Download ABFM ITE EXAM 2024 WITH 100% CORRECT ANSWERS GRADED A+ and more Exams Nursing in PDF only on Docsity!
ABFM ITE EXAM 2024 WITH 100%
CORRECT ANSWERS
CAP antibiotic that causes VF - correct answer✔✔ Azithromycin
- The arrhythmia results from prolongation of the QT interval and is also more common in patients with a prior cardiac history. Anti-DM medications for weight loss - correct answer✔✔ GLP1 receptor agonists e.g. Exenatide SGLT-2 inhibitor e.g. Canagliflozin Screening test with greatest potential for over diagnosis - correct answer✔✔ PSA Clinical manifestation of amyotrophic lateral sclerosis - correct answer✔✔ Asymmetric leg weakness Opioid to avoid in palliative patient with severe hepatic dysfunction - correct answer✔✔ Methadone
- It is metabolized and cleared by the liver, and should therefore not be used in patients with severe hepatic impairment. It is, however, a reasonable option for patients with severe renal impairment. Lung cancer screening with low dose CT Chest annually - correct answer✔✔ Adults 55-80yo with 30 pack year history and currently smoking or quit within last 15 years NOAC with reversal agent - correct answer✔✔ Dabigatran Reduces alcoholism but creating an acute ethanol sensitivity - correct answer✔✔ Disulfiram Antidepressant to be avoided in the elderly - correct answer✔✔ Paroxetine (associated with more anticholinergic effects)
SSRIs > SNRIs, atypical antipsychotics may be added for resistant depression Age group between which American Academy of Pediatrics recommends administration of an autism- specific screening tool - correct answer✔✔ 18-24 months old Most common neurological complication of Paget's disease of the bone - correct answer✔✔ Most common cardiac complication of Lyme disease - correct answer✔✔ Heart blocks Examination finding of those with bacterial vaginosis - correct answer✔✔ Vaginal pH >4.5 (normal vaginal pH should be acidic) Most common cause of medication-related adverse events across health care settings in the United States - correct answer✔✔ Antibiotics Screening for asymptomatic carotid artery stenosis - correct answer✔✔ Not recommended In anaphylaxis, which drug is most likely helpful in preventing the need for intubation? - correct answer✔✔ Barrett's oesophagus with no dysplasia - correct answer✔✔ Positive family history of colorectal cancer - correct answer✔✔ Individuals who have a first-degree relative with colorectal cancer or advanced adenoma diagnosed before 60 years of age or two first- degree relatives diagnosed at any age should be advised to start screening colonoscopy at 40 years of age or 10 years younger than the earliest diagnosis in their family, whichever comes first. Most common cause of hearing loss in newborns - correct answer✔✔ Genetic inheritance Lab findings in Von Willebrand disease - correct answer✔✔
Most effective medication for treating fibromyalgia - correct answer✔✔ TCAs > SSRIs (helps with some pain reduction) In a healthy full-term infant who is exclusively breastfed, iron supplementation should begin at what age in order to prevent iron deficiency anaemia? - correct answer✔✔ 4 months
- In preterm babies (before 37w), elemental iron supplementation (2mg/kg per day) should begin at 1 month of age and should continue until 12 months of age, unless the infant had multiple blood transfusions. In primary nephrotic syndrome, other than proteinuria and low albumin, what else is commonly observed? - correct answer✔✔ Coagulopathy Chronic medication that can cause B12 deficiency - correct answer✔✔ Metformin Strongest risk factor for primary hypertension in children and adolescents - correct answer✔✔ Elevated BMI While Staphylococcus aureus and Streptococcus species are the most common causes of skin and soft- tissue infection, which organism should also be considered? - correct answer✔✔ Pseudomonas Treatment of erythrasma (Wood's lamp coral pink/red fluorescence, fine-scaled with a cigarette-paper appearance) caused by Corynebacterium minutissimum infection - correct answer✔✔ Erythromycin Which radiologic funding of a lung nodule is most predictive of malignancy? - correct answer✔✔ Which investigation is routine in all newborns with Down syndrome? - correct answer✔✔ Echocardiography Treatment duration for provoked vs unprovoked PE - correct answer✔✔ 3 months and indefinitely respectively
