ABFM IN-TRAINING EXAMINATION ACTUAL PRACTICE QUESTIONS WITH CORRECT ANSWERS AND EXPLANATION FROM PAGE 70 American Board of Family Medicine

ABFM IN-TRAINING EXAMINATION ACTUAL PRACTICE QUESTIONS WITH CORRECT ANSWERS AND EXPLANATION FROM PAGE 70 American Board of Family Medicine 1. A 67-year-old male sees you for a Medicare annual wellness visit. He tells you that his best friend had a stroke and he asks about his risk for stroke. He has no history of stroke, TIA, or neurologic symptoms. He has a family history of cardiovascular disease in his father, who had a myocardial infarction at age 65 and died from a thrombotic stroke at age 71. The patient exercises regularly and has a BMI of 27 kg/m2. His only current medical condition is hyperlipidemia, and his cholesterol level is at goal on rosuvastatin (Crestor), 10 mg daily. He also takes aspirin, 81 mg daily. His blood pressure is 125/78 mm Hg. Based on U.S. Preventive Services Task Force guidelines, which one of the following would be most appropriate at this time? A) No additional testing for stroke risk B) Auscultation for carotid bruits C) Carotid duplex ultrasonography D) Magnetic resonance angiography E) CT angiography of the carotid arteries 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 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 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 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. She has not had any numbness, weakness, or tingling. She has minimal discomfort when she presses on the lump, and it does not affect her activity. On examination her left wrist is neurovascularly intact. You note the Which one of the following management options would you recommend? A) Re-examination if she develops numbness, weakness, or increased pain B) Immobilization of the wrist for 6 weeks and then re-examination C) Aspiration of the lesion D) Aspiration and injection of the lesion with a corticosteroid E) Referral for excision of the lesion 6. A 57-year-old female with diabetes mellitus comes to your office for a routine follow-up. Her current medications include metformin (Glucophage), 1000 mg twice daily. She tells you that she does not exercise regularly and finds it difficult to follow a healthy diet. A hemoglobin A1c today is 7.5%. She does not want to add medications at this time, but she does want to get her hemoglobin A1c below 7%, which is the goal that was previously discussed. Which one of the following would be the most effective way to improve glucose control for this patient? A) Discuss the components of a healthy diabetic diet and encourage her to follow it more closely B) Discuss the importance of regular exercise and encourage her to exercise 30–45 minutes daily C) Recommend that she check her glucose level 1–3 times daily to help determine what adjustments need to be made D) Start her on an additional medication E) Refer her to a diabetes educator for medical nutrition therapy