ABFM HYPERTENSION EXAM 2025 | QUESTIONS
AND VERTIFIED CORRECT ANSWERS FOR
GUARANTEED PASS
Question 1
A 39-year-old male sees you for evaluation of high blood pressure. His past medical history is
unremarkable. On examination, he has a BMI of 32 kg/m², a round face, and a plethoric
complexion. His blood pressure is 150/98 mm Hg, pulse rate is 88 beats/min, and respiratory rate
is 16/min. Other notable findings include a prominent dorsal cervical fat pad, supraclavicular fat
pads, and violaceous striae on his trunk. Laboratory findings are notable only for a fasting
glucose level of 114 mg/dL.
Which one of the following is the most likely cause of his hypertension?
A) Addison's disease
B) Cushing syndrome
C) Hemochromatosis
D) Pheochromocytoma
E) Primary hyperaldosteronism
Answer: B) Cushing syndrome
Explanation:
This patient's clinical findings (round face, plethoric complexion, dorsal fat pad, supraclavicular
fat pads, violaceous striae, and elevated fasting glucose) are classic for Cushing syndrome,
which results from chronic glucocorticoid excess. The most common cause is exogenous
corticosteroid use, but adrenal neoplasms can also lead to endogenous hypercortisolism.
Question 2
You diagnose stage 2 hypertension in a 54-year-old male. His past medical history is otherwise
unremarkable, and a physical examination is notable for mild AV nicking on funduscopic
examination. A baseline EKG reveals evidence of left ventricular hypertrophy.
Which one of the following classes of antihypertensive agents has NOT been shown to
produce a regression of left ventricular hypertrophy?
A) ACE inhibitors
B) β-Blockers
C) Calcium channel blockers
D) Direct vasodilators
E) Thiazide diuretics
,Answer: D) Direct vasodilators
Explanation:
Regression of left ventricular hypertrophy (LVH) has been demonstrated with ACE inhibitors,
β-blockers, calcium channel blockers, and thiazide diuretics, but not with direct
vasodilators (e.g., hydralazine, minoxidil).
Question 3
According to currently accepted criteria, hypertension in children is defined as repeated blood
pressure measurements at or above a threshold of which one of the following percentiles for age,
sex, and height?
A) 80th
B) 85th
C) 90th
D) 95th
E) 99th
Answer: D) 95th
Explanation:
Hypertension in children is defined as blood pressure ≥95th percentile for age, sex, and height
on repeated measurements.
Question 4
Which one of the following conditions is associated with isolated systolic hypertension?
A) Aortic stenosis
B) Hypothyroidism
C) Paget's disease
D) Renovascular hypertension
E) Severe osteoporosis
Answer: C) Paget's disease
Explanation:
Isolated systolic hypertension (elevated systolic BP with normal diastolic BP) can occur in
conditions with increased cardiac output, such as Paget’s disease, hyperthyroidism, anemia,
and arteriovenous fistulas.
Question 5
A 59-year-old African-American male with hypercholesterolemia and gout has a blood pressure
of 144/85 mm Hg. Laboratory findings include:
, LDL-cholesterol: 82 mg/dL
HDL-cholesterol: 47 mg/dL
Serum triglycerides: 134 mg/dL
Serum creatinine: 1.7 mg/dL (eGFR 56 mL/min/1.73 m²).
Which one of the following does the JNC 8 panel recommend as initial management of this
patient's blood pressure elevation?
A) Lifestyle measures only
B) An ACE inhibitor
C) A calcium channel blocker
D) Hydralazine
E) Hydrochlorothiazide
Answer: B) An ACE inhibitor
Explanation:
JNC 8 recommends ACE inhibitors or ARBs as initial therapy in patients with chronic kidney
disease (CKD), regardless of ethnicity. Although thiazides or calcium channel blockers are
preferred in African-Americans without CKD, this patient’s reduced eGFR warrants an ACE
inhibitor.
Question 6
A 67-year-old male with hypertension and type 2 diabetes has inadequately controlled blood
pressure despite lisinopril (40 mg/day), hydrochlorothiazide (25 mg/day), and metformin (1500
mg/day). Laboratory findings include:
Hemoglobin A1c: 6.8%
Urinary albumin/creatinine ratio: 80 mg/g (normal <30).
Which one of the following agents should be AVOIDED in this patient?
A) Aliskiren (Tekturna)
B) Atenolol (Tenormin)
C) Diltiazem (Cardizem)
D) Doxazosin (Cardura)
E) Felodipine (Plendil)
Answer: A) Aliskiren (Tekturna)
Explanation:
The ALTITUDE trial showed that aliskiren (a direct renin inhibitor) increases renal
impairment, hypotension, and hyperkalemia when combined with ACE inhibitors or ARBs in
diabetic patients. The FDA contraindicates its use in this setting.
