ABFM ITE REAL EXAM 2024-2025 COMPLETE 200
ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (CORRECT
VERIFIED SOLUTIONS) LATEST UPDATES |ALREADY
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During rounds at the nursing home, you are informed that there are
two residents on the unit with laboratory-confirmed influenza.
According to CDC guidelines, who should receive chemoprophylaxis for
influenza?
A) Only symptomatic residents on the same unit
B) Only symptomatic residents in the entire facility
C) All asymptomatic residents on the same unit
D) All residents of the facility regardless of symptoms
E) All staff regardless of symptoms
ANSWER: C
RATIONALE: In long-term care facilities, an influenza outbreak is
defined as two laboratory-confirmed cases of influenza within 72 hours
in patients on the same unit. The CDC recommends chemoprophylaxis
for all asymptomatic residents of the affected unit. Any resident
exhibiting symptoms of influenza should be treated for influenza and
not given chemoprophylaxis dosing. Chemoprophylaxis is not
recommended for residents of other units unless there are two
laboratory-confirmed cases in those units. Facility staff of the affected
unit can be considered for chemoprophylaxis if they have not been
,vaccinated or if they had a recent vaccination, but chemoprophylaxis is
not recommended for all staff in the entire facility.
A 24-year-old female presents with a 2-day history of mild to moderate
pelvic pain. She has had two male sex partners in the last 6 months and
uses oral contraceptives and sometimes condoms. A physical
examination reveals a temperature of 36.4°C (97.5°F) and moderate
cervical motion and uterine tenderness. Urine hCG and a urinalysis are
negative. Vaginal microscopy shows only WBCs.
The initiation of antibiotics for treatment of pelvic inflammatory
disease in this patient
A) is appropriate at this time
B) requires an elevated temperature, WBC count, or C-reactive protein
level
C) should be based on the results of gonorrhea and Chlamydia testing
D) should be based on the results of pelvic ultrasonography
ANSWER: A
RATIONALE: Pelvic inflammatory disease (PID) is a clinical diagnosis, and
treatment should be administered at the time of diagnosis and not
delayed until the results of the nucleic acid amplification testing (NAAT)
for gonorrhea and Chlamydia are returned. The clinical diagnosis is
based on an at-risk woman presenting with lower abdominal or pelvic
pain, accompanied by cervical motion, uterine, or adnexal tenderness
that can range from mild to severe. There is often a mucopurulent
discharge or WBCs on saline microscopy. Acute phase indicators such as
fever, leukocytosis, or an elevated C-reactive protein level may be
,helpful but are neither sensitive nor specific. A positive NAAT is not
required for diagnosis and treatment because an upper tract infection
may be present, or the causative agent may not be gonorrhea or
Chlamydia. PID should be considered a polymicrobial infection. Pelvic
ultrasonography may be used if there is a concern about other
pathology such as a tubo-ovarian abscess.
A 24-year-old patient wants to start the process of transitioning from
female to male. He has been working with a psychiatrist who has
confirmed the diagnosis of gender dysphoria.
Which one of the following would be the best initial treatment for this
patient?
A) Clomiphene
B) Letrozole (Femara)
C) Leuprolide (Eligard)
D) Spironolactone (Aldactone)
E) Testosterone
ANSWER: E
RATIONALE: For patients with gender dysphoria or gender
incongruence who desire hormone treatment, the treatment goal is to
suppress endogenous sex hormone production and maintain sex
hormone levels in the normal range for their affirmed gender. For a
female-to-male transgender patient this is most easily accomplished
with testosterone. When testosterone levels are maintained in the
normal genetic male range, gonadotropins and ovarian hormone
, production is suppressed, which accomplishes both goals for hormonal
treatment without the need for additional gonadotropin suppression
from medications such as leuprolide.
Clomiphene can increase serum testosterone levels, but only in the
presence of a functioning testicle. Letrozole is an estrogen receptor
antagonist, but it would not increase serum testosterone levels.
Spironolactone has androgen receptor blocking effects and would not
accomplish either of the hormone treatment goals.
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
E) At age 35
ANSWER: D
RATIONALE: 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
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