In patients with symptoms indicative of pneumonia or heart failure, what investigations can be done to determine treatment of either condition or both? - correct answer✔✔ BNP and procalcitonin levels How to increase HDL (good cholesterol)? - correct answer✔✔ Add niacin Dietary recommendation in diverticulosis - correct answer✔✔ High fibre or take fibre supplements Side effects of prolonged PPI use - correct answer✔✔ C diff infection, hypoMg, hip fracture Which antiemetic blocks dopamine stimulation in the chemoreceptor trigger zone? - correct answer✔✔ Metoclopramide Little League shoulder is a repetitive use injury causing disruption at the proximal growth plate of the humerus - correct answer✔✔ Proximal humeral epiphysitis. Can be seen on plain radiographs as widening, demineralization, or sclerosis at the growth plate. Taking beta carotene and Vit E to prevent cancer and heart disease - correct answer✔✔ Fluoride supplementation should be started at what age when primary water supply is deficient in fluoride - correct answer✔✔ 6 months Medications that can reduce serum Vitamin D levels - correct answer✔✔ Rifampicin, Phenytoin Isolated posterior cruciate ligament tear - correct answer✔✔ Direct blow to the anterior tibia whilst knee is in flexion What should patients be periodically monitored for whilst on Amiodarone? - correct answer✔✔ TSH Drug of choice in depressed persons with cardiovascular disease - correct answer✔✔ SSRIs
Indication for 2nd dose of pneumococcal polysaccharide vaccine in children - correct answer✔✔ Sickle Cell Disease Excessive femoral anteversion with normal mobility - correct answer✔✔ Observation Surgery should be reserved for children 8-10 years of age who still have cosmetically unacceptable, dysfunctional gaits. Most effective treatment for OCD - correct answer✔✔ Repetitive exposure to fearful stimuli Tricyclic antidepressants and SSRIs are also effective Effective treatment for post-herpetic neuralgia - correct answer✔✔ Topical agents such as lidocaine patches and capsaicin cream or patches, as have the oral agents gabapentin, pregabalin, and amitriptyline. Empiric treatment of pyelonephritis - correct answer✔✔ Ciprofloxacin Light's criteria: exudative if pleural:serum protein >0.5 and LDH >0.6 (or >2/3 upper limit of normal LDH)
- correct answer✔✔ Pulmonary embolism
- Pleural effusions associated with malignancy, pneumonia, viral illness, and asbestosis tend to be exudative. Brachial cleft cyst - correct answer✔✔ Congenital lesion, usually results in solitary cyst located in lateral neck anterior to the SCM; may have sinus to skin. Antibiotic prophylaxis for dog bites - correct answer✔✔ Hand involvement Leading cause of death worldwide - correct answer✔✔ Cardiovascular disease
Which one of the following potential bioterrorism agents requires treatment with 60 days of continuous antibiotics? - correct answer✔✔ Anthrax What is a pet reptile most likely to transmit to its human contacts? - correct answer✔✔ Salmonella Supplement to be added shortly after birth to infants who are fully or partially breastfed - correct answer✔✔ Vitamin D 400IU daily Continuing until the child is consuming at least 500 mL/day of formula or milk containing vitamin D What should be monitored whilst on testosterone replacement therapy? - correct answer✔✔ Haematocrit (may increase)
- Polycythaemia is thus an absolute contraindication to starting testosterone Treatment of narcolepsy - correct answer✔✔ Treatment involves improving both the quantity and quality of sleep during the night, which can be accomplished with sodium oxybate. This improves daytime alertness and cataplexy. Scheduling naps is the second important aspect of managing narcolepsy. The third important step is the use of stimulants such as methylphenidate to improve function during the day. Periodic daytime naps may also help to reduce symptoms. Initial screening for Hereditary Haemochromatosis in those with persistent abnormal LFTs i.e. raised transaminases - correct answer✔✔ Fe and transferrin saturation Most common cause of chest pain in children - correct answer✔✔ Musculoskeletal When should patient with hyperplastic polyps on colonoscopy be due for repeat surveillance? - correct answer✔✔ Small (less than 10 mm) hyperplastic polyps in the rectum and sigmoid rarely exhibit dysplasia or develop into colon cancer, colonoscopy may be repeated in 10 years if they are the only finding. Elevated serum levels of this is indicative of Vitamin B12 deficiency - correct answer✔✔ Mmethylmalonic acid
