ABFM NEWEST EXAM STUDY GUIDE WITH COMPLETE QUESTIONS AND CORRECT ANSWERS RATED A+, Exams of Nursing

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ABFM NEWEST ACTUAL EXAM STUDY

GUIDE WITH COMPLETE QUESTIONS AND

CORRECT ANSWERS RATED A+

what does not work for IBS A) Fiber B) Probiotics C) Antispasmodics D) Antidepressants Correct Answer fiber what works

• probiotics, antispasmodics, antidepressants, peppermint oil Which one of the following is associated with the use of stimulant medications for attention-deficit disorder in adults? A) Lower success rates compared to nonstimulant medications B) Weight gain C) A low risk of medication abuse D) Serious adverse cardiovascular events

E) Increases in blood pressure Correct Answer increase high BP aggravate psychosis, tics In the first 24 hours after his stroke, starting treatment to control his blood pressure is recommended if it reaches what threshold level? A) 150/90 mm Hg B) 160/100 mm Hg C) 180/100 mm Hg D) 200/110 mm Hg E) 220/120 mm Hg Correct Answer 220/ high BP actually protective in stroke but should drop down within 24hrs Which one of the following BP medications has been shown to reduce bone loss and may reduce her risk of future hip fractures? A) Amlodipine (Norvasc) B) Hydrochlorothiazide C) Lisinopril (Prinivil, Zestril) D) Losartan (Cozaar) E) Metoprolol (Lopressor, Toprol-XL) Correct Answer HCTZ

• loss of benefit within 4 months of discontnuation Plan-Do-Check-Act (PDCA) describes which one of the following? A) The accreditation process to become a patient-centered medical home B) One of the National Quality Forum's Safe Practices for Better Healthcare C) The cycle of continuous quality improvement D) Donabedian categories of quality measurement E) The Chronic Care Model Correct Answer The cycle of continuous quality improvement suspect acute pancreatitis imaging? A) no routine imaging unless the clinical course becomes complicated B) transabdominal ultrasonography C) contrast-enhanced CT D) magnetic resonance cholangiopancreatography (MRCP) E) MRI Correct Answer transabdominal ultrasonography pt on PPI for peptic ulcer disease

Which one of the following would be the most appropriate calcium supplement for this patient? A) Oyster shell calcium B) Calcium carbonate C) Calcium lactate D) Calcium gluconate E) Calcium citrate Correct Answer calcium citrate

• does not require acidic condition fro absorption if not on ppi, use calcium carbonate (require acid for absorption) CI for bupropion Correct Answer seizure eating disorder MAO inhibitor pt on naltrexone for alcohol dependence ned meds for pain relief A) Fentanyl B) Hydromorphone (Dilaudid)

C) Ketorolac D) Meperidine (Demerol) E) Morphine Correct Answer ketorolac

• does not work on opioid receptor since naltrexone blocks these Which one of the following is most effective for assessing right ventricular dysfunction in this situation? A) Echocardiography B) Physical examination C) 12-Lead electrocardiography D) Contrast-enhanced CT of the chest Correct Answer echocardiography A 21-year-old male college student presents to the emergency department with a 2-day history of fever, severe muscle and joint pain, nausea, and vomiting. He spent his winter break traveling in South America and returned 4 days ago. On examination he has a temperature of 39.4°C (103.0°F), gingival bleeding, lower extremity non-pitting edema, right upper quadrant tenderness, a diffuse maculopapular rash, muscle tenderness, and petechiae on his extremities.

labs:

• low WBC
• low platelets
• high hematocrit
• high AST and ALT (same range)
• normal bilirubin
• no jaundice A) Hepatitis A B) Yellow fever C) Dengue fever D) Typhoid fever E) Influenza Correct Answer dengue
• supportive care
• avoid NSAIDs and aspirin due to anticoagulation properties
• avoid via bed nets, misquito repellents, protective clothing note: yellow fever present same way but with jaundice and high bilirubin Stretching has NO demonstrable benefit for which one of the following? A) Hamstring strain B) Chronic neck pain

C) Joint contracture D) Osteoarthritis E) Rehabilitation post knee replacement Correct Answer jint contracture Which one of the following is most appropriate in the management of frostbite? A) Complete surgical debridement of hemorrhagic blisters B) Rapid rewarming with dry heat and warm blankets C) Withholding analgesics to ensure accurate assessment D) Vigorously rubbing affected tissues to restore circulation E) Leaving simple, non-tense areas of clear blistering intact Correct Answer Leaving simple, non-tense areas of clear blistering intact rapid warming is done in whirlpool bath with antiseptic rx polymyagia rheumatica A) Oral dexamethasone, 8 mg twice a day B) Oral methylprednisolone (Medrol Dosepak), taper 24 mg to 0 mg over 7 days C) Oral prednisolone (Orapred), 60 mg daily D) Oral prednisone, 15 mg/day

