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ABFM Questions (Adult) 2024/2025
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ABFM Questions (Adult) 2024/2025 ABFM Questions (Adult) 2024/2025 ABFM Questions (Adult) 2024/2025
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ABFM Questions (Adult) 2024/2025Side effect of denosumab and bisphosphonates - verified answer Jaw osteonecrosis
Most likely to induce remission in Crohn dz - verified answer corticosteroids > 5-ASA > infliximab
Bisphosphonates shouldn't be used in pts w/CLCr less than - verified answer 35 mL/min/1.73m2
Bisphosphonates use for 5+ years risks... - verified answer atypical femoral shaft fractures,
recommend drug holiday
Denosumab is safe in CKD because - verified answer not cleared by kidneys
IBD diagnosis made via - verified answer endoscopy with biopsies
First line for treating DM neuropathy - verified answer TCAs (amitriptyline) > SNRI, pregabalin >
antiSz
Best management for acute urticaria - verified answer second generation X-H1 (longer acting, less
drowsy vs 1st gen)
Type of symptoms of depression seen most in elderly - verified answer somatic symptoms (also in
preg women, children, low income)
Best abx treatment for diabetic foot ulcer - verified answer Vanc/Zosyn (Piperacillin/tazobactam) ->
covers MRSA, pseudomonas
Percent of wt loss leading to stat-significant improvement of lipid ratios, blood glucose, CAD risk
reduction - verified answer at least 10%
Most effective weight reduction and long-term maintenance treatment for morbidly obese - verified
answer bariatric surgery (gastric bypass had mean wt loss 71.2% at 3 year, 20% at 6 years); reduce
blood glucose, resolve DMII
,Which are some severe CAP symptoms requiring inpatient - verified answer confusion, tachypnea,
hypotension, multilobar infiltrates (IV ceftriaxone and oral azithromycin)
Outpatient treatment for mild/mod CAP w/out many comorbidities - verified answer oral
macrolide (azithromycin, clarithromycin, erythromycin) or doxycycline -> add fluoroquins, beta-
lactams if comorbidities
Next drug to step up to after albuterol fails to control mild asthma - verified answer fluticasone
inhaler
Shown to shorten course of Bell's palsy - verified answer corticosteroids (antivirals don't do a thing)
Best TB test for immigrants w/bacille Calmette-Guerin (BCG) vaccine - verified answer Interferon
gamma release assay (QuantiFERON-TB Gold)
... - verified answer
If blood sugar of DM pt who takes long acting insulin at night is high during breakfast/lunch/dinner,
how do you switch up their insulin regimen? - verified answer add short acting insulin before the
last meal (if high during bedtime, add insulin during dinner; if high b4 dinner, add insulin at lunch
time; if high b4 lunch, add at breakfast)
Post-op delirium in elderly -> tx? - verified answer adequate pain control and reorientation, don't
sedate
Hoarseness that doesn't resolve in 3 months, next best step - verified answer laryngoscopy (sooner
than 3 mo if more serious condition suspected); voice rest for 2 weeks if Hx of URI/vocal abuse
Effect of long term tx for narcotic addiction w/methadone and buprenorphine - verified answer
greater success at producing opiate abstinence than detox programs
How often to monitor serum Ca and Phos level in CKD? - verified answer 3-6 mo for Ca2+ and 6-12
mo for Phos w/goal to normalize
,Tramadol should be avoided in pts w/which kind of dz - verified answer seizures, lower sz threshold
Linear excoriation, thickened skin on forearms/legs/neck due to excessive scratching -> dx? tx? -
verified answer Lichen simplex chronicus presentation -> topical steroids w/occlusive bandage
Best initial approach to wt loss per USPSTF - verified answer behavioral counseling (high intensity)
Medical conditions that reduce response to warfarin (reduce INR) - verified answer
hypothyroidism, visceral carcinoma, high vitK intake, DM, hyperlipidemia
Medical conditions that increase response to warfarin (increase INR more) - verified answer vitK
def (low dietary intake), malabsorption, scurvy, malnutrition, cachexia, small body size, liver dz, renal
dz, fever, hyperthyroidism, infectious dz, HF, biliary obstruction
MC etiology for acute laryngitis - verified answer viral, tx symptoms (red oropharynx w/out
exudate, mucosal congestion, can't talk)
Although helpful by themselves in protecting kidneys in DM, which two drugs should not be used
together - verified answer ACE inhibitors and ARBs; higher Cr levels, increased likelihood that
dialysis will become necessary
Dermatologic disease assoc with Hep C - verified answer lichen planus (pruritic polygonal papules)
and porphyria cutanea tarda
Has the legal authority to revoke/restrict a patient's driver's license - verified answer
representative of state DMV (physicians can make recommendations but can't legally restrict)
MC causes of CAP in healthy adolescents - verified answer Mycoplasma, Chlamydophilia, group A
Strep (outpatient -> azithromycin; inpatient -> ceftriax + erythromycin/azithromycn
Still suspecting subarachnoid bleed (continued worse HA) after neg/equivocal head CT, next step? -
verified answer lumbar puncture (look for xanthochromia, its absence rules out subarachnoid
bleed)
, Morphine should be avoided in patients with this kind of organ disease - verified answer renal
disease; toxic metabolites of morphine are not eliminated by kidneys in this case -> resp depression,
myoclonus, confusion (use fentanyl, methadone in CKD)
Do this if you find trace valvular regurgitation on initial echocardiogram - verified answer nothing,
normal finding (70-90% of norm individuals)
Risk factor for esophageal adenocarcinoma - verified answer obesity -> GERD
Rx: Increase risk of bruising, oral candidiasis, decrease COPD exacerbations, but no effect on
mortality/FEV1 - verified answer inhaled corticosteroids
Post-tx febrile reaction w/malaise and HA within a 6-8 hours of treating syphilis - verified answer
Jarisch-Herxheimer reaction -> reassurance, pyretics
Other receptors besides aldosterone that are bound by spironolactone - verified answer androgen
and progesterone -> breast tenderness/ gynecomastia (eplerenone, ++specific to aldost-R, less ADEs)
Hematospermia in pts younger than 40, next best step after examining testes and prostate - verified
answer STD screen (no imaging, PSA levels, or referral to uro unless Hx or exam suggests unusual
cause)
Best kind of nutrition for patients with severe pancreatitis and prolonged bowel rest - verified
answer enteral nutrition (assoc w/shorter stay)
Biggest electrolyte feature of hypoparathyroidism plus clinically relevant symptoms - verified
answer hypocalcemia (refractory HF due to low Ca2+ interfering w/myocyte contractility, tetany, sz,
AMS, stridor)
Middle age patient with resistant HTN and kypokalemia - verified answer hyperaldosterone-
secreting adrenal mass -> get [peripheral aldosterone] and peripheral renin activity, PAC/PRA > 20);
get aldo suppression test only after PAC/PRA comes back abn
Incidentally discovered AST elevation in absence of etOH or drug induced liver injury - verified
answer NAFLD, assoc w/DM, obesity, HLP -> wt loss shown to help
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