ABFM ITE EXAM NEWEST 2026 ACTUAL EXAM TEST
BANK| AMERICAN BOARD OF FAMILY MEDICINE IN-
TRAINING FINAL EXAM REVIEW WITH 350 REAL
EXAM QESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED
A+ (MOST RECENT!!)
Based on American Cancer Society guidelines for cervical cancer
screening, when should HPV DNA co-testing first be performed along
with Papanicolaou testing?
A) At the onset of sexual activity
B) At age 21
C) At age 25
D) At age 30 - Correct Answer - D
According to American Cancer Society guidelines for cervical cancer
screening, Papanicolaou (Pap) testing should begin at age 21 irrespective
of sexual activity and should be continued every 3 years until age 29.
The preferred screening strategy beginning at age 30 is Pap testing with
HPV co-testing, which should be continued every 5 years until age 65.
Cervical screening may be discontinued at that time if the patient's last
two tests have been negative and the patient was tested within the
previous 5 years.
Long-term proton pump inhibitor use is associated with an increased risk
for
A) Barrett's esophagus
B) gout
C) hypertension
pg. 1
,D) pneumonia - Correct Answer - D
Acid suppression therapy is associated with an increased risk of
community-acquired and health care-associated pneumonia, which is
related to gastric overgrowth by gram-negative bacteria. Long-term
treatment of Barrett's esophagus is an indication for chronic proton
pump inhibitor (PPI) use. PPI therapy does not increase the risk of gout,
hypertension, or type 2 diabetes.
An 87-year-old female comes to your office for an annual health
maintenance visit. She appears cachectic and tells you that for the past 6
months she has had a decreased appetite and generalized muscle
weakness. The patient is alert and oriented to person and place. She has
a 10% weight loss, dry mucous membranes, and tenting of the skin on
the extensor surface of her hands. While inflating the blood pressure cuff
on her right arm you observe carpopedal spasms.
Which one of the following is the most likely electrolyte disturbance?
A) Hypercalcemia
B) Hypocalcemia
C) Hypokalemia
D) Hypernatremia - Correct Answer - B
A Trousseau sign, defined as spasmodic contraction of muscles caused
by pressure on the nerves that control them, is present in up to 94% of
patients with hypocalcemia. Hypercalcemia is more likely to present
with hyperreflexia. Patients with hypokalemia, hypernatremia, or
hyponatremia may present with weakness and confusion, but tetany is
not a common sign of either sodium or potassium imbalance.
A 32-year-old female who is one of your longtime patients calls you
because of a 24-hour history of painful urination with urinary frequency
and urgency. She is otherwise healthy and does not have any fever,
pg. 2
,chills, back pain, or vaginal discharge. She uses an oral contraceptive
pill and states that her last menstrual period was normal and occurred
last week.
Which one of the following would be most appropriate at this time?
A) Empiric antibiotic treatment
B) A urinalysis
C) A urine culture
D) Plain abdominal radiographs - Correct Answer - A
This patient has symptoms of acute simple cystitis and does not have
any symptoms that would suggest a complicated urinary tract infection
or vaginal infection. In these cases treatment with oral antibiotic therapy
may be prescribed without further evaluation (SOR B). Simple cystitis is
a clinical diagnosis and a urinalysis and urine culture are not necessary.
The patient does not have any symptoms that warrant evaluation with
abdominal radiographs or pelvic ultrasonography.
You are asked for your advice as part of a committee formed by your
local health system to focus on fall prevention. Based on U.S. Preventive
Services Task Force recommendations, which one of the following
interventions has the strongest evidence for preventing falls in
community-dwelling older adults at increased risk for falls?
A) Calcium supplementation
B) Vitamin D supplementation
C) Supportive footwear
D) Exercise classes - Correct Answer - D
In the United States falls are the leading cause of injury-related
morbidity and mortality among older adults. The U.S. Preventive
Services Task Force (USPSTF) concluded with moderate certainty that
exercise interventions provide a moderate net benefit in fall prevention
pg. 3
, in community-dwelling adults 65 years of age or older who are at
increased risk for falls (B recommendation). The USPSTF also
concluded with moderate certainty that supplementation with calcium
and vitamin D has no clear benefit in preventing falls in older adults.
Environmental modifications and psychological interventions lack
sufficient evidence for fall prevention.
A 42-year-old male presents with a 10-day history of hoarseness. He also
has a 2-month history of reflux symptoms and has been taking antacids
as needed. He does not take any other medications. There is no history
of fever, weight loss, night sweats, or appetite changes. You note that the
patient is hoarse, and a physical examination is normal, including
HEENT, cardiovascular, and pulmonary examinations. He is a member
of a community choir that rehearses twice a week.
In addition to voice rest, which one of the following would be most
appropriate at this time?
A) Supportive care only
B) Azithromycin (Zithromax)
C) Omeprazole (Prilosec)
D) A course of prednisone - Correct Answer - C
This patient has hoarseness that has been present for less than 2 weeks.
In addition to voice rest, treatment in patients with a history of GERD
should include a 3- to 4-month trial of a high-dose proton pump inhibitor
(SOR C). In patients with hoarseness lasting longer than 2 weeks
without an apparent benign etiology, the larynx should be examined by
direct or indirect laryngoscopy (SOR C). Antibiotics and oral
corticosteroids should not be used for the empiric treatment of
hoarseness in the absence of signs and symptoms that suggest an
underlying cause.
pg. 4
BANK| AMERICAN BOARD OF FAMILY MEDICINE IN-
TRAINING FINAL EXAM REVIEW WITH 350 REAL
EXAM QESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED
A+ (MOST RECENT!!)