E) Intravenous methylprednisolone, 120 mg every 6 hours Correct Answer Oral prednisone, 15 mg/day with a slow taper over 1- 2years A 46-year-old perimenopausal female complains of hot flashes, which are very troubling to her. She would like treatment for these symptoms, but has a history of deep vein thrombosis while taking oral contraceptives. Which one of the following treatments has evidence of benefit for her symptoms with the least potential for causing deep vein thrombosis? A) Vaginal estradiol B) Oral estradiol combined with progestin C) Oral phytoestrogens such as soy protein D) Oral venlafaxine (Effexor XR) E) Topical bio-identical hormones Correct Answer SSRI or SNRI pt with severe c diff rx with oral vanc no improvement

Which one of the following intravenous antibiotics would be most appropriate? A) Ciprofloxacin (Cipro) B) Imipenem/cilastatin (Primaxin) C) Meropenem (Merrem) D) Metronidazole E) Vancomycin Correct Answer IV metronidazole Which one of the following is NOT a risk factor for stillbirth? A) Smoking B) Advanced maternal age C) Congenital anomalies D) Vigorous exercise E) BMI >30 kg/m2 Correct Answer vigorous exercise Which one of the following is the first-line treatment for her urge incontinence? A) Anticholinergic drugs such as oxybutynin or solifenacin (Vesicare) B) $-Adrenergic agonists such as mirabegron (Myrbetriq) C) Duloxetine (Cymbalta) D) Bladder training

E) A pessary Correct Answer bladder training Which one of the following physical examination findings would be pathognomonic for slipped capital femoral epiphysis? A) Excessive forward passive motion of the tibia with the knee flexed B) Lateral displacement of the patella with active knee flexion C) Limited internal rotation of the flexed hip D) Reduced hip abduction with the hip flexed E) An inability to extend the hip past the neutral position Correct Answer Limited internal rotation of the flexed hip A 54-year-old male presents with hearing loss associated with tinnitus. Which one of the following additional characteristics would be an indication for MRI of the brain to assess for an intracranial tumor? A) A rapid onset of symptoms

B) Unilateral symptoms C) Association with pain and otorrhea in the affected ear D) Exposure to loud noise shortly before the symptoms began Correct Answer unilateral

• acoustic neuroma (hearing loss and tinnitus, slow growing tumor, vertigo) rx PAD A) Aspirin B) Warfarin (Coumadin) C) Clopidogrel (Plavix) D) Pentoxifylline E) Cilostazol (Pletal) Correct Answer cilostazol what is CI in pt taking statin A) Amoxicillin/clavulanate (Augmentin) B) Azithromycin (Zithromax) C) Clarithromycin (Biaxin) D) Doxycycline E) Levofloxacin (Levaquin) Correct Answer macrolides
• inhibit cyp
• statin metabolized by cyp

• risk statin toxicity pt with egg allergy A) Avoid giving influenza vaccine B) Administer the live-attenuated influenza vaccine and observe for 30 minutes C) Administer trivalent inactivated vaccine and observe for 30 minutes D) Have the patient take prednisone, 20 mg for 3 days, then administer the live-attenuated influenza vaccine and observe for 30 minutes E) Have the patient take prednisone, 20 mg for 3 days, and then administer the trivalent inactivated vaccine and observe for 30 minutes Correct Answer Administer trivalent inactivated vaccine and observe for 30 minutes A 45-year-old male with diabetes mellitus sees you for the first time. If the patient has not

previously received it, which one of the following vaccines is recommended for him by the Advisory Committee on Immunization Practices? A) Hepatitis A B) Hepatitis B C) Meningococcal D) Varicella zoster Correct Answer hep b What class of medications for T2DM is associated with ketoacidosis? Correct Answer SGLT2 inhibitors such as dapagliflozin Definition of febrile neutropenia. Correct Answer Single oral temp of 38.5 C, sustained temp of 38 C for over 1 hr with ANC < 500 Antihypertensive of choice in gout patients? Correct Answer Losartan (ARBs) Preferred method for diagnosing lymphoma? Staging? Correct Answer Open lymph node biopsy? Staging = PET-CT Name 2 nonsynthetic opioids that drug tests will usually catch? Correct Answer Morphine and codeine The rest are synthetic

