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ABFM BOARD REVIEW LATEST 2025 EXAM WITH COMPLETE QUESTIONS AND CORRECT ANSWERS RATED A+, Exams of Nursing

ABFM BOARD REVIEW LATEST 2025 EXAM WITH COMPLETE QUESTIONS AND CORRECT ANSWERS ALREADY RATED A+

Typology: Exams

2024/2025

Available from 11/18/2024

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Download ABFM BOARD REVIEW LATEST 2025 EXAM WITH COMPLETE QUESTIONS AND CORRECT ANSWERS RATED A+ and more Exams Nursing in PDF only on Docsity!

ABFM BOARD REVIEW LATEST 2025 EXAM

WITH COMPLETE QUESTIONS AND

CORRECT ANSWERS ALREADY RATED A+

Greatest risk factor for developing dementia? A. Family Hx B. Phys Activity C. Aging D. Lack of mental exercise Correct Answer Aging What is the criteria for chorioamnionitis? How would you treat? Correct Answer Maternal Fever >38 plus one of the following....

  • Uterine tenderness
  • Fetal tachycardia (>160bpm)
  • Maternal leukocytosis
  • Maternal tachycardia
  • Foul-smelling amniotic fluid Tx: Amp+ gent OR Clinda + Gent (if allergic to amp) 80 yo with 1yr becoming more sedentary w/difficulty completing ADLs, 2 falls. Stepwise progression of deficits, can't manage finances, no change in mood/personality. PMHx of diabetes, smoker, HTN. R grip is weaker vs L, no tremor. 1/5 on mini-cog

test and the pt attempts to joke about not being able to perform word recall. A. Alzheimer's B. Lewy Body C. Vascular D. Frontotemporal Correct Answer C. Vascular

  • Hint is that it is stepwise progression
  • Preserved personality, but emotional incontinence 69yo with rigidity, short-stepped gait, and masked facies. He also has become more forgetful (mini-cog 2/5). Family thinks he sees things that aren't real. What kind of dementia? Correct Answer Lewy Body
  • Dementia
  • Parkinsonism + visual hallucinations
  • Significant visuospatial deficits 76 yo is brought by her daughter who is concerned about her mother's memory. 6 months ago, daughter took over mom's checkbook after she failed to pay bills. Her mother seems unable to knit, something she enjoyed for years. She has difficulty finding the words to complete a thought. Dx? A. PT has dementia B. Pt is delirious

C. The patient is depressed D. The pt has mild cog impairment Correct Answer The patient has dementia

  • Progressive impairment
  • Lead to loss of social and functional abilities What is Mild Cognitive Impairment? Correct Answer - Complaint of memory impairment
  • Objective memory loss
  • Preserved general cog fnx
  • Intact activities of daily living
  • High risk of developing dementia 64 yo brought in after exposing himself in public. He has also been urinating in the kitchen sink and refuses to bathe. MMSE 26/30. Has some word-finding difficulties Correct Answer Frontotemporal Key is this starts younger First thing is behavioral issues 76 yo, difficulty walking and his "feet seem stuck together." Gait is widened, but arm swing is maintained. Mild memory loss. Urge incontinence. Correct Answer Normal Pressure Hydrocephalus
  • Key here is that the arm swing is maintained (less likely Parkinson's) 84 yo rapidly progressive dementia over 4 months. Has low-grade fever, very rigid, and has myoclonic jerks when startled. EEG shows triphasic sharp wave complexes Correct Answer Creutzfeldt-Jakob Dz
  • Rapid with myoclonus
  • Tend to be younger, viral-like prions Which is proven to be protective against dementia? A. Estrogen B. Educational attainment C. Vit E D Turmeric Correct Answer Educational Attainment USPSTF: Screening guideline for AAA Correct Answer Men ages 65 - 75 one time who have ever smoked You identify a AAA in your pt. At what size should you refer for surgical intervention? A. 3-3. B. 4-4. C. 5-5. D. 6-6.5 Correct Answer 5 - 5.