What are koplik spots pathogmonic for? What causes this? - correct answer✔✔ Measles Anti-DM medication that increases risk of UTI as well as thrush (in women) - correct answer✔✔ SGLT2- inhibitors (Dapa, Empa)
- May be used as second line choice in those intolerant of Metformin When titrating the dosage of opioids, the CDC recommends that you should also consider prescribing naloxone when the opioid dosage reaches what morphine milligram equivalent (MME) per day threshold? - correct answer✔✔ 50 Investigation for spina bifida - correct answer✔✔ Ultrasound Goal for fasting blood glucose reading in GDM - correct answer✔✔ <95 mg/dL What is the recommended first line agent to prevent steroid-induced osteoporosis? - correct answer✔✔ Bisphosphonates Remission in alcohol use disorder - correct answer✔✔ Early (3-12m), Sustained (>12m) Groups with highest prevalence of syphilis - correct answer✔✔ Men who have sex with men Features of foetal alcohol syndrome - correct answer✔✔ In addition to clinodactyly (curved 5th finger), it is also associated with camptodactyly (flexion deformity of the fingers), other flexion contractures, radioulnar synostosis, scoliosis, and spinal malformations. Avulsion tuberosity fracture of proximal 5th metatarsal - correct answer✔✔ Treatment of nondisplaced tuberosity avulsion fractures is conservative. Options include elastic wrapping, ankle splints and low- profile walking boots or casts. Weight bearing is allowed as tolerated. Treatment should be continued until symptoms abate—usually within three to six weeks. Treatment of depression associated with erectile dysfunction - correct answer✔✔ Bupropion or Mirtazapine
Treatment of menopausal symptoms - correct answer✔✔ Black cohosh Diagnostic criteria for PCOS - correct answer✔✔ NEED 2 OF 3
- Oligo or anovulation
- Clinical/biochem signs of hyperandrogenism
- Sonographic evidence of polycytic ovary Indication for carotid endarterectomy - correct answer✔✔ >70% stenosis of carotid vessels for symptomatic patient Ringed appearance of oesophagus - correct answer✔✔ Is indicative of eosinophilic oesophagitis to treat with PPIs Medication that increases risk of osteoporosis - correct answer✔✔ Ranitidine, Thiazolidinediones (glitazones) Greatest modifiable risk factor of AAA - correct answer✔✔ Cigarette smoking Immunotherapy can prevent recurrence of severe allergic reactions triggered by - correct answer✔✔ Wasp (insect) stings Infant factor to look out for in potential breastfeeding issues - correct answer✔✔ Dimpled cheeks, chin not pressed against breast, chalky stools Which disorder of sexual development is associated with an increased risk of endometrial cancer, coeliac disease, and structural heart defects? - correct answer✔✔ Turner's syndrome
- Karyotyping Treatment of life-threatening heat stroke - correct answer✔✔ Aggressive ice water immersion
At what age should a child's Hb be checked as recommended by the AAP? - correct answer✔✔ 12 months Antibiotic that increases risk of AAA rupture - correct answer✔✔ Fluoroquinolones (floxacins) An otherwise healthy 55-year-old male who is visiting from Arizona presents to your office with a 4- week history of intermittent fevers, night sweats, dry cough, weight loss, and myalgia. The patient has no other recent history of travel. - correct answer✔✔ Valley Fever (medical name coccidioidomycosis or "cocci" for short) is an infection in the lungs caused by the fungus coccidioides spp., which grows in soils in areas of low rainfall, high summer temperatures and moderate winter temperatures, such as: throughout Arizona, the San Joaquin and Central Valleys of California, southern parts of Nevada, New Mexico and western Texas, east-central Utah, south-eastern Washington, and the semiarid and arid soils of Central and South America. First-line pharmacotherapy for diabetic gastroparesis - correct answer✔✔ Metoclopramide, Erythromycin Expedited Partner Therapy (EPT) in STDs - correct answer✔✔ Treating the sex partners of patients diagnosed with chlamydia or gonorrhea by providing prescriptions or medications to the patient to take to his/her partner without the health care provider first examining the partner. Antibiotic time-out - correct answer✔✔ Occurs 48-72h after first administration, part of antibiotic stewardship programme to ensure judicious use. Prehn's sign - correct answer✔✔ Physical lifting of the testicles relieves the pain of epididymitis but not pain caused by testicular torsion. Treatment of epididymitis - correct answer✔✔ Bed rest, antibiotics (Levofloxacin), scrotal support, and ice compresses. A healthy 2-month-old female is brought to your office for a routine well baby examination by both of her parents, who have no concerns. The parents refuse routine recommended vaccines for their daughter because of their personal beliefs. You want to incorporate patient-centeredness and are also
