ABFM ABFM Patient Care Management 2 — Questions and Answers
Question 1: A 50-year-old woman with well-controlled type 2 diabetes on metformin has a new LDL of 135 mg/dL. According to ABFM guidelines, what is the most appropriate next step?
- Lifestyle modification only for 6 months
- Initiate statin therapy (Correct answer)
- Refer to cardiology
- No treatment needed if asymptomatic
Correct answer: Initiate statin therapy
Adults aged 40-75 with diabetes and LDL ≥70 mg/dL qualify for moderate-intensity statin therapy per ACC/AHA guidelines endorsed in family medicine.
Question 2: Which criterion is part of the USPSTF recommendation for lung cancer screening with low-dose CT in the US?
- Age 40-69, 15 pack-year smoking history
- Age 50-80, 20 pack-year history, current or former smoker within 15 years (Correct answer)
- Age 60-75, any smoking history
- Age 55-80, 30 pack-year history only
Correct answer: Age 50-80, 20 pack-year history, current or former smoker within 15 years
USPSTF recommends annual low-dose CT lung cancer screening for adults aged 50-80 with a 20 pack-year history who currently smoke or quit within the past 15 years.
Question 3: When counseling a patient on weight management, which strategy has the strongest evidence for sustained weight loss?
- Fad diets alone
- Intensive lifestyle intervention combining diet, exercise, and behavioral support (Correct answer)
- Over-the-counter diet pills
- Skipping meals
Correct answer: Intensive lifestyle intervention combining diet, exercise, and behavioral support
Intensive lifestyle interventions that combine caloric restriction, increased physical activity, and behavioral support are the most evidence-based approach for sustained weight loss.
Question 4: A 75-year-old patient on warfarin for atrial fibrillation requires a minor dental procedure. What is the most appropriate anticoagulation management?
- Stop warfarin 7 days before
- Continue warfarin with INR in therapeutic range for most minor dental procedures (Correct answer)
- Switch to heparin bridge
- Hold warfarin indefinitely
Correct answer: Continue warfarin with INR in therapeutic range for most minor dental procedures
For most minor dental procedures, current guidelines support continuing warfarin with the INR in the therapeutic range, as bleeding risk is low and thrombotic risk of stopping is higher.
Question 5: Which component of chronic disease management is most important for improving outcomes in patients with heart failure?
- Annual hospitalization for adjustment
- Daily weight monitoring and medication adherence (Correct answer)
- Restricting all physical activity
- High-sodium diet
Correct answer: Daily weight monitoring and medication adherence
Daily weight monitoring to detect fluid retention and consistent medication adherence are the cornerstones of outpatient heart failure management and reduce hospitalizations.
Question 6: A family physician sees a 28-year-old male with a BMI of 32 and no other risk factors. What is the most appropriate preventive intervention?
- Prescribe weight loss medication immediately
- Provide counseling on diet, exercise, and lifestyle modification (Correct answer)
- Order bariatric surgery consultation
- No intervention until BMI exceeds 40
Correct answer: Provide counseling on diet, exercise, and lifestyle modification
For overweight and obese adults without comorbidities, intensive behavioral counseling focused on diet and physical activity is the recommended first-line intervention.
ABFM ABFM Patient Care Management 2
A 50-year-old woman with well-controlled type 2 diabetes on metformin has a new LDL of 135 mg/dL.
According to ABFM guidelines, what is the most appropriate next step?