How often should you monitor a 3-3.9 cm AAA? Correct Answer Every 36 months How often should you monitor a 4-4.9cm AAA? Correct Answer Every 12 months How often should you monitor a 5-5.4 cm AAA? Correct Answer Every 6 months Most common cause of AAA Correct Answer Atherosclerosis Most common cause of Aortic Dissection Correct Answer HTN ( lumen problem) 68 yo M presents with aching pain in both thighs after walking 1 block. Pain subsides 1-2 mins after he stops ambulating. The best initial test is: A. ABI B. Bil leg US C. PVRs D MRA of LE Correct Answer A. ABI What is a normal ABI? Correct Answer 0.9-1.

What if you have a very high ABI? Correct Answer Noncompressible arteries (calcified likely) When obtaining ABI, AHA/ACC recommends obtaining the systolic BP in both arms and using the higher of the readings. However, if a difference in systolic BP >20mmHg between the arms, what is the most likely dx? Correct Answer Subclavian Artery Stenosis What medication can be given to help with pain with claudication? Correct Answer Cilostazol 72 yo F comes with sudden, severe R leg pain from knees to toes. PMHx HTN, DB. Vitals 160/90, pulse 120 and irregular, afebrile. R leg is cool to touch, pale in color, you're unable to obtain a posterior tibial or dorsalis pedis pulse. At this point, you should A. Start heparin and immediately consult vasc sx B. Immediately obtain US of the lower extremity C. Immediately obtain an echo D. Immediately obtain an AA US Correct Answer A. Start heparin and immediately consult vasc sx What are the 5 Ps of acute arterial occlusion? Correct Answer Pain Pallor Paresthesia

Pulselessness Paralysis TX: Heparin and consult vascular What is the most common source of acute arterial occlusion? Correct Answer Thromboembolism from the heart! Think A Fib 76 yo M with Hx of HTN, HLD, and smoking presents with with blue painful toes in the setting of intact pulses. The most likely diagnosis is A. Acute Gout B. Raynaud's C. Cellulitis D. Blue Toe Syndrome Correct Answer Blue Toe Syndrome Raynaud's secondary disease association Correct Answer Scleroderma/Sclerosis SLE What is GDMT for HFrEF? Correct Answer RAAS Inhibitor (ARNI or ACE) BB (carvedilol, metoprolol succ) MRAs (spironolactone) SGLT2 Inhibitor (empagliflozin)

How to treat LOW RISK, stable angina Correct Answer Stable Angina: pain only with exertion, alleviated at rest LOW RISK: Not LAD or multivessel disease (seen on stress) Tx: ASA, statin, BB/CCB. No PCI!! What is the appropriate first line test for hyperaldosteronism? Correct Answer - Aldosterone/renin ratio

  • Hypokalemia, HTN Benign Esophageal Varices Treatment A. Propanolol B. Octreotide C. Ligation D. Repeat EGD 1-2yr E. Nothing Correct Answer Repeat EGD in 1-2 years Mod risk? (Red whale sign or moderate size) = propanolol or ligation High Risk/Bleeding = Octreotide (From ITE 2022 #3)

What are the indications for dental antibiotic prophylaxis? Correct Answer - Infective endocarditis

  • Valve replacement
  • Hx of congenital heart defect (From ITE 2022) What is CDC guidelines for treatment of urethritis, NAAT for gonorrhea is positive and Chlamydia is negative? Correct Answer
  • Ceftriaxone 1g IM Gonorrhea: ceftriaxone once Chlamydia: doxy for 7 days (From ITE 2022) What is the Rotterdam Criteria for PCOS? Correct Answer - Oligomenorrhea
  • Hyperandrogenism
  • Presence of polycystic ovaries *You need 2/3 for diagnosis

What is the most common cause of unconjugated hyperbilirubinemia? Correct Answer - Elevated indirect bilirubin level

