ABFM Competency study guide Exam test questions with approved Answers 2024/2025
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Course
ABFM
Institution
ABFM
ABFM Competency study guide Exam test questions with approved Answers 2024/2025
A 24-year-old female presents with progressively worsening vulvar pain for 3 days. On examination a 3×3-cm tender, fluctuant mass is noted on the right labia minora. She had a similar episode of this problem last ye...
ABFM Competency study guide Exam test
questions with approved Answers 2024/2025
A 24-year-old female presents with progressively worsening
vulvar pain for 3 days. On examination a 3×3-cm tender,
fluctuant mass is noted on the right labia minora. She had a
similar episode of this problem last year.
Which one of the following would be the most appropriate
management?
A) Expectant management
B) Fine-needle aspiration
C) Incision and drainage
D) Marsupialization
E) Excision under general anesthesia - correct answer
ANSWER: D
The most appropriate management of a recurrent Bartholin
gland abscess would be marsupialization, which has a 0%
recurrence rate at 6 months. Local anesthesia can be used in the
office to effectively treat Bartholin gland abscesses and sedation
is not required (SOR A). If the Bartholin gland abscess is >5 cm,
referral to a gynecologist is recommended. Expectant
management, fine-needle aspiration, or incision and drainage
would likely lead to recurrence.
A 34-year-old female at 32 weeks gestation presents with a right-
sided, pounding headache that began 8 hours ago and is similar
to headaches she has had in the past. She is sensitive to light and
sound, and has vomited several times since the onset of pain. She
has taken acetaminophen without relief. She takes prenatal
vitamins but no other routine medications. On examination her
blood pressure is normal.
,Which one of the following would be the most appropriate
treatment for this patient?
A) Dihydroergotamine
B) Metoclopramide (Reglan)
C) Naproxen
D) Oxycodone (OxyContin)
E) Sumatriptan (Imitrex) - correct answer ANSWER: B
Metoclopramide and acetaminophen are the only two
medications considered safe for abortive migraine treatment
during pregnancy (SOR B). The dopamine antagonist antiemetics
are considered second-line abortive treatments in the general
population. Dihydroergotamine should not be used during
pregnancy due to its oxytocic properties and the potential risk of
intrauterine growth restriction with its use. NSAIDs are not
considered safe during pregnancy, particularly in the first and
third trimesters. Opioids are only moderately useful for migraine
treatment and should be avoided during pregnancy due to their
abuse potential. Triptans are generally considered safe during
the first trimester but not in the second and third trimesters.
Their use has been associated with uterine atony, increased risk
of bleeding during delivery, and increased risk of preterm birth.
Broad definitions of ADLs vs iADLs - correct answer ADLs = self
care
iADLs = live independently
A 10-year-old female is brought to your office for a sports
preparticipation examination. You note thoracic rib asymmetry
during the Adams forward bend test. Radiographs confirm
rightward thoracolumbar scoliosis with a Cobb angle of 32°.
,Which one of the following would be most appropriate at this
time?
A) Genetic testing (ScoliScore)
B) MRI of the thoracic and lumbar spine without contrast
C) Scoliosis radiography in 1 year
D) Referral to physical therapy
E) Referral to a pediatric orthopedist - correct answer
ANSWER: E
This patient is a skeletally immature female with a Cobb angle
that puts her at increased risk for progression (>29°). Referral to
a spine specialist for consideration of bracing and appropriate
follow-up is recommended. Genetic testing is available to help
determine the risk of progression, but it is not a widely validated
tool at this time. MRI does not provide any additional information
to help with decision-making. Because of the patient's increased
risk of progression, simple follow-up in 1 year is not
recommended. Physical therapy is not indicated for the primary
treatment of scoliosis.
An 85-year-old nursing home patient with dementia who has
bilateral hearing aids has been slightly more confused over the
past 2 weeks according to the staff. He is also speaking at a
louder volume than normal. He does not have any pain, but an
examination shows impacted cerumen in both ears.
Which one of the following would be most appropriate in the
management of this patient?
A) No therapy
B) Irrigation of the ears with cold water
C) Use of olive oil drops
D) Removal of the cerumen using peroxide
, E) Restraining the patient and attempting manual removal of the
cerumen - correct answer ANSWER: D
Removal of cerumen should be attempted when the patient has
symptoms such as pain, tinnitus, hearing loss, or itching.
Removal of the impaction is also indicated in patients who are
not able to communicate about their symptoms, such as patients
with developmental delay or dementia, a nonverbal patient who
has had recent behavioral changes, or children with fever or
speech delay. Cerumen impaction resulting in hearing loss can
cause reversible cognitive impairment in older persons with
dementia. Treatment options include irrigation with warm water,
cerumenolytic agents such as carbamide peroxide otic, or
manual removal if the patient is cooperative and if the procedure
can be completed without the use of restraints. The use of cold
water, olive oil drops, ear candling, or cotton-tipped swabs
should be avoided.
A previously healthy 18-year-old female presents with finger
pain. About 5 days ago she started to have mild burning of her
left distal index finger. Two days later she developed worsening
pain and redness of her fingertip. She does not remember
injuring her finger or having a similar problem previously.
On examination you note erythema of the medial palmar tip of
her affected finger, with several vesicles that have opaque fluid
in them. The distal digital pulp is soft but tender.
Which one of the following is the most appropriate treatment for
this condition?
A) Warm water soaks
B) Pain control and dressings
C) Antibiotics
D) Antifungals
E) Incision and drainage - correct answer ANSWER: B
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