ABFM ITE EXAM | ABFM ITE 2024 ACTUAL
g g g g g g g
EXAM (200 QUESTIONS AND ANSWERS WITH R
g g g g g g
ATIONALES RATED A g g
Ag42-year-oldgAsiangmalegpresentsgforgfollow-
upgofgelevatedgbloodgpressure.gHeghasgnogadditionalgchronicgmedicalgproblemsgan
dgisgotherwisegasymptomatic.gAngexaminationgisgsignificantgforgagbloodgpressurego
fg162/95gmmgHggbutgisgotherwisegunremarkable.
LaboratorygFindings
Sodiumg138gmEq/Lg(Ng135-145)gPotassiumg3.9gmEq/Lg(Ng3.5-
5.5)gFastingglucoseg86mg/dLBUNg14gmg/dLg(Ng10-20)gCreatinineg0.6mg/dL(N0.6-
1.3)gUrinemicroalbumingnegative
AccordinggtogthegAmericangCollegegofgCardiology/AmericangHeartgAssociationg201
7gguidelines,gwhichgonegofgthegfollowinggwouldgbegthegmostgappropriategmedicati
ongtoginitiategatgthisgtime?
A) Clonidineg(Catapres),g0.1gmggtwicegdaily
B) Hydralazine,g25gmggthreegtimesgdaily
C) Lisinopril/hydrochlorothiazideg(Zestoretic),g10/12.5gmggdaily
D) Metoprololgtartrateg(Lopressor),g25gmggtwicegdaily
E) Triamtereneg(Dyrenium),g50gmggdaily
ANSWER:gC
g
ThisgpatientghasghypertensiongandgaccordinggtogbothgJNCg8gandgAmericangColleg
egofgCardiology/AmericangHeartgAssociationg2017gguidelines,gantihypertensivegt
reatmentgshouldgbeginitiated.gForgtheggeneralgnon-African-
Americang population,gmonotherapygwithgangACEginhibitor,gangangiotensingrecep
torgblocker,gagcalciumgchannelgblocker,gorgagthiazidegdiureticgwouldgbegappropria
tegforginitialgmanagement.gItgisgalsogappropriategtoginitiategcombinationgantihyp
ertensivegtherapygasganginitialgmanagementgstrategy,galthoughgpatientsgshouldg
notgtakegangACEginhibitorgandgangangiotensingreceptorgblocker
,simultaneously.gStudiesghavegshowngthatgbloodgpressuregcontrolgisgachievedg
fastergwithgtheginitiationgofgcombinationgtherapygcomparedgtogmonotherapy,
gwithoutgangincreasegingmorbidity.gLisinopril/hydrochlorothiazidegwouldgbega
ngappropriategchoicegingthisgpatient.g-Blockers,gvasodilators,g-
blockers,gandgpotassium-
sparinggdiureticsgaregnotgrecommendedgasginitialgchoicesgforgthegtreatmentgo
fghypertension.
Duringgroundsgatgthegnursingghome,gyougareginformedgthatgtheregaregtwogresidents
gongthegunitgwithglaboratory-
confirmedginfluenza.gAccordinggtogCDCgguidelines,g whogshouldgreceivegchemopro
phylaxisgforginfluenza?
A) Onlygsymptomaticgresidentsgongthegsamegunit
B) Onlygsymptomaticgresidentsgingthegentiregfacility
C) Allgasymptomaticgresidentsgongthegsamegunit
D) Allgresidentsgofgthegfacilitygregardlessgofgsymptoms
E) Allgstaffgregardlessgofgsymptoms
ANSWER:gC
g
Inglong-termgcaregfacilities,ganginfluenzagoutbreakgisgdefinedgasgtwoglaboratory-
gconfirmedgcasesgofginfluenzagwithing72ghoursgingpatientsgongthegsamegunit.gTheg
CDCgrecommendsgchemoprophylaxisgforgallgasymptomaticgresidentsgofgthegaffec
tedgunit.gAnygresidentgexhibitinggsymptomsgofginfluenzagshouldgbegtreatedgforgin
fluenzagandgnotggivengchemoprophylaxisgdosing.gChemoprophylaxisgisgnotgreco
mmendedgforgresidentsgofgothergunitsgunlessgtheregaregtwoglaboratory-
gconfirmedgcasesgingthosegunits.gFacilitygstaffgofgthegaffectedgunitgcangbegconsider
edgforgchemoprophylaxisgifgtheyghavegnotgbeengvaccinatedgorgifgtheyghadgagrecen
tgvaccination,gbutgchemoprophylaxisgisgnotgrecommendedgforgallgstaffgingthegenti
regfacility.