concerned about improving the health of the population. You decide to follow the CDC recommendations by? - correct answer✔✔ Having the parents sign a refusal to vaccinate form. Prepatellar bursitis is a common superficial bursitis caused by microtrauma from repeated kneeling and crawling. Other terms for this include housemaid's knee, coal miner's knee, and carpet layer's knee. It is usually associated with minimal to no pain. - correct answer✔✔ The proper management of prepatellar bursitis is conservative and includes ice, compression wraps, padding, elevation, analgesics, and modification of activity. There is little evidence that a corticosteroid injection is beneficial, even though it is often done. If inflammatory bursitis is suspected, a corticosteroid injection may be helpful. Fluid aspiration is indicated if septic bursitis is suspected. Surgery can be considered for significant enlargement of a bursa if it interferes with function. Absolute contraindication to fibrinolytic therapy - correct answer✔✔ A history of an ischemic stroke within the past 3 months unless the stroke is diagnosed within 4½ hours. Treatment of sudden SNHL likely idiopathic - correct answer✔✔ Oral Prednisolone (recommended dosage is 1 mg/kg/day with a maximum dosage of 60 mg daily for 10-14 days) Ottawa Ankle rules: negative i.e. ankle sprain - correct answer✔✔ Compression combined with lace-up ankle support or an air cast, along with cryotherapy, is recommended and can increase mobility. Early mobilization, including weight bearing as tolerated for daily activities, is associated with better long- term outcomes than prolonged rest. Risk factor for atrial fibrillation - correct answer✔✔ Alcohol use Assessing response to oral iron therapy in iron deficiency anaemia - correct answer✔✔ Reticulocyte count Use of IV contrast in those with shellfish allergies - correct answer✔✔ No correlation Shoulder pain with weak internal rotation - correct answer✔✔ Subscapularis Shoulder pain with weak external rotation - correct answer✔✔ Infraspinatus, teres minor
Occupations causing silicosis - correct answer✔✔ Stone cutting, sand blasting, mining, and quarrying HOCM systolic murmur intensifies with Valsava's and is the most common primary cardiomyopathy - correct answer✔✔ First-line treatment with beta-blockers, CCBs (non-dipines) if beta-blockers not tolerated BPSD of dementia can be treated (off-label) with antipsychotics - correct answer✔✔ Aripiprazole produces small reductions in behavioral and psychological symptoms of dementia, and it has the least adverse effects of the atypical antipsychotics. Both typical and atypical antipsychotics increase the risk of mortality in patients with dementia. The typical antipsychotics are more commonly associated with extrapyramidal side effects. Diabetes mellitus and agranulocytosis are associated with the atypical antipsychotics, including Risperidone. Periodic monitoring of serum glucose levels and CBCs is recommended. For patients who have been taking antipsychotics for >/= 3 months and whose symptoms have stabilized, or for patients who have not responded to an adequate trial of an antipsychotic, it is recommended that the drug be tapered slowly with goal of stopping. Secondary prevention of coronary heart disease - correct answer✔✔ Patients <75 years of age with established coronary artery disease should be on high-intensity statin regimens if tolerated. These regimens include Atorvastatin, 40-80 mg/day, and Rosuvastatin, 20-40 mg/day. Moderate-intensity regimens include Simvastatin, 40 mg/day. Subclinical hyperthyroidism patients are at higher risk for several health conditions, including atrial fibrillation, heart failure, and osteoporosis. - correct answer✔✔ The American Thyroid Association recommends treating patients with complications who are either over age 65 or have a TSH level <0. U/mL. BPPV characteristics - correct answer✔✔ Rotational vertigo with test-related head movements, latency period 5-20s sometimes up to 60s, associated with torsional upbeating nystagmus.
