ABFM IN TRAINING EXAM PEARLS
QUESTIONS AND ANSWERS GRADED A+
2025/2026
Pre-exposure prophylaxis (PrEP), what meds, and what do you have check first? -
ANS Emtricitabine/tenofovir
gotta check Hep B first
-apparently they kill hep B too, so if you suddenly stop the med, then reactivated hep B can lead
to liver disease
entry to balloon time for PCI! - ANS 120 minutes
time limit from onset of MI to balloon time - ANS should get it done w/in 12 hours
Absolute contraindications to Fibrinolysis - ANS 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
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,acute cholecystitis - ANS Acute inflammation of the gallbladder wall
Patient with pulmonary HTN due to left heart failure, can they have vasodilators (PDE5?) -
ANS NO! can make things worse
-maximize heart failure treatment!
Sever's Diseaese - ANS 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! - ANS 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 - ANS 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 - ANS chronic pulmonary embolus
Antibiotic ppx for dental procedures - ANS give amoxicillin only if prior endocarditis,
prosthetic valve, heart txp, or severe or repaired congenital heart
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, -if allergic to penicillin, then give clinda!!
when to refer patient with CKD to nephrology - ANS 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 - ANS 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 - ANS 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 - ANS Confusion Assessment Method
(CAM)
to diagnose adult ADHD, symptoms must be present before what age? - ANS Age 12
Complications of GERD in infants - ANS Gastroesophageal reflux accounts for a significant
number of cases of failure to thrive, crib death, and recurrent pneumonia. Features of
gastroesophageal reflux include a history of recurrent pneumonia, a low growth curve, a family
history of sudden infant death syndrome, and normocytic anemia.
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
QUESTIONS AND ANSWERS GRADED A+
2025/2026
Pre-exposure prophylaxis (PrEP), what meds, and what do you have check first? -
ANS Emtricitabine/tenofovir
gotta check Hep B first
-apparently they kill hep B too, so if you suddenly stop the med, then reactivated hep B can lead
to liver disease
entry to balloon time for PCI! - ANS 120 minutes
time limit from onset of MI to balloon time - ANS should get it done w/in 12 hours
Absolute contraindications to Fibrinolysis - ANS 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
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,acute cholecystitis - ANS Acute inflammation of the gallbladder wall
Patient with pulmonary HTN due to left heart failure, can they have vasodilators (PDE5?) -
ANS NO! can make things worse
-maximize heart failure treatment!
Sever's Diseaese - ANS 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! - ANS 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 - ANS 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 - ANS chronic pulmonary embolus
Antibiotic ppx for dental procedures - ANS give amoxicillin only if prior endocarditis,
prosthetic valve, heart txp, or severe or repaired congenital heart
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, -if allergic to penicillin, then give clinda!!
when to refer patient with CKD to nephrology - ANS 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 - ANS 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 - ANS 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 - ANS Confusion Assessment Method
(CAM)
to diagnose adult ADHD, symptoms must be present before what age? - ANS Age 12
Complications of GERD in infants - ANS Gastroesophageal reflux accounts for a significant
number of cases of failure to thrive, crib death, and recurrent pneumonia. Features of
gastroesophageal reflux include a history of recurrent pneumonia, a low growth curve, a family
history of sudden infant death syndrome, and normocytic anemia.
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
