2025 NEWEST ABFM ITE EXAM WITH 200 COMPLETE QUESTIONS AND CORRECT ANSWERS WITH RATIONALES (VERIFIED ANSWERS) | ABFM ITE 2025 EXAM (BRAND NEW!)
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ABFM
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ABFM
2025 NEWEST ABFM ITE EXAM WITH 200 COMPLETE QUESTIONS AND CORRECT ANSWERS WITH RATIONALES (VERIFIED ANSWERS) | ABFM ITE 2025 EXAM (BRAND NEW!)
A 45-year-old female who works as a house cleaner present with left shoulder pain. On examination she has pain and relative weakness when pushing toward ...
2025 NEWEST ABFM ITE EXAM WITH 200
COMPLETE QUESTIONS AND CORRECT ANSWERS
WITH RATIONALES (VERIFIED ANSWERS) | ABFM
ITE 2025 EXAM (BRAND NEW!)
1. A 45-year-old female who works as a house cleaner present with left shoulder
pain. On examination she has pain and relative weakness when pushing toward
the midline against resistance while the shoulder is adducted and the elbow is
bent to 90°. With the elbow still at 90° she is unable to keep her left hand away
from her body when you position her hand behind her back.
This presentation is most consistent with an injury of which one of the
following tendons?
A) Deltoid
B) Infraspinatus
C) Subscapularis
D) Supraspinatus
E) Teres minor - ANSWER-ANSWER: C
This patient's pain and weakness while pushing against resistance reveals
weakness on internal rotation of the shoulder, which suggests a possible tear of
the subscapularis tendon. The inability to keep her hand away from her body
when it is placed behind her back describes a positive internal lag test, also
suggesting involvement of the subscapularis tendon. The infraspinatus and teres
minor are involved in external rotation rather than internal rotation. The
supraspinatus and deltoid are involved in abduction of the shoulder.
2. An 8-year-old male is brought to your office because of acute lower
abdominal pain. He is not constipated and has never had abdominal surgery.
You suspect acute appendicitis.
Which one of the following would be most appropriate at this point?
A) Plain radiography
B) Ultrasonography
,C) CT without contrast
D) CT with contrast
E) MRI - ANSWER-ANSWER: B
Ultrasonography is recommended as the first imaging modality to evaluate
acute abdominal pain in children. It avoids radiation exposure and is useful for
detecting many causes of abdominal pain, including appendicitis. After
ultrasonography, CT or MRI can be used if necessary to diagnose appendicitis.
Abdominal radiography is helpful in patients with constipation, possible bowel
obstruction, or a history of previous abdominal surgery.
The American Academy of Pediatrics Choosing Wisely recommendation on the
evaluation of abdominal pain states that CT is not always necessary. The
American College of Surgeons Choosing Wisely recommendation on the
evaluation of suspected appendicitis in children says that CT should be avoided
until after ultrasonography has been considered as an option.
15. You see a patient with a serum sodium level of 122 mEq/L (N 135-145) and
a serum osmolality of 255 mOsm/kg H2O (N 280-295). Which one of the
following would best correlate with a diagnosis of syndrome of inappropriate
antidiuresis?
A) A fractional excretion of sodium below 1%
B) Elevated urine osmolality
C) Elevated serum glucose
D) Elevated BUN
E) Low plasma arginine vasopressin - ANSWER-ANSWER: B
The syndrome of inappropriate antidiuresis (SIAD, formerly SIADH) is related
to a variety of pulmonary and central nervous system disorders in which
hyponatremia and hypo-osmolality are paradoxically associated with an
inappropriately concentrated urine. Most cases are associated with increased
levels of the antidiuretic hormone arginine vasopressin (AVP). Making a
diagnosis of SIAD requires that the patient be euvolemic and has not taken
diuretics within the past 24-48 hours, and the urine osmolality must be high in
conjunction with both low serum sodium and low osmolality. The BUN should
be normal or low and the fractional excretion of sodium >1%.
,Fluid restriction (<800 cc/24 hrs) over several days will correct the
hyponatremia/hypo-osmolality, but definitive treatment requires eliminating the
underlying cause, if possible. In the case of severe, acute hyponatremia with
symptoms such as confusion, obtundation, or seizures, hypertonic (3%) saline
can be slowly infused intravenously but might have dangerous neurologic side
effects.
Elevated serum glucose levels may cause a factitious hyponatremia, but not
SIAD.
3. A 45-year-old African-American male returns to your clinic to evaluate his
progress after 6 months of dedicated adherence to a diet and exercise plan you
prescribed to manage his blood pressure. His blood pressure today is 148/96
mm Hg. He is not overweight and he does not have other known medical
conditions or drug allergies.
Which one of the following would be the most appropriate initial
antihypertensive treatment option for this patient?
A) Chlorthalidone
B) Hydralazine
C) Lisinopril (Prinivil, Zestril)
D) Losartan (Cozaar)
E) Metoprolol - ANSWER-ANSWER: A
Lifestyle modifications addressing diet, physical activity, and weight are
important in the treatment of hypertension, particularly for African-American
and Hispanic patients. When antihypertensive drugs are also required, the best
options may vary according to the racial and ethnic background of the patient.
The presence or absence of comorbid conditions is also important to consider.
For African-Americans, thiazide diuretics and calcium channel blockers, both as
monotherapy and as a component in multidrug regimens, have been shown to be
more effective in lowering blood pressure than ACE inhibitors, angiotensin II
receptor blockers, or -blockers, and should be considered as first-line options
over the other classes of antihypertensive drugs unless a comorbid condition is
present that would be better addressed with a different class of drugs. Racial or
ethnic background should not be the basis for the exclusion of any drug class
when multidrug regimens are required to reach treatment goals.
, 4. An 85-year-old female with metastatic breast cancer requests hospice care.
She has type 2 diabetes mellitus, stage 3 renal failure, and heart disease.
The patient's eligibility for hospice care will be based on her
A) age
B) cancer diagnosis
C) comorbid conditions
D) life expectancy
E) Medicare Part B plan - ANSWER-ANSWER: D
Eligibility for hospice care is based on a life expectancy of 6 months or less in
the natural course of an illness. A majority of hospice patients have cancer but it
is not a requirement to qualify for hospice care. Age is not relevant. Comorbid
conditions may affect longevity but are not required. For those insured by
Medicare, Medicare Part A provides hospice care but Medicare Part B does not.
5. A 15-year-old female presents with a 3-month history of intermittent
abdominal pain and headaches. She does not have any associated weight loss,
fever, nausea, change in bowel habits, or other worrisome features. An
examination is unremarkable. She does report being stressed at school and has a
PHQ-2 score of 4.
Which one of the following would be most appropriate at this point?
A) Further evaluation for depression
B) Laboratory studies
C) Abdominal imaging
D) Citalopram (Celexa)
E) Fluoxetine (Prozac) - ANSWER-ANSWER: A
The U.S. Preventive Services Task Force recommends depression screening for
all adolescents 12-18 years of age. Although this patient has abdominal pain, the
history and physical examination suggest that depression may be playing a role
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