoker, HTN. R grip is weaker vs L, no tremor.
1/5 on mini-cog test and the pt attempts to joke about not being able to perform
word recall.
A. Alzheimer's
B. Lewy Body
,C. Vascular
D. Frontotemporal - ANSWER: C. Vascular
-Hint is that it is stepwise progression
-Preserved personality, but emotional incontinence
69yo with rigidity, short-stepped gait, and masked facies. He also has become more
forgetful (mini-cog 2/5). Family thinks he sees things that aren't real.
What kind of dementia? - ANSWER: Lewy Body
-Dementia
-Parkinsonism + visual hallucinations
-Significant visuospatial deficits
64 yo brought in after exposing himself in public. He has also been urinating in the
kitchen sink and refuses to bathe. MMSE 26/30. Has some word-finding difficulties -
ANSWER: Frontotemporal
Key is this starts younger
First thing is behavioral issues
76 yo, difficulty walking and his "feet seem stuck together." Gait is widened, but arm
swing is maintained. Mild memory loss. Urge incontinence. - ANSWER: Normal
Pressure Hydrocephalus
-Key here is that the arm swing is maintained (less likely Parkinson's)
84 yo rapidly progressive dementia over 4 months. Has low-grade fever, very rigid,
and has myoclonic jerks when startled. EEG shows triphasic sharp wave complexes -
ANSWER: Creutzfeldt-Jakob Dz
-Rapid with myoclonus
-Tend to be younger, viral-like prions
Which is proven to be protective against dementia?
A. Estrogen
B. Educational attainment
C. Vit E
D Turmeric - ANSWER: Educational Attainment
USPSTF: Screening guideline for AAA - ANSWER: Men ages 65-75 one time who have
ever smoked
You identify a AAA in your pt. At what size should you refer for surgical intervention?
A. 3-3.5
B. 4-4.5
C. 5-5.5
D. 6-6.5 - ANSWER: 5-5.5
How often should you monitor a 3-3.9 cm AAA? - ANSWER: Every 36 months
,How often should you monitor a 4-4.9cm AAA? - ANSWER: Every 12 months
How often should you monitor a 5-5.4 cm AAA? - ANSWER: Every 6 months
Most common cause of AAA - ANSWER: Atherosclerosis
Most common cause of Aortic Dissection - ANSWER: HTN (2 lumen problem)
68 yo M presents with aching pain in both thighs after walking 1 block. Pain subsides
1-2 mins after he stops ambulating. The best initial test is:
A. ABI
B. Bil leg US
C. PVRs
D MRA of LE - ANSWER: A. ABI
What is a normal ABI? - ANSWER: 0.9-1.4
What if you have a very high ABI? - ANSWER: Noncompressible arteries (calcified
likely)
When obtaining ABI, AHA/ACC recommends obtaining the systolic BP in both arms
and using the higher of the readings. However, if a difference in systolic BP
>20mmHg between the arms, what is the most likely dx? - ANSWER: Subclavian
Artery Stenosis
What medication can be given to help with pain with claudication? - ANSWER:
Cilostazol
72 yo F comes with sudden, severe R leg pain from knees to toes. PMHx HTN, DB.
Vitals 160/90, pulse 120 and irregular, afebrile. R leg is cool to touch, pale in color,
you're unable to obtain a posterior tibial or dorsalis pedis pulse. At this point, you
should
A. Start heparin and immediately consult vasc sx
B. Immediately obtain US of the lower extremity
C. Immediately obtain an echo
D. Immediately obtain an AA US - ANSWER: A. Start heparin and immediately consult
vasc sx
What are the 5 Ps of acute arterial occlusion? - ANSWER: Pain
Pallor
Paresthesia
Pulselessness
Paralysis
TX: Heparin and consult vascular
, What is the most common source of acute arterial occlusion? - ANSWER:
Thromboembolism from the heart! Think A Fib
76 yo M with Hx of HTN, HLD, and smoking presents with with blue painful toes in
the setting of intact pulses. The most likely diagnosis is
A. Acute Gout
B. Raynaud's
C. Cellulitis
D. Blue Toe Syndrome - ANSWER: Blue Toe Syndrome
Raynaud's secondary disease association - ANSWER: Scleroderma/Sclerosis
SLE
What is GDMT for HFrEF? - ANSWER: RAAS Inhibitor (ARNI or ACE)
BB (carvedilol, metoprolol succ)
MRAs (spironolactone)
SGLT2 Inhibitor (empagliflozin)
How to treat LOW RISK, stable angina - ANSWER: Stable Angina: pain only with
exertion, alleviated at rest
LOW RISK: Not LAD or multivessel disease (seen on stress)
Tx: ASA, statin, BB/CCB. No PCI!!
What is the appropriate first line test for hyperaldosteronism? - ANSWER: -
Aldosterone/renin ratio
-Hypokalemia, HTN
Benign Esophageal Varices Treatment
A. Propanolol
B. Octreotide
C. Ligation
D. Repeat EGD 1-2yr
E. Nothing - ANSWER: Repeat EGD in 1-2 years
Mod risk? (Red whale sign or moderate size) = propanolol or ligation
High Risk/Bleeding = Octreotide
(From ITE 2022 #3)
What are the indications for dental antibiotic prophylaxis? - ANSWER: -Infective
endocarditis
-Valve replacement
-Hx of congenital heart defect
(From ITE 2022)