,Ag24-year-oldgfemalegpresentsgwithgag2-
dayghistorygofgmildgtogmoderategpelvicgpain.gSheghasghadgtwogmalegsexgpartnersgi
ngtheglastg6gmonthsgandgusesgoralgcontraceptivesgandgsometimesgcondoms.gAgphy
sicalgexaminationgrevealsgagtemperaturegofg36.4°Cg(97.5°F)gandgmoderategcervical
gmotiongandguterinegtenderness.gUrineghCGgandgagurinalysisgaregnegative.gVaginalg
microscopygshowsgonlygWBCs.
Theginitiationgofgantibioticsgforgtreatmentgofgpelvicginflammatorygdiseasegingthisgp
atient
A) isgappropriategatgthisgtime
B) requiresgangelevatedgtemperature,gWBCgcount,gorgC-reactivegproteinglevel
C) shouldgbegbasedgongthegresultsgofggonorrheagandgChlamydiagtesting
D) shouldgbegbasedgongthegresultsgofgpelvicgultrasonography
ANSWER:gA
g
Pelvicginflammatorygdiseaseg(PID)gisgagclinicalgdiagnosis,gandgtreatmentgshouldgb
egadministeredgatgthegtimegofgdiagnosisgandgnotgdelayedguntilgthegresultsgofgtheg
nucleicgacidgamplificationgtestingg(NAAT)gforggonorrheagandgChlamydiagaregretu
rned.gThegclinicalgdiagnosisgisgbasedgongangat-
riskgwomangpresentinggwithglowergabdominalgorgpelvicgpain,gaccompaniedgbygc
ervicalgmotion,guterine,gorgadnexalgtendernessgthatgcangrangegfromgmildgtogseve
re.gTheregisgoftengagmucopurulentgdischargegorgWBCsgongsalinegmicroscopy.gAcu
tegphasegindicatorsgsuchgasgfever,gleukocytosis,gorgangelevatedgC-
reactivegproteinglevelgmaygbeghelpfulgbutgaregneithergsensitivegnorgspecific.gAgpo
sitivegNAATgisgnotgrequiredgforgdiagnosisgandgtreatmentgbecauseganguppergtractg
infectiongmaygbegpresent,gorgthegcausativegagentgmaygnotgbeggonorrheagorgChla
mydia.gPIDgshouldgbegconsideredgagpolymicrobialginfection.gPelvicgultrasonogra
phygmaygbegusedgifgtheregisgagconcerngaboutgothergpathologygsuchgasgagtubo-
ovariangabscess.
, Ag24-year-
oldgpatientgwantsgtogstartgthegprocessgofgtransitioninggfromgfemalegtogmale.gHegha
sgbeengworkinggwithgagpsychiatristgwhoghasgconfirmedgthegdiagnosisgofggendergdys
phoria.
Whichgonegofgthegfollowinggwouldgbegthegbestginitialgtreatmentgforgthisgpatient?
A) Clomiphene
B) Letrozoleg(Femara)
C) Leuprolideg(Eligard)
D) Spironolactoneg(Aldactone)
E) Testosterone
ANSWER:gE
Forgpatientsgwithggendergdysphoriagorggendergincongruencegwhogdesireghormo
negtreatment,gthegtreatmentggoalgisgtogsuppressgendogenousgsexghormonegprod
uctiongandgmaintaingsexghormoneglevelsgingthegnormalgrangegforgtheirgaffirmedg
gender.gForgagfemale-to-
malegtransgendergpatientgthisgisgmostgeasilygaccomplishedgwithgtestosterone.g
Whengtestosteroneglevelsgaregmaintainedgingthegnormalggeneticgmalegrange,ggo
nadotropinsgandgovarianghormonegproductiongisgsuppressed,gwhichgaccomplish
esgbothggoalsgforghormonalgtreatmentgwithoutgthegneedgforgadditionalggonadotr
opingsuppressiongfromgmedicationsgsuchgasgleuprolide.
Clomiphenegcangincreasegserumgtestosteroneglevels,gbutgonlygingthegpresencegof
gagfunctioninggtesticle.gLetrozolegisgangestrogengreceptorgantagonist,gbutgitgwoul
dgnotgincreasegserumgtestosteroneglevels.gSpironolactoneghasgandrogengrecepto
rgblockinggeffectsgandgwouldgnotgaccomplishgeithergofgtheghormonegtreatmentgg
oals.
BasedgongAmericangCancergSocietygguidelinesgforgcervicalgcancergscreening,gwhengsho
uldgHPVgDNAgco-testinggfirstgbegperformedgalonggwithgPapanicolaougtesting?