Typical incubation period for COVID 19? Correct Answer 4-5 days All patients aged 40-75 with diabetes and an LDL above 70 should be taking... Correct Answer A moderate intensity statin USPSTF recommends ASA 81mg daily after ___ weeks gestation for those at high risk for preeclampsia. Correct Answer 12 According to the ADVANCE and ACCORD trials, harms increase in aggressive tx of T2DM with an A1c less than 6.5%. In choosing between removing MTF vs insulin you should remove... Correct Answer Insulin Best regimen for preventing exacerbations in mild asthma? Correct Answer ICS/LABA PRN What are HIDA scans used to diagnose? Correct Answer Functional gallbladder diseases such as acalculous cholecystitis, biliary dyskinesia, biliary dysmotility The AAP recommends screening for maternal depression at which WCCs? Correct Answer 1, 2, 4, 6 months

In women with large symptomatic fibroids which treatment option reduces size, bleeding and improves QOL? Correct Answer Uterine artery embolization and occlusion Consider use of the Hunter Serotonin Toxicity criteria when serotonin syndrome is suspected. SSRIs mixed with ___ puts pt at higher risk? Correct Answer Tramadol Guidelines from the American College of Radiology recommend imaging in children and adolescents that meet which criteria? Correct Answer Pain that awakens them at night Abnormal neurologic findings Pain that radiates Pain that persists more than 4 weeks AAA screening is for... Correct Answer Men aged 65-75 who have ever smoked Treatment of delusion of infestation? Correct Answer Initial blood work and then typical antipsychotic such as olanzapine or risperidone Triad of Meniere's disease? Correct Answer Episodic vertigo Hearing loss Tinnitus

Children do not need a booster / car seat when they reach what height? Correct Answer 145 cm 57 inches Best prevention of CAUTIs in patients with chronic indwelling Foley? Correct Answer Routine cleaning of meatal surface with soap and water during baths / shower Which type of burns blister, but do NOT blanch with pressure? Correct Answer Deep partial thickness burns Tx of CAP in pt with comorbidity? Correct Answer Augmentin + macrolide Tx of buckle fx? Correct Answer Short arm splint for 4 weeks, can then return to activity if pain-free No need for repeat imaging or ortho referral DOC for severe hypertriglyceridemia? Correct Answer Fibrates What has been proven to prevent perinatal depression? Correct Answer CBT Which one of the following would make you suspect retinal vein occlusion as the cause of her sudden visual loss?

A) An afferent pupillary defect in the contralateral eye B) Right eye redness C) Tortuous retinal veins on funduscopic examination D) Macular drusen on funduscopic examination Correct Answer tortous veins

• cotton wool spots rx radial fracture A) A long arm posterior splint B) A radial gutter splint C) A sugar-tong splint D) A thumb spica splint E) An ulnar gutter splint Correct Answer immobilization 4-8weeks
• sugar tong splint or
• short arm cast A post-bronchodilator FEV1/FVC ratio of ___ is required to diagnose COPD. Correct Answer Less than 0.

1st line tx for non-low back pain MSK pain? Correct Answer Topical NSAIDs What should be administered as soon as acute rheumatic fever is diagnosed? Correct Answer Naproxen Any bruising of a nonmobile infant (especially under ___) warrants an abuse investigation. Correct Answer 4 months ___ is 95% specific for rheumatoid arthritis when significantly elevated? Correct Answer Anti-citrullinated protein antibody According to GINA, patients with COPD who are on monotherapy with a LAMA or LABA with continued dyspnea should... Correct Answer Get started on the other one If on LAMA , add LABA If on LABA, add LAMA Tx of ARBS in pts with PCN allergy. Correct Answer Levofloxacin How do you prevent calcium stones despite optimal lifestyle modifications (increase water intake to 3L per day, normal calcium diet, low salt diet, 0.8-1 g protein / kg / day Correct Answer Citrate supplementation with potassium citrate

Tx of hallux rigidus (OA of MTP joint in elderly)? Correct Answer Rigid shoe insert to restrict motion across MTP joint Start a statin in pediatric pts with T1DM with an LDL over... Correct Answer 100 Most common cause of death in 45-64 age range? Correct Answer Malignancy For newborns that fail initial hearing screen, repeat should be done before what age? Correct Answer 3 months Cystic fibrosis can cause a ___ pattern on spirometry. Correct Answer Obstructive Tx of metatarsus adductus? Correct Answer Adjustable orthotic shoes Best type of therapy for peds patient with anorexia nervosa? Correct Answer Family therapy New uterine bleeding symptoms in women aged 45 should undergo... Correct Answer Endometrial biopsy