Based on American Cancer Society guidelines for cervical cancer
screening, when should HPV DNA co-testing first be performed along
with Papanicolaou testing?
A) At the onset of sexual activity
B) At age 21
C) At age 25
D) At age 30 - Correct Answer - D
According to American Cancer Society guidelines for cervical cancer
screening, Papanicolaou (Pap) testing should begin at age 21 irrespective
of sexual activity and should be continued every 3 years until age 29.
The preferred screening strategy beginning at age 30 is Pap testing with
HPV co-testing, which should be continued every 5 years until age 65.
Cervical screening may be discontinued at that time if the patient's last
two tests have been negative and the patient was tested within the
previous 5 years.
Long-term proton pump inhibitor use is associated with an increased risk
for
A) Barrett's esophagus
B) gout
C) hypertension
pg. 1
,D) pneumonia - Correct Answer - D
Acid suppression therapy is associated with an increased risk of
community-acquired and health care-associated pneumonia, which is
related to gastric overgrowth by gram-negative bacteria. Long-term
treatment of Barrett's esophagus is an indication for chronic proton
pump inhibitor (PPI) use. PPI therapy does not increase the risk of gout,
hypertension, or type 2 diabetes.
An 87-year-old female comes to your office for an annual health
maintenance visit. She appears cachectic and tells you that for the past 6
months she has had a decreased appetite and generalized muscle
weakness. The patient is alert and oriented to person and place. She has
a 10% weight loss, dry mucous membranes, and tenting of the skin on
the extensor surface of her hands. While inflating the blood pressure cuff
on her right arm you observe carpopedal spasms.
Which one of the following is the most likely electrolyte disturbance?
A) Hypercalcemia
B) Hypocalcemia
C) Hypokalemia
D) Hypernatremia - Correct Answer - B
A Trousseau sign, defined as spasmodic contraction of muscles caused
by pressure on the nerves that control them, is present in up to 94% of
patients with hypocalcemia. Hypercalcemia is more likely to present
with hyperreflexia. Patients with hypokalemia, hypernatremia, or
hyponatremia may present with weakness and confusion, but tetany is
not a common sign of either sodium or potassium imbalance.
A 32-year-old female who is one of your longtime patients calls you
because of a 24-hour history of painful urination with urinary frequency
and urgency. She is otherwise healthy and does not have any fever,
pg. 2
,chills, back pain, or vaginal discharge. She uses an oral contraceptive
pill and states that her last menstrual period was normal and occurred
last week.
Which one of the following would be most appropriate at this time?
A) Empiric antibiotic treatment
B) A urinalysis
C) A urine culture
D) Plain abdominal radiographs - Correct Answer - A
This patient has symptoms of acute simple cystitis and does not have
any symptoms that would suggest a complicated urinary tract infection
or vaginal infection. In these cases treatment with oral antibiotic therapy
may be prescribed without further evaluation (SOR B). Simple cystitis is
a clinical diagnosis and a urinalysis and urine culture are not necessary.
The patient does not have any symptoms that warrant evaluation with
abdominal radiographs or pelvic ultrasonography.
You are asked for your advice as part of a committee formed by your
local health system to focus on fall prevention. Based on U.S. Preventive
Services Task Force recommendations, which one of the following
interventions has the strongest evidence for preventing falls in
community-dwelling older adults at increased risk for falls?
A) Calcium supplementation
B) Vitamin D supplementation
C) Supportive footwear
D) Exercise classes - Correct Answer - D
In the United States falls are the leading cause of injury-related
morbidity and mortality among older adults. The U.S. Preventive
Services Task Force (USPSTF) concluded with moderate certainty that
exercise interventions provide a moderate net benefit in fall prevention
pg. 3
, in community-dwelling adults 65 years of age or older who are at
increased risk for falls (B recommendation). The USPSTF also
concluded with moderate certainty that supplementation with calcium
and vitamin D has no clear benefit in preventing falls in older adults.
Environmental modifications and psychological interventions lack
sufficient evidence for fall prevention.
A 42-year-old male presents with a 10-day history of hoarseness. He also
has a 2-month history of reflux symptoms and has been taking antacids
as needed. He does not take any other medications. There is no history
of fever, weight loss, night sweats, or appetite changes. You note that the
patient is hoarse, and a physical examination is normal, including
HEENT, cardiovascular, and pulmonary examinations. He is a member
of a community choir that rehearses twice a week.
In addition to voice rest, which one of the following would be most
appropriate at this time?
A) Supportive care only
B) Azithromycin (Zithromax)
C) Omeprazole (Prilosec)
D) A course of prednisone - Correct Answer - C
This patient has hoarseness that has been present for less than 2 weeks.
In addition to voice rest, treatment in patients with a history of GERD
should include a 3- to 4-month trial of a high-dose proton pump inhibitor
(SOR C). In patients with hoarseness lasting longer than 2 weeks
without an apparent benign etiology, the larynx should be examined by
direct or indirect laryngoscopy (SOR C). Antibiotics and oral
corticosteroids should not be used for the empiric treatment of
hoarseness in the absence of signs and symptoms that suggest an
underlying cause.
pg. 4
