2023 American Board of Family Medicine In-Training Examination PDF

American Board of Family Medicine IN-TRAINING EXAMINATION Publication or reproduction in whole or in part is strictly prohibited. Copyright © 2023 The American Board of Family Medicine. All rights reserved. 1. A 45-year-old female presents to the emergency department...

American Board of Family Medicine IN-TRAINING EXAMINATION Publication or reproduction in whole or in part is strictly prohibited. Copyright © 2023 The American Board of Family Medicine. All rights reserved. 1. 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 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 urgent next step in the management of this condition? A) Intravenous antibiotics B) Echocardiography C) Plasmapheresis D) Bronchoscopy E) Radiation 2. A 22-year-old male presents for follow-up of moderate persistent asthma. After discussing his treatment options, you decide to use a single maintenance and reliever therapy (SMART) approach. Which one of the following daily inhaled therapies is appropriate to prescribe in this setting? A) Budesonide (Pulmicort) B) Budesonide/formoterol (Symbicort) C) Fluticasone/salmeterol (Advair Diskus) D) Fluticasone/vilanterol (Breo Ellipta) E) Tiotropium/olodaterol (Stiolto Respimat) 3. Which one of the following is an indication for long-term, rather than short-term, proton pump inhibitor therapy? A) The eradication of Helicobacter pylori B) Gastroprotection in users of high-dose NSAIDs at high risk for gastrointestinal bleeding C) The prevention of rebleeding from a Mallory-Weiss tear D) The prevention of ulcers after band ligation of esophageal varices E) The treatment of an NSAID-related gastric ulcer 4. An 85-year-old male presents for an annual Medicare examination. His wife tells you that he has been repeating himself in conversations, buying the same item multiple times, and taking longer to complete routine tasks such as balancing the checkbook. He recalls 1 out of 3 items on the Mini-Cognitive Assessment Instrument (Mini-Cog) and is unable to draw a clock. A depression screening is negative. Which one of the following is the greatest risk factor for this patient’s condition? A) Advanced age B) Atrial fibrillation C) Diabetes mellitus D) A history of head trauma E) Smoking 1 Item #1 2 5. Which one of the following would be the most appropriate initial pharmacotherapy for a temporomandibular disorder in an otherwise healthy 54-year-old male? A) Amitriptyline, 25 mg at bedtime B) Gabapentin (Neurontin), 300 mg daily C) Naproxen, 500 mg twice daily D) Tramadol, 50 mg every 6 hours E) Corticosteroid injection into the temporomandibular joint 6. A 33-year-old female presents to your office concerned about feeling fatigued for the past few months. She says that she feels cold often, has intermittent joint discomfort, and has gained 5 lb. She has not experienced any pain or problems swallowing. She gave birth to her youngest child almost 3 years ago, and she recently started an oral contraceptive. She has not had any recent illnesses. Her family history is significant for rheumatoid arthritis. A physical examination reveals a mild goiter but is otherwise unremarkable. Her vital signs are stable. A CBC and comprehensive metabolic panel are normal. A TSH level is 6.48 U/mL (N 0.4–4.5) and a thyroid peroxidase antibody level is 378 IU/mL (N