Bộ câu hỏi thi AAFP - American Board of Family Medicine (IN-TRAINING EXAMINATION) | Cộng đồng Kỹ thuật cơ điện Việt Nam EBOOKBKMT

1. A 36-year-old female presents for evaluation of elevated blood pressure. She is asymptomatic and does not take any medications. On examination her blood pressure is 160/96 mm Hg and her BMI is 26 kg/m2

. Fasting laboratory studies include the following:

Sodium                               142 mEq/L (N 136–145)

Potassium                             3.0 mEq/L (N 3.5–5.1)

Creatinine                             0.76 mg/dL (N 0.6–1.1)

Glucose                               97 mg/dL

Which one of the following additional laboratory evaluations should be performed to assess her

blood pressure?

A) A 24-hour urine collection for 5-hydroxyindoleacetic acid (5-HIAA)

B) A serum aldosterone/renin ratio

C) A serum cortisol level

D) A serum cystatin C level

2. A 26-year-old male diagnosed with coccidioidomycosis (valley fever) develops a rash on the

extensor surfaces of his lower legs consisting of painful, subcutaneous, nonulcerated,

erythematous nodules. This rash is consistent with which one of the following?

A) Erythema ab igne

B) Erythema infectiosum

C) Erythema migrans

D) Erythema multiforme

E) Erythema nodosum

3. A 50-year-old male presents with chronic abdominal pain. A workup leads you to suspect peptic

ulcer disease, and you refer him for endoscopy, which shows a small duodenal ulcer. The

endoscopist also notes some small esophageal varices without red wale signs.

Further evaluation confirms that the patient has compensated cirrhosis in the setting of alcohol

use disorder. He readily accepts this diagnosis and enters an Alcoholics Anonymous program.

His ulcer symptoms resolve with antibiotic therapy for Helicobacter pylori. He says he has

abstained from alcohol for 6 weeks, and he would like to further reduce his risks from cirrhosis.

The most appropriate next step in the management of his esophageal varices would be

A) octreotide (Sandostatin)

B) omeprazole (Prilosec)

C) propranolol

D) endoscopic variceal ligation

E) repeat endoscopy in 1–2 years

4. An 83-year-old female with a history of Alzheimer’s dementia presents with concerns about

worsening agitation in the evenings. She is accompanied by her daughter who has power of

attorney. The patient is dependent on her daughter for all instrumental activities of daily living

and requires assistance with certain core activities of daily living such as dressing and bathing.

She has no other chronic medical problems. Her daughter states that starting around 4:00 p.m.,

the patient becomes increasingly disoriented and agitated. There has been no physical

aggression, but the daughter asks for medical intervention to “help calm her down.”

Which one of the following should you recommend initiating first for the management of this

patient’s symptoms?

A) Sensory stimulation including touch and music

B) Cognitive training

C) Haloperidol

D) Quetiapine (Seroquel)

E) Valproic acid

5. A 62-year-old female underwent a total knee replacement 3 months ago. She has no other

surgical history and is in good health. Her dental office calls you to discuss antibiotic

prophylaxis prior to a dental cleaning.

Based on current guidelines, which one of the following would be most appropriate regarding

antibiotic prophylaxis prior to routine dental procedures in this patient?

A) No prophylaxis

B) Prophylaxis for 6 months post knee replacement

C) Prophylaxis for 1 year post knee replacement

D) Prophylaxis for 5 years post knee replacement

E) Prophylaxis for the patient’s lifetime

6. Which one of the following cardiovascular medications may lead to hyperthyroidism?

A) Amiodarone

B) Digoxin

C) Flecainide

D) Metoprolol

E) Valsartan (Diovan)

7. An otherwise healthy 29-year-old gravida 2 para 1 at 28 weeks gestation presents to your office

with a laceration sustained while doing yard work. After thoroughly cleaning the wound, you

decide not to suture it because of the risk of infection. The patient received Tdap during her

previous pregnancy 6 years ago and you confirm in her medical records that she completed her

primary immunizations as a child.

Which one of the following would be most appropriate regarding tetanus prophylaxis?

A) No tetanus prophylaxis

B) Tetanus immune globulin now

C) Td now

D) Tdap now

E) Tdap at 38 weeks gestation

8. Based on the current CDC treatment guidelines, which one of the following is recommended as

first-line treatment of urethritis in a 24-year-old male who weighs 152 kg (335 lb), when nucleic

acid amplification testing (NAAT) for gonorrhea is positive and Chlamydiatesting is negative?