  • Hemolysis!
  • #2 is Gilbert's According to AAP, what age should you start BP screening? Correct Answer - Start at age 3 When are triptans contraindicated? Correct Answer - Pts with established CAD, cerebrovascular disease, or peripheral vasc disease
  • Multiple cardiovascular risk factors
  • High-risk migraine sx (basilar and hemiplegic migraines) What is HS commonly associated with? Correct Answer Crohn's Disease DB Obesity PCOS Metabolic Syndrome What lab values would you expect in tumor lysis syndrome? Correct Answer High cell turnover --> acute kidney failure 2/2 high uric acid
  • High uric acid
  • High K+, Phosphorus (both because of the kidneys not filtering)
  • Low Calcium because of the high phos When is cardiac stress testing contraindicated? Correct Answer - After recent stroke or TIA
  • Severe symptomatic aortic stenosis When would a stress test be indicated in preop optimization? Correct Answer Preop assessment when surgery is at least a moderate risk and the patient can't reach 4 METs of exertion (climbing a single flight of stairs) without cardiac symptoms Which medications when used in combination with statins increase your likelihood of statin-induced myopathy? Correct Answer - Statin --> liver clearance
  • CCBs, some anti-HIV meds, and some antifungals can increase complications such as statin-induced myopathy because they are liver metabolized! **D/c statin if CK >10x ULN What age do you start screening for Depression per the USPSTF? Correct Answer Age 12!

Delirium vs Dementia Correct Answer Delirium: altered consciousness, major attention deficit, fluctuation, acute Dementia: appear to at least be making eye contact, less fluctuation When is delirium tremens onset? Correct Answer 48 - 96hrs 85 yo hospitalized, develops confusion post-operatively which is atypical. No hx of memory loss. Which tool should you use to assess? What can you do first-line? Correct Answer - CAM (confusion assessment method)

  • You can't use the normal dementia tools (MOCA, etc)
  • Tx: Reorient!! What rash is associated with celiac disease? Correct Answer Dermatitis herpetiformis What is first line treatment for motor symptoms in Parkinson's? Correct Answer Carbidopa/levodopa Nothing to stop progression! Which class of DB medicine is associated with ketoacidosis? Correct Answer SGLT- 2

What do you need under the Clozapine Risk Evaluation and Mitigation Strategy? A. Signed consent B. Serum levels C. neutrophil counts D. Training in pych Correct Answer C. Neutrophil counts What is the most common cause of chronic cough in adults? Correct Answer Upper airway cough syndrome (postnasal drip) What is the most common location for cysts in ADPKD? Correct Answer Liver (outside the kidney) What is first-line treatment for IBS with best quality evidence? Correct Answer Soluble Fiber ****This is according to the American College of Gastroenterologists G2P2 delivered, had GDMA1 in pregnancy, here for 6wk f/u. How do you follow-up her diabetes? Correct Answer A 2hr, 75g glucose tolerance test should be performed 4-12wks post-partum following a preg in which gestational DB was diagnosed.

What antihypertensive med is useful for both BP and OSA? Correct Answer Spironolactone! Aldosterone can play a role in HTN and disordered breathing 17 yo, normal PFTs, still having episodic SOB/chest tightness. PFTs revealed normal expiratory findings including normal FEV and FVC, but had a flattened inspiratory flow loop (the bottom part) What is going on? Correct Answer Vocal Cord Dysfunction!

  • Get nasolaryngoscopy to evaluate
  • Tx with breathing techniques What is first line tx for PTSD? Correct Answer Trauma-focused psychotherapy MED: Fluoxetine Heat stroke vs heat exhaustion vs Heat Injury Correct Answer Heatstroke: Neuro + > Heat Exhaustion: Neuro < Heat Injury: No neuro, >104. TX: Complete immersion to the neck in ice water (2-3C) What are the hormones for primary ovarian insufficiency? How would you tx? Correct Answer Elevated FSH and LH

Tx: HRT as soon as possible (within a year of dx) UTERUS: estrogen/progesterone (IUD) What are the hormones for PCOS? Correct Answer LH >>>FSH What treatment is the most efficacious for Fibromyalgia? Correct Answer Exercise!! FDA approved med is cymbalta, but exercise is better. What is the vision loss pattern of glaucoma? Correct Answer Peripheral vision loss (increased pressure pushes on periphery of the ophthalmic) What is the vision loss pattern of macular degen? Correct Answer Central vision loss How do you manage Levothyroxine in pregnancy? Correct Answer - Increase by 30% by taking an extra dose 2 days per week for a total of 9 weekly doses

