ABFM ITE ACTUAL EXAM WITH CORRECT
ACTUAL QUESTIONS AND CORRECTLY
WELL DEFINED ANSWERS LATEST 2024 –
2025 ALREADY GRADED A+
A 34-year-old male presents with a 2-week history of right plantar heel pain that
began after he started training for a marathon. The pain is most severe
immediately upon standing in the morning and then gradually improves
somewhat after ambulation. It worsens again if he stands after sitting for a period
of time or after excessive walking or running. Which one of the following is
supported by evidence as a first-line intervention to provide pain relief for this
condition?
A) Night splints
B) Plantar fascia stretching exercises
C) Acupuncture
D) Extracorporeal shock wave therapy
E) Platelet-rich plasma injection - ANSWERS-ANSWER: B
This patient most likely has plantar fasciitis. Stretching exercises are effective in
reducing heel pain caused by plantar fasciitis.
,Clinical trials regarding pain relief with the use of night splints are conflicting and
thus inconclusive. The American College of Foot and Ankle Surgeons does not
advocate for or against acupuncture to treat plantar fasciitis, as the studies
available are of low quality. Extracorporeal shock wave therapy is only
recommended after conservative therapies fail and for chronic plantar fasciitis.
Platelet-rich plasma injections may be indicated in refractory plantar fasciitis but
are not considered first-line therapy for an acute presentation.
An 18-month-old male is brought to your office by his parents for a well child
check. The child was born at 28 weeks gestation and had a month-long NICU stay
but has remained healthy and out of the hospital since that time. He is up to date
on vaccines and his growth and development are appropriate. He was on
omeprazole (Prilosec) for GERD but the parents have recently stopped the
medication and he is doing well. He received palivizumab (Synagis) monthly last
year during respiratory syncytial virus (RSV) season and never developed a
respiratory infection. His parents are hoping that he can receive palivizumab again
this year to prevent complications if he develops RSV. He recently started
attending day care and they are worried about his exposure risk. Which one of
the following would you recommend this year for chemoprophylaxis against RSV
in this patient?
A) No chemoprophylaxis
B) A single dose of palivizumab on - ANSWERS-ANSWER: A
With the increasing shortage of pediatric providers, especially in rural areas,
family physicians need to be comfortable managing the care of premature infants.
Palivizumab is recommended for all infants born before 29 weeks gestational age
who are less than 1 year of age at the beginning of respiratory syncytial virus
season, or for those born at less than 32 weeks gestational age who develop
chronic lung disease of prematurity. After 1 year of age, palivizumab is only
recommended for infants with chronic lung disease of prematurity who continue
,to require medical intervention for their lung disease. Therefore, this child should
not receive palivizumab.
A 62-year-old male presents with a 3-day history of left lower quadrant pain and a
low-grade fever. Findings on CT are consistent with acute diverticulitis. The
patient has a history of intolerance to metronidazole (Flagyl). If antibiotics are
given, the preferred agent for this patient would be
A) amoxicillin/clavulanate (Augmentin)
B) azithromycin (Zithromax)
C) cephalexin (Keflex)
D) ciprofloxacin (Cipro)
E) doxycycline - ANSWERS-ANSWER: A
The traditional approach to outpatient management of acute diverticulitis
consists of clinical diagnosis (with or without imaging), antibiotics, and bowel rest.
Two cohort studies found no difference in the effectiveness of outpatient
treatment of diverticulitis with amoxicillin/clavulanate or with metronidazole +
fluoroquinolone.
A 24-hour urine collection for 5-hydroxyindoleacetic acid (5-HIAA) would be used
to evaluate for a neuroendocrine tumor, which can present as chronic flushing
and diarrhea. Cortisol levels can be checked if Cushing syndrome is suspected.
Hypertension can be present in Cushing syndrome, but it is typically associated
with other signs such as obesity and an elevated blood glucose level due to insulin
, resistance. Cystatin C is a marker of renal function and measurement would not
be indicated given this patient's normal creatinine level.
A 26-year-old male diagnosed with coccidioidomycosis (valley fever) develops a
rash on the extensor surfaces of his lower legs consisting of painful,
subcutaneous, nonulcerated, erythematous nodules. This rash is consistent with
which one of the following?
A) Erythema ab igne
B) Erythema infectiosum
C) Erythema migrans
D) Erythema multiforme
E) Erythema nodosum - ANSWERS-ANSWER: E
Erythema nodosum, a panniculitis that typically affects the subcutaneous fat on
the anterior surface of the lower legs, is associated with coccidioidomycosis
(valley fever) and can suggest the diagnosis. It is a manifestation of the patient's
immune response and often indicates a good prognosis. In addition to
coccidioidomycosis, it can also be associated with streptococcal infections as well
as tuberculosis.
Erythema ab igne is a cutaneous rash caused by prolonged heat exposure (such as
a heating pad) presenting as an otherwise asymptomatic, red, reticulated pattern
on the skin. Erythema infectiosum is associated with parvovirus B19 infection and
is usually seen in young children. It manifests as an erythematous rash of the face
(slapped cheek appearance), arms, and legs. Erythema migrans is an expanding,
erythematous, annular rash with or without central clearing and is often
associated with tick exposure (Lyme disease). Erythema multiforme consists of
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