A) Atgthegonsetgofgsexualgactivity
g g g g g g g
EXAM (200 QUESTIONS AND ANSWERS WITH R
g g g g g g
ATIONALES RATED A g g
Ag42-year-oldgAsiangmalegpresentsgforgfollow-
upgofgelevatedgbloodgpressure.gHeghasgnogadditionalgchronicgmedicalgproblemsgan
dgisgotherwisegasymptomatic.gAngexaminationgisgsignificantgforgagbloodgpressurego
fg162/95gmmgHggbutgisgotherwisegunremarkable.
LaboratorygFindings
Sodiumg138gmEq/Lg(Ng135-145)gPotassiumg3.9gmEq/Lg(Ng3.5-
5.5)gFastingglucoseg86mg/dLBUNg14gmg/dLg(Ng10-20)gCreatinineg0.6mg/dL(N0.6-
1.3)gUrinemicroalbumingnegative
AccordinggtogthegAmericangCollegegofgCardiology/AmericangHeartgAssociationg201
7gguidelines,gwhichgonegofgthegfollowinggwouldgbegthegmostgappropriategmedicati
ongtoginitiategatgthisgtime?
A) Clonidineg(Catapres),g0.1gmggtwicegdaily
B) Hydralazine,g25gmggthreegtimesgdaily
C) Lisinopril/hydrochlorothiazideg(Zestoretic),g10/12.5gmggdaily
D) Metoprololgtartrateg(Lopressor),g25gmggtwicegdaily
E) Triamtereneg(Dyrenium),g50gmggdaily
ANSWER:gC
g
ThisgpatientghasghypertensiongandgaccordinggtogbothgJNCg8gandgAmericangColleg
egofgCardiology/AmericangHeartgAssociationg2017gguidelines,gantihypertensivegt
reatmentgshouldgbeginitiated.gForgtheggeneralgnon-African-
Americang population,gmonotherapygwithgangACEginhibitor,gangangiotensingrecep
torgblocker,gagcalciumgchannelgblocker,gorgagthiazidegdiureticgwouldgbegappropria
tegforginitialgmanagement.gItgisgalsogappropriategtoginitiategcombinationgantihyp
ertensivegtherapygasganginitialgmanagementgstrategy,galthoughgpatientsgshouldg
notgtakegangACEginhibitorgandgangangiotensingreceptorgblocker
,simultaneously.gStudiesghavegshowngthatgbloodgpressuregcontrolgisgachievedg
fastergwithgtheginitiationgofgcombinationgtherapygcomparedgtogmonotherapy,
gwithoutgangincreasegingmorbidity.gLisinopril/hydrochlorothiazidegwouldgbega
ngappropriategchoicegingthisgpatient.g-Blockers,gvasodilators,g-
blockers,gandgpotassium-
sparinggdiureticsgaregnotgrecommendedgasginitialgchoicesgforgthegtreatmentgo
fghypertension.
Duringgroundsgatgthegnursingghome,gyougareginformedgthatgtheregaregtwogresidents
gongthegunitgwithglaboratory-
confirmedginfluenza.gAccordinggtogCDCgguidelines,g whogshouldgreceivegchemopro
phylaxisgforginfluenza?
A) Onlygsymptomaticgresidentsgongthegsamegunit
B) Onlygsymptomaticgresidentsgingthegentiregfacility
C) Allgasymptomaticgresidentsgongthegsamegunit
D) Allgresidentsgofgthegfacilitygregardlessgofgsymptoms
E) Allgstaffgregardlessgofgsymptoms
ANSWER:gC
g
Inglong-termgcaregfacilities,ganginfluenzagoutbreakgisgdefinedgasgtwoglaboratory-
gconfirmedgcasesgofginfluenzagwithing72ghoursgingpatientsgongthegsamegunit.gTheg
CDCgrecommendsgchemoprophylaxisgforgallgasymptomaticgresidentsgofgthegaffec
tedgunit.gAnygresidentgexhibitinggsymptomsgofginfluenzagshouldgbegtreatedgforgin
fluenzagandgnotggivengchemoprophylaxisgdosing.gChemoprophylaxisgisgnotgreco
mmendedgforgresidentsgofgothergunitsgunlessgtheregaregtwoglaboratory-
gconfirmedgcasesgingthosegunits.gFacilitygstaffgofgthegaffectedgunitgcangbegconsider
edgforgchemoprophylaxisgifgtheyghavegnotgbeengvaccinatedgorgifgtheyghadgagrecen
tgvaccination,gbutgchemoprophylaxisgisgnotgrecommendedgforgallgstaffgingthegenti
regfacility.
