ABFM ITE EXAM VERSION A, B, C AND STUDY

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ABFM ITE EXAM VERSION A, B, C AND STUDY

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ABFM ITE EXAM A

QUESTION: An 87-year-old female comes to your office for an annual health maintenance visit.She appears cachectic and tells you that for the past 6 months she has had a decreased appetite and generalized muscle weakness. The patient is alert and oriented to person and place. She has a 10% weight loss, dry mucous membranes, and tenting of the skin on the extensor surface of her hands. While inflating the blood pressure cuff on her right arm you observe carpopedal spasms.Which one of the following is the most likely electrolyte disturbance?

• Hypercalcemia
• Hypocalcemia
• Hypokalemia
• Hypernatremia
• Hyponatremia - ANSWER-B

QUESTION: A 24-year old female presents to your office with a 3-month history of difficulty sleeping. She says that she struggles to fall asleep and wakes up multiple times at night at least three times a week. She tries to go to bed at 10:00 p.m. and wakes up at 6:30 a.m. to start her day. She lies awake for an hour in bed before falling asleep and spends up to 2 hours awake in the middle of the night trying to fall back asleep. Lately she has been feeling fatigued and having difficulty concentrating at work. You conduct a full history and physical examination and tell her to return in 2 weeks with a sleep diary. At this follow-up visit you see from her diary that she is sleeping an average of 51⁄2 hours per night.Which one of the following would be the most appropriate recommendation? 1 / 4

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A) Set her alarm for 5:30 a.m.

• Add a mid-afternoon nap

C) Move her bedtime to 9:00 p.m.

D) Move her bedtime to 12:30 a.m.

• Stay up for a - ANSWER-D

QUESTION: A 45-year-old female presents to the emergency department with a 1-week history of facial swelling and progressive dyspnea with exertion. She was diagnosed 1 week ago with non-Hodgkin's lymphoma but her medical history is otherwise unremarkable. A chest radiograph is shown below.After hospital admission, which one of the following would be the most appropriate next step in the management of this condition?

• Intravenous antibiotics
• Urgent chemotherapy and radiation
• Urgent chemotherapy and plasmapheresis
• Urgent echocardiography
• Urgent bronchoscopy - ANSWER-B

QUESTION: A nonverbal 22-year-old male with intellectual disability is brought to your office by the staff of the group home where he lives. They report that the patient has been functioning at his baseline until this morning when he was found to have loud breathing. No other history is available at the time of this visit.On examination he has a temperature of 37.3°C (99.1°F), a blood pressure of 124/82 mm Hg, a pulse rate of 100 beats/min, and a respiratory rate of 16/min. The patient appears to be in mild distress and a high-pitched whistling, crowing sound on inspiration is heard as you walk in the room.Which one of the following would be the most appropriate next step for this patient?

• Oral antibiotics 2 / 4

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• Oral corticosteroids
• Nebulized albuterol
• Nebulized epinephrine
• Urgent evaluation in the emergency department - ANSWER-E

QUESTION: A 16-year-old female presents with chronic acne on her nose, forehead, and chin consisting of a few comedones and a few mildly inflamed papules and pustules. She says it is minimally improved after 12 weeks of daily adapalene 0.1% gel. There are no scars or cysts. The patient would like to try to achieve better control.Which one of the following would you recommend at this time?

• Continue adapalene 0.1% gel for 12 more weeks
• Add clindamycin (Cleocin T) 1% gel for up to 12 weeks
• Add clindamycin 1% gel for maintenance
• Stop adapalene 0.1% gel and start clindamycin 1% gel for maintenance
• Stop adapalene 0.1% gel and start erythromycin 2% gel for maintenance - ANSWER-B

QUESTION: A 32-year-old female who is one of your longtime patients calls you because of a 24-hour history of painful urination with urinary frequency and urgency. She is otherwise healthy and does not have any fever, chills, back pain, or vaginal discharge. She uses an oral contraceptive pill and states that her last menstrual period was normal and occurred last week.Which one of the following would be most appropriate at this time?

• Empiric antibiotic treatment
• A urinalysis
• A urine culture
• Plain abdominal radiographs
• Pelvic ultrasonography - ANSWER-A
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QUESTION: A 70-year-old female develops thrombocytopenia during a prolonged

hospitalization for endocarditis. Her current medications include scheduled unfractionated heparin injections for venous thromboembolism prophylaxis. You suspect heparin-induced thrombocytopenia (HIT).Assuming that her thrombocytopenia is caused by HIT, which one of the following is the most likely complication?

• Anaphylaxis
• Disseminated intravascular coagulation
• Hemorrhage
• Sepsis
• Thrombosis - ANSWER-E

A 42-year-old Asian male presents for follow-up of elevated blood pressure. He has no additional chronic medical problems and is otherwise asymptomatic. An examination is significant for a blood pressure of 162/95 mm Hg but is otherwise unremarkable.

all the labs are normal. (Claire's notes, ily)

According to the American College of Cardiology/American Heart Association 2017 guidelines, which one of the following would be the most appropriate medication to initiate at this time?

• Clonidine (Catapres), 0.1 mg twice daily
• Hydralazine, 25 mg three times daily
• Lisinopril/hydrochlorothiazide (Zestoretic), 10/12.5 mg daily
• Metoprolol tartrate (Lopressor), 25 mg twice daily
• Triamterene (Dyrenium), 50 mg daily - ANSWER-C
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