Consider ___ in a patient over 40 with obesity and neuropathy presenting with unilateral foot swelling. There may be erythema and warmth and pain may be absent. The next step is bilateral weight-bearing foot radiographs. Correct Answer Charcot neuropathy Tx after exposure to syphilis within 90 days? Correct Answer 1 dose of PCN G 2.4 million units IM Criteria for CTA Correct Answer D-dimer over 1000 OR D-dimer over 500 and hemoptysis or signs of DVT or suspicion that PE is the most likely diagnosis Tx of patellar tendinopathy Correct Answer Eccentric quadriceps- strengthening exercises Pts with takotsubo cardiomyopathy are most likely to have a normal... Correct Answer Coronary angiography Most common cause of koilonychia (spoon-shaped nails)? Correct Answer IDA According to the ADA and ACOG the preferred management of gestational diabetes is... Correct Answer Insulin

Which class of antihypertensives is associated with elevated triglycerides? Correct Answer B-blockers (except carvedilol) All patients with croup should receive dexamethasone. Those with moderate or severe croup should also receive... Correct Answer Nebulized epinephrine According to ACOG, woman should continue OCPs until... Correct Answer Menopause or age 50- 55 ___ is a sensitive screening test for SLE. Correct Answer ANA Patients with scoliosis with a Cobb angle of less than ___ can be treated with observation. Over ___ should receive a surgery referral. Correct Answer 20 40 First line medications to prevent migraine without aura? Correct Answer Valproic acid Topiramate Metoprolol Propanolol Timolol Duration of treatment with alendronate? Correct Answer 5 years

Primary ovarian insufficiency is associated with what lab results? Correct Answer Low estradiol High LH / FSH Megestrol increases the risk of ___ in cancer patients undergoing chemotherapy. Correct Answer VTE 1st line tx for hirsutism? Correct Answer OCPs ___ should be considered in patients with HTN and low K+ or on 3+ antihypertensives. Correct Answer Primary hyperaldosteronism Check aldosterone/renin ratio Rash associated with coccidiomycosis? Correct Answer Erythema nodosum How often should patients with cirrhosis or clinically significant portal hypertension be screened for varices? Correct Answer Every 2-3 years via EGD AAP recommends blood pressure screening at age... Correct Answer 3

Triptan use is contraindicated in... Correct Answer CAD, stent placement, CVD, PVD 4 supplements used in patients with thalassemia and osteoporosis. Correct Answer Bisphosphonates Vitamin D Calcium Zinc 1st line therapy for seasonal affective disorder Correct Answer 1st line = Light therapy Followed by SSRI Biologic therapy should be considered in which asthma patients? Correct Answer Severe type 2 inflammatory asthma (allergic and eosinophilia) who have symptoms despite adherence to optimal therapy including LABA and high dose ICS A RAIU scan with multiple areas of increased and suppressed intake is consistent with... Correct Answer Toxic multinodular goiter Lab abnormalities of TLS? Correct Answer Hyperkalemia Hyperuricemia Hyperphosphatemia

Hypocalcemia Which class of antiHTN increase risk of myopathy when starting a statin? Correct Answer CCBs Which diabetes class of medications most often cause hypoglycemia? Correct Answer Sulfonylureas Class of diabetes medications a/w DKA? Correct Answer SGLT2 inhibitors Patients on clozapine must be enrolled in the Clozapine Risk Evaluation and Mitigation strategy program. What must be checked every 30 days? Correct Answer Neutrophil count True or False. The USPSTF recommends starting ASA 81mg for primary stroke prevention in patients aged 60+. Correct Answer FALSE There is no net benefit In pts with ADPKD the most common location of extrarenal cysts is... Correct Answer Liver The most severe complication is intracranial aneurysms Best nonpharmacologic tx option for pts with IBS-D? Correct Answer High soluble fiber diet

What should be done for patients 4-12 weeks after delivery in pregnancies where gestational diabetes was diagnosed? Correct Answer 2 hour GTT Legg-Calve-Perthes disease is a type of osteochondritis. What is the tx? Correct Answer Refer to ortho Avoid weight-bearing activities Tx option for patients with resistant HTN and OSA? Correct Answer Spironolactone High likelihood of excess aldosterone in these patients Initial w/u for suspected hemochromatosis. Correct Answer Serum iron, ferritin, transferrin saturation. Transferrin >45% and serum ferritin >300 are suggestive. In elderly patients with elevated Alk phos with normal liver function and GTT, what do you suspect? Next steps? Correct Answer Paget disease Plain film of skull, pelvis, tibia What can be used for secondary prevention of heart attack/stroke in patients with chronic CAD? Correct Answer Colchicine