  • Then monitor TSH every 4 wks

In someone with stable angina and documentaed coronary atherosclerosis. positive stress test and underwent coronary angiography, which showed atherosclerotic dz without stenting..... What medications have been shown to decrease cardiac and all- cause mortality in pts with CAD? Correct Answer - Xarelto What is first line treatment for bacterial sinusitis? Correct Answer Tx: Augmentin for 5-7 days What should you monitor with SLE flare? Correct Answer Anti- dsdna, complement, ESR/CRP, UA (for lupus nephritis), WBC, BMP What do you need prophylaxis for HIV with CD4 <200? What do you need prophylaxis for HIV with CD4 <100? What do you need prophylaxis for HIV with CD4 <50? Correct Answer <200: Bactrim for PJP <100: Bactrim for Toxo <50: Azithro for MAC Pt sustains nondisplaced radial head fracture, how would you treat this? A. Immobilization for 3 days then ROM exercise B. Long arm posterior splint for 6 weeks C. Long arm cast for 6 weeks D. Referral to ortho for cast

E. Referral to ortho for surgery Correct Answer A. Immobilization for 3 days with ROM What is the best approach to vaccine hesitancy? Correct Answer Presumptive approach rather than participatory What lab abnormalities would you expect in multiple myeloma? What is the difference between MGUS and MM? Correct Answer MM LABS:

  • Elevated globulin
  • Hypercalcemia
  • Renal Insufficiency (monoclonal light chains toxic to kidney) "CRAB" findings hyperCalcemia, Renal insuff, Anemia, Bone lytic lesions *MGUS is premalignant WITHOUT any CRAB findings, <10% clonal plasma cells When thinking of multiple myeloma, what test would you get after high globulin-to-albumin ratio? Correct Answer - Serum and urine immunoelectrophoresis

In an old person with depression, what class of meds is the best when considering adverse effects? Correct Answer SSRIs! Better than SNRIs What is guideline-directed therapy for PAD? Correct Answer - Low dose ASA

  • Statin
  • ACE inh
  • Exercise
  • Smoking cessation When is too late to start Rotavirus series? Correct Answer 15 weeks!! (If you see a 4 month old, DON'T DO IT)
  • Must complete the series by 8 months What is the USPSTF recommendation for statin therapy? Correct Answer For primary prevention of CVD for adults aged 40 to 75 years who have 1 or more CVD risk factors (i.e. dyslipidemia, diabetes, hypertension, or smoking) and an estimated 10-year risk of a cardiovascular event of 10% or greater. What is the goal A1C in T2DM? What about in the elderly? Correct Answer <7 for younger patients

<8 for older pts with comorbidities What is the recommendation for statins in DB tx? Correct Answer Moderate intensity for primary prevention for CVD in all pts with db age 40- 75 High Intensity for known multiple atherosclerotic risk factors What are the USPSTF guidelines for DB screening? Correct Answer Screen age 35-70 for those overweight or obese (BMI>25) Diagnosis for Diabetes....

  1. A1C
  2. Oral GTT
  3. Fasting glucose
  4. Sx plus glucose lvl Correct Answer 1. A1C>6.
  5. 2hr GTT >
  6. Fasting glucose >
  7. Sx of db + random glucose > What DB medication puts you at higher risk of DKA with not as high sugars? Correct Answer SGLT- 2

What DB medication is associated with Fournier's? Correct Answer SGLT- 2 What DB medication is associated with increased HF? Correct Answer TZDs What percent weight reduction was found to lower the risk of developing diabetes? Correct Answer 5 - 10% What is the most common cause of AKI? Correct Answer ATN What are pigmented, muddy brown casts associated with? Correct Answer ATN What are the indications for urgent dialysis? Correct Answer - Fluid Overload refractory to diuresis

  • K+ >6.
  • Uremic pericarditis or uremic encephalopathy
  • Severe met acidosis (pH <7.1) and hypervolemia
  • Acute poisoning In what cases do you want K+>4? Correct Answer Known heart disease, arrhythmias,