A) One dose of ceftriaxone, 1 g intramuscularly

B) One dose of ceftriaxone, 500 mg intramuscularly, plus one dose of azithromycin

(Zithromax), 1 g orally

C) One dose of ceftriaxone, 500 mg intramuscularly, plus doxycycline, 100 mg orally twice

daily for 7 days

D) One dose of gentamicin, 240 mg intramuscularly, plus one dose of azithromycin, 2 g

orally

9. Which one of the following statements regarding hormone therapy for transgender patients is

true?

A) Hormone therapy to facilitate development of secondary sex characteristics is generally

reversible

B) Patients who receive hormone therapy generally report improved quality of life, higher

self-esteem, and decreased anxiety

C) Masculinizing hormone therapy is associated with reduced muscle mass and fat

redistribution

D) Patients receiving feminizing hormone therapy are at increased risk for erythrocytosis

10. A 42-year-old female presents with a 2-day history of a rash on her neck along her hairline

(shown below). Which one of the following is the most likely diagnosis?

A) Atopic dermatitis

B) Contact dermatitis

C) Psoriasis

D) Seborrheic dermatitis

Item #10

11. Which one of the following is the most common cause of prerenal acute kidney injury in the

intensive-care setting?

A) ACE inhibitor use

B) NSAID use

C) Membranoproliferative glomerulonephritis

D) Polyarteritis nodosa

E) Sepsis

12. A 37-year-old female presents to your clinic with a long-standing history of abnormal menstrual

cycles, often occurring irregularly more than 40 days apart. She has ongoing struggles with

weight gain, acne, and facial hair growth. She states that she is not currently sexually active. Her

last Papanicolaou smear 2 years ago was normal. Her vital signs and a physical examination are

unremarkable other than a BMI of 36 kg/m

. An office urine pregnancy test is negative.

Laboratory evaluation reveals a hemoglobin A

of 6.2%, and normal TSH, prolactin, and

17-hydroxyprogesterone levels.

Which one of the following is required to confirm the most likely diagnosis?

A) No additional evaluation

B) A serum C-peptide test

C) A dexamethasone suppression test

D) Ultrasonography of the pelvis

E) CT of the abdomen and pelvis

13. A 56-year-old male presents to your office with a new onset of nonvalvular atrial fibrillation.

His CHA

-VASc score is 3 based on his previous history of hypertension, diabetes mellitus,

and heart failure. He has no major risk factors for bleeding.

Which one of the following would be recommended for the prevention of ischemic stroke

secondary to atrial fibrillation in this patient?

A) No antithrombotic therapy

B) Apixaban (Eliquis), 5 mg twice daily

C) Aspirin only, 81 mg daily

D) Aspirin only, 325 mg daily

E) Aspirin, 81 mg daily, plus full-dose warfarin, with a target INR of 2.0–3.0

14. Which one of the following is the most common radiologic finding in early pulmonary

sarcoidosis?

A) Bilateral hilar adenopathy

B) Caseating granulomas

C) Pleural granulomas

D) Peribronchiolar thickening

15. A 62-year-old male was recently diagnosed with adhesive capsulitis. Which one of the following

is associated with a higher risk of developing adhesive capsulitis compared with the general

population?

A) Addison’s disease

B) Diabetes mellitus

C) Hyperparathyroidism

D) Hypertension

E) Rheumatoid arthritis

16. Once hemolysis is excluded, the most common cause of unconjugated hyperbilirubinemia is

A) alcoholic liver disease

B) biliary tract disease

C) fatty liver disease

D) Gilbert syndrome

E) Wilson disease

17. A 35-year-old female presents to your office with a feeling of vague fullness in her neck for the

last month. She has noticed a gradual onset of fatigue, constipation, and cold intolerance over

that time. A few weeks ago the patient took a selfie and was surprised by how puffy her face

appeared in the photo.

On examination her thyroid is diffusely enlarged and nontender and feels pebbly on palpation.

An HEENT examination, including an eye examination, is otherwise normal.

Which one of the following is the most likely diagnosis?

A) Chronic autoimmune (Hashimoto) thyroiditis

B) Graves disease

C) Lymphadenitis

D) Lymphoma

E) Thyroid cancer

18. A 12-year-old female presents with a sore throat and tonsillar exudate, and a rapid antigen test

is positive for streptococcal pharyngitis. She returns to your office after completing a 10-day

course of penicillin this morning. She says that although she saw some initial improvement, she

now has a sore throat again, accompanied by a runny nose and cough. Her mother asks if

another antibiotic would be appropriate. A physical examination reveals nonexudative

pharyngitis, but a rapid antigen test for group A Streptococcusis again positive.

Which one of the following would be the most appropriate treatment at this point?

A) No further antibiotic therapy

B) Oral azithromycin (Zithromax) for 5 days

C) Oral ciprofloxacin (Cipro) for 10 days

D) A single dose of intramuscular benzathine penicillin

E) A single dose of intramuscular ceftriaxone

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