ABFM Clinical Decision Making Flashcards

A 45-year-old male presents with chest pain radiating to the left arm and diaphoresis. Which initial diagnostic test is most critical according to ABFM clinical guidelines?

Answer: 12-lead ECG

A 12-lead ECG should be obtained within 10 minutes of presentation for any patient with suspected acute coronary syndrome.

When applying evidence-based medicine in family practice, which study design provides the highest level of evidence for clinical decision making?

Answer: Randomized controlled trial

Randomized controlled trials are considered the gold standard for evaluating treatment efficacy due to their controlled design and reduced bias.

A 60-year-old woman with type 2 diabetes has an HbA1c of 9.2%. According to ABFM guidelines, what is the most appropriate next step?

Answer: Intensify glycemic management

An HbA1c of 9.2% indicates poor glycemic control and requires intensification of the treatment regimen per ADA and ABFM guidelines.

Which clinical decision support tool is most appropriate for estimating 10-year cardiovascular risk in a primary care patient?

Answer: Framingham Heart Score

The Framingham Heart Score (or Pooled Cohort Equations) is the recommended tool for estimating 10-year atherosclerotic cardiovascular disease risk in primary care.

In shared decision making, which element is MOST essential for family physicians to incorporate with patients?

Answer: Discussing patient values and preferences

Shared decision making requires eliciting and incorporating patient values and preferences alongside clinical evidence to reach a mutually agreed-upon care plan.

A 35-year-old pregnant woman at 28 weeks gestation presents with new-onset headache and blood pressure of 158/102 mmHg. What is the most appropriate clinical decision?

Answer: Diagnose preeclampsia and manage urgently

New-onset hypertension with symptoms after 20 weeks gestation meets criteria for preeclampsia and requires urgent evaluation and management.