How does CKD change your potassium? Correct Answer Increases! Kidney is responsible for excretion What are causes of Hypokalemia? Correct Answer 1. GI Losses (Diarrhea, vom, bowel prep)

  1. Renal Losses (hypomag, RTAs, mineralocorticoid excess)
  2. Transcellular shift (refeeding syndrome, alkalosis, thyrotoxicosis, hypothermia) What meds cause low K+? Correct Answer Thiazides, loops Corticosteroids Laxatives Causes of hyperkalemia Correct Answer - Transcellular shift (insulin resistance or deficiency)
  • Excessive intake
  • Impaired excretion
  • Medications
  • Crush injuries (muscular injuries, rhabdo) When do you need to limit potassium? Correct Answer AFTER CKD3b What are some meds responsible for Hyperkalemia? Correct Answer ACE/ARB

Bactrim Heparin BB DIg NSAIDs Physical exam of Hyperkalemia? Correct Answer - Muscle weakness

  • Ascending paralysis What tests do you need for Hyperkalemia? Correct Answer - BMP
  • EKG (peaked T earliest sign)
  • Acid/base status What medication stabilizes the cardiac membrane with K+? What meds used to shift? What meds used to eliminate? Correct Answer Stabilize: calcium gluc Shift: Insulin (10U insulin followed by 25g glucose unless the glucose >250 you don't need it) Eliminate: lokelma, kayexylate *Lasix will help you excrete K+

If you have a pt who you are concerned is experiencing ACS, what do you do? Correct Answer *Give O2, aspirin, and nitro *Repeat trop in 2-3 hours DAPT duration after stent placement:

  1. ACS Patients (DES or BMS)
  2. Stable CAD (DES)
  3. Stable CAD (BMS) Correct Answer ACS PTs: tx for at least 12 months! Then you may stop P2Y12, but continue ASA indefinitely STABLE CAD:
  • BMS: tx for at least 1 month
  • DES: tx for at least 6 months *DAPT is aspirin + P2Y12 inhibitor (clopidogrel, ticagrelor, prasugrel) What are the symptoms/findings in pericarditis? Correct Answer - Pleuritic chest pain
  • Fever
  • Scratchy systolic and diastolic auscultatory findings (pericardial rub)

You have a pt with acute STEMI.... how do you decide whether to perform PCI vs fibrinolytic? Correct Answer If PCI can't be performed within 120 mins of first medical contact, fibrinolytic therapy (alteplase, tenecteplase, or reteplase) should be given

  • THEN after fibrinolytic therapy, transfer to a center where PCI can be performed within 24 hrs
  • Also make sure to give heparin and aspirin What is first line therapy for chronic stable angina? Correct Answer Beta Blocker What is second line therapy for chronic stable angina after maximizing BB? Correct Answer A long-acting nitrate (isosorbide mononitrate) or a CCB How do you reduce the risk for contrast-induced nephropathy in someone with reduced renal fnx? Correct Answer Volume expansion with isotonic fluid (NS from 3hrs before cath to 6hrs after) What is first-line lipid management for pts <75yrs with established CAD? Correct Answer High-intensity statin! Atorva 40-80mg Rosuva 20-40mg

Which of the following is true with regard to screening for depression? A. Brief, 2-question screens for depression are equivalent to longer ones B. The Edinburgh Postnatal Dep Scale should not be routinely used at the 1st pp visit C. There are few standardized scales that can be used for screening D. USPSTF does NOT rec screening adults and adolescents for depression Correct Answer A PHQ-2 Qs:

  1. Over the past 2 wks, have you ever felt down, depressed, or hopeless?
  2. Have you felt little interest or pleasure in doing things? What are the two questions from the PHQ-2? Correct Answer 1. Over the past 2 wks, have you ever felt down, depressed, or hopeless?
  3. Have you felt little interest or pleasure in doing things? Which of the following is true about depression and Persistent Depressive Disorder (dysthymia)? A. Depression assoc w/ dysthymia is as severe as that of MDD B. Lifetime risk is equal for women and men