,Ag24-year-oldgfemalegpresentsgwithgag2-
dayghistorygofgmildgtogmoderategpelvicgpain.gSheghasghadgtwogmalegsexgpartnersgi
ngtheglastg6gmonthsgandgusesgoralgcontraceptivesgandgsometimesgcondoms.gAgphy
sicalgexaminationgrevealsgagtemperaturegofg36.4°Cg(97.5°F)gandgmoderategcervical
gmotiongandguterinegtenderness.gUrineghCGgandgagurinalysisgaregnegative.gVaginalg
microscopygshowsgonlygWBCs.
Theginitiationgofgantibioticsgforgtreatmentgofgpelvicginflammatorygdiseasegingthisgp
atient
A) isgappropriategatgthisgtime
B) requiresgangelevatedgtemperature,gWBCgcount,gorgC-reactivegproteinglevel
C) shouldgbegbasedgongthegresultsgofggonorrheagandgChlamydiagtesting
D) shouldgbegbasedgongthegresultsgofgpelvicgultrasonography
ANSWER:gA
g
Pelvicginflammatorygdiseaseg(PID)gisgagclinicalgdiagnosis,gandgtreatmentgshouldgb
egadministeredgatgthegtimegofgdiagnosisgandgnotgdelayedguntilgthegresultsgofgtheg
nucleicgacidgamplificationgtestingg(NAAT)gforggonorrheagandgChlamydiagaregretu
rned.gThegclinicalgdiagnosisgisgbasedgongangat-
riskgwomangpresentinggwithglowergabdominalgorgpelvicgpain,gaccompaniedgbygc
ervicalgmotion,guterine,gorgadnexalgtendernessgthatgcangrangegfromgmildgtogseve
re.gTheregisgoftengagmucopurulentgdischargegorgWBCsgongsalinegmicroscopy.gAcu
tegphasegindicatorsgsuchgasgfever,gleukocytosis,gorgangelevatedgC-
reactivegproteinglevelgmaygbeghelpfulgbutgaregneithergsensitivegnorgspecific.gAgpo
sitivegNAATgisgnotgrequiredgforgdiagnosisgandgtreatmentgbecauseganguppergtractg
infectiongmaygbegpresent,gorgthegcausativegagentgmaygnotgbeggonorrheagorgChla
mydia.gPIDgshouldgbegconsideredgagpolymicrobialginfection.gPelvicgultrasonogra
phygmaygbegusedgifgtheregisgagconcerngaboutgothergpathologygsuchgasgagtubo-
ovariangabscess.
, Ag24-year-
oldgpatientgwantsgtogstartgthegprocessgofgtransitioninggfromgfemalegtogmale.gHegha
sgbeengworkinggwithgagpsychiatristgwhoghasgconfirmedgthegdiagnosisgofggendergdys
phoria.
Whichgonegofgthegfollowinggwouldgbegthegbestginitialgtreatmentgforgthisgpatient?
A) Clomiphene
B) Letrozoleg(Femara)
C) Leuprolideg(Eligard)
D) Spironolactoneg(Aldactone)
E) Testosterone
ANSWER:gE
Forgpatientsgwithggendergdysphoriagorggendergincongruencegwhogdesireghormo
negtreatment,gthegtreatmentggoalgisgtogsuppressgendogenousgsexghormonegprod
uctiongandgmaintaingsexghormoneglevelsgingthegnormalgrangegforgtheirgaffirmedg
gender.gForgagfemale-to-
malegtransgendergpatientgthisgisgmostgeasilygaccomplishedgwithgtestosterone.g
Whengtestosteroneglevelsgaregmaintainedgingthegnormalggeneticgmalegrange,ggo
nadotropinsgandgovarianghormonegproductiongisgsuppressed,gwhichgaccomplish
esgbothggoalsgforghormonalgtreatmentgwithoutgthegneedgforgadditionalggonadotr
opingsuppressiongfromgmedicationsgsuchgasgleuprolide.
Clomiphenegcangincreasegserumgtestosteroneglevels,gbutgonlygingthegpresencegof
gagfunctioninggtesticle.gLetrozolegisgangestrogengreceptorgantagonist,gbutgitgwoul
dgnotgincreasegserumgtestosteroneglevels.gSpironolactoneghasgandrogengrecepto
rgblockinggeffectsgandgwouldgnotgaccomplishgeithergofgtheghormonegtreatmentgg
oals.
BasedgongAmericangCancergSocietygguidelinesgforgcervicalgcancergscreening,gwhengsho
uldgHPVgDNAgco-testinggfirstgbegperformedgalonggwithgPapanicolaougtesting?
A) Atgthegonsetgofgsexualgactivity