AND VERTIFIED CORRECT ANSWERS FOR
GUARANTEED PASS
Question 1
A 39-year-old male sees you for evaluation of high blood pressure. His past medical history is
unremarkable. On examination, he has a BMI of 32 kg/m², a round face, and a plethoric
complexion. His blood pressure is 150/98 mm Hg, pulse rate is 88 beats/min, and respiratory rate
is 16/min. Other notable findings include a prominent dorsal cervical fat pad, supraclavicular fat
pads, and violaceous striae on his trunk. Laboratory findings are notable only for a fasting
glucose level of 114 mg/dL.
Which one of the following is the most likely cause of his hypertension?
A) Addison's disease
B) Cushing syndrome
C) Hemochromatosis
D) Pheochromocytoma
E) Primary hyperaldosteronism
Answer: B) Cushing syndrome
Explanation:
This patient's clinical findings (round face, plethoric complexion, dorsal fat pad, supraclavicular
fat pads, violaceous striae, and elevated fasting glucose) are classic for Cushing syndrome,
which results from chronic glucocorticoid excess. The most common cause is exogenous
corticosteroid use, but adrenal neoplasms can also lead to endogenous hypercortisolism.
Question 2
You diagnose stage 2 hypertension in a 54-year-old male. His past medical history is otherwise
unremarkable, and a physical examination is notable for mild AV nicking on funduscopic
examination. A baseline EKG reveals evidence of left ventricular hypertrophy.
Which one of the following classes of antihypertensive agents has NOT been shown to
produce a regression of left ventricular hypertrophy?
A) ACE inhibitors
B) β-Blockers
C) Calcium channel blockers
D) Direct vasodilators
E) Thiazide diuretics
,Answer: D) Direct vasodilators
Explanation:
Regression of left ventricular hypertrophy (LVH) has been demonstrated with ACE inhibitors,
β-blockers, calcium channel blockers, and thiazide diuretics, but not with direct
vasodilators (e.g., hydralazine, minoxidil).
Question 3
According to currently accepted criteria, hypertension in children is defined as repeated blood
pressure measurements at or above a threshold of which one of the following percentiles for age,
sex, and height?
A) 80th
B) 85th
C) 90th
D) 95th
E) 99th
Answer: D) 95th
Explanation:
Hypertension in children is defined as blood pressure ≥95th percentile for age, sex, and height
on repeated measurements.
Question 4
Which one of the following conditions is associated with isolated systolic hypertension?
A) Aortic stenosis
B) Hypothyroidism
C) Paget's disease
D) Renovascular hypertension
E) Severe osteoporosis
Answer: C) Paget's disease
Explanation:
Isolated systolic hypertension (elevated systolic BP with normal diastolic BP) can occur in
conditions with increased cardiac output, such as Paget’s disease, hyperthyroidism, anemia,
and arteriovenous fistulas.
Question 5
A 59-year-old African-American male with hypercholesterolemia and gout has a blood pressure
of 144/85 mm Hg. Laboratory findings include:
, LDL-cholesterol: 82 mg/dL
HDL-cholesterol: 47 mg/dL
Serum triglycerides: 134 mg/dL
Serum creatinine: 1.7 mg/dL (eGFR 56 mL/min/1.73 m²).
Which one of the following does the JNC 8 panel recommend as initial management of this
patient's blood pressure elevation?
A) Lifestyle measures only
B) An ACE inhibitor
C) A calcium channel blocker
D) Hydralazine
E) Hydrochlorothiazide
Answer: B) An ACE inhibitor
Explanation:
JNC 8 recommends ACE inhibitors or ARBs as initial therapy in patients with chronic kidney
disease (CKD), regardless of ethnicity. Although thiazides or calcium channel blockers are
preferred in African-Americans without CKD, this patient’s reduced eGFR warrants an ACE
inhibitor.
Question 6
A 67-year-old male with hypertension and type 2 diabetes has inadequately controlled blood
pressure despite lisinopril (40 mg/day), hydrochlorothiazide (25 mg/day), and metformin (1500
mg/day). Laboratory findings include:
Hemoglobin A1c: 6.8%
Urinary albumin/creatinine ratio: 80 mg/g (normal <30).
Which one of the following agents should be AVOIDED in this patient?
A) Aliskiren (Tekturna)
B) Atenolol (Tenormin)
C) Diltiazem (Cardizem)
D) Doxazosin (Cardura)
E) Felodipine (Plendil)
Answer: A) Aliskiren (Tekturna)
Explanation:
The ALTITUDE trial showed that aliskiren (a direct renin inhibitor) increases renal
impairment, hypotension, and hyperkalemia when combined with ACE inhibitors or ARBs in
diabetic patients. The FDA contraindicates its use in this setting.