Preferred antidepressant in elderly - correct answer✔✔ Escitalopram. Amitriptyline, Imipramine, and paroxetine are highly anticholinergic and sedating, and according to the Beers Criteria, they can cause orthostatic hypotension. COPD screening with spirometry - correct answer✔✔ All patients with a smoking history and symptoms of COPD such as a chronic cough with sputum production and/or chronic and progressive dyspnea. No screening if asymptomatic despite smoking history. The dietary herbal supplement with the highest risk for drug interactions is - correct answer✔✔ St John's wort Splint for distal radial fracture - correct answer✔✔ Sugar tong Worrisome characteristics of palpitations - correct answer✔✔ Patients with a history of cardiovascular disease, palpitations that affect their sleep, or palpitations that occur at work have an increased risk of an underlying cardiac cause. HPV screening in women 21-29yo - correct answer✔✔ Current recommendations are for a Pap test with cytology every 3 years for women age 21-29 years with normal results, and the frequency does not change with an increased number of normal screens. Annual HPV screening in patients age 21-29 years has very little effect on cancer prevention and leads to an increase in procedures and treatments without significant benefit. Patient who has had a sleeve gastrectomy should avoid - correct answer✔✔ NSAIDs as it is thought to increase the risk of anastomotic ulcerations or perforations Confirming proteinuria in those with positive dipstick protein or with symptoms of nephrotic syndrome - correct answer✔✔ Spot urine PCR The only evidence-based treatment that confers significant benefits to children with autism is - correct answer✔✔ Intensive behavioral interventions, which should be initiated before 3 years of age.
Desiring pregnancy: Letrozole > Clomiphene Initial evaluation of hypogonadism - correct answer✔✔ FSH and LH Internal tibial torsion - correct answer✔✔ Usually resolves by 5yo, surgery may be considered in patients older than 8yo who have a severe residual deformity, especially if it is symptomatic or cosmetically unacceptable. Yersinia pestis is an aerobic fermentative gram-negative rod. It causes a zoonotic infection with humans as the accidental host. The disease is spread by a bite from a flea vector, direct contact with infected tissue, or inhalation of infectious aerosols from a person with pulmonary plague. - correct answer✔✔ Plague occurs in two regions in the western United States. One region includes northern New Mexico, northern Arizona, and southern Colorado, and the other region includes California, southern Oregon, and far western Nevada. Greatest risk factor for developing osteoarthritis in older adults - correct answer✔✔ Obesity Preferred initial evaluation of acute mesenteric ischaemia - correct answer✔✔ CT Angiography Contraindication of oestrogen-containing contraception methods - correct answer✔✔ Smokers > years of age and in patients with migraine with aura. Highest cure rate of basal cell carcinoma - correct answer✔✔ Mohs surgery Pharmacotherapy to reduce alcohol consumption and increase abstinence - correct answer✔✔ Acamprosate Valvular heart disease in Marfan's syndrome - correct answer✔✔ Aortic insufficiency/regurgitation in 80-100%, increases with age and is progressive. May also be associated with mitral valve prolapse.
Haemoptysis work-up - correct answer✔✔ CXR normally but CT Chest if high risk for malignancy (age, smoking history) If findings are normal, patient should be observed for 2-6 weeks. If there is a recurrence of haemoptysis further evaluation is indicated, which should include an interval history, a repeat examination, and CT Chest. Severe symptomatic aortic stenosis requires surgical intervention i.e. valve replacement - correct answer✔✔ Pressure mean gradient >40 mmHg, aortic valve area <1 cm2 and peak aortic jet velocity
4.0 m/s
- ACE inhibitors may improve symptoms in patients with aortic stenosis who are not surgical candidates. Rome IV criteria for IBS - correct answer✔✔ Recurrent abdominal pain associated with two or more additional symptoms at least 1 day per week in the last 3 months. These symptoms include pain related to defaecation, a change in stool frequency, or a change in stool form. Screening for GDM in pregnancy - correct answer✔✔ From 24w Proximal fifth metatarsal stress fracture (Jones fracture) management - correct answer✔✔ Particularly prone to non-union and completion of the fracture. Because complete non-weight bearing or surgical intervention may be necessary with this high-risk fracture, MRI is indicated as the most sensitive test.
- It has been shown that active patients have shorter healing times and return to activity sooner with surgical management.
- If the nonsurgical option is chosen the patient is given an initial posterior splint and followed up in 3- days, then placed in a short non-weight-bearing cast for 6 weeks, at which time a repeat radiograph is taken. If the radiograph shows healing, the patient can return to gradual weight bearing. If the radiograph does not show proper healing, then the period of non-weight bearing is extended. Adolescent physiologic gynaecomastia - correct answer✔✔ One half of all adolescent males, usually bilateral but left sided more common if unilateral, typically resolves 6-24m after onset.
