Mixed Deck — All ABFM Topics Flashcards

Which element of the PCMH (Patient-Centered Medical Home) model most directly improves chronic disease management outcomes?

Answer: Care coordination with a designated care team

Coordinated care delivered by a dedicated, multidisciplinary care team is the central feature of PCMH that drives improved chronic disease outcomes.

The 'substituted judgment' standard for surrogate decision-making requires the surrogate to:

Answer: Make the decision the patient would have made based on known values and preferences

Substituted judgment requires the surrogate to replicate the patient's own decision based on previously expressed values, not what the surrogate believes is best.

Which strategy is most effective in reducing catheter-associated urinary tract infections (CAUTIs) in hospitalized patients?

Answer: Daily reassessment of catheter necessity and prompt removal when no longer needed

Daily review of catheter necessity and prompt removal is the most evidence-based strategy for reducing CAUTIs by limiting the duration of catheterization.

A 22-year-old sexually active woman presents for her annual visit. She has never had a Pap smear. Per current USPSTF guidelines, when should her first cervical cancer screening occur?

Answer: At age 21, so she is already overdue and should be screened today

USPSTF guidelines recommend cervical cancer screening starting at age 21 with cytology alone every 3 years, regardless of sexual activity.

A family medicine physician who holds ABFM certification and also seeks certification in a focused area such as Hospice and Palliative Medicine would pursue which type of credential?

Answer: An ABFM Certificate of Added Qualifications (CAQ)

ABFM offers Certificates of Added Qualifications (CAQs) in focused areas like Hospice and Palliative Medicine, Sports Medicine, and Geriatric Medicine for diplomates seeking additional credentials.

Which federal agency enforces the Anti-Kickback Statute in healthcare?

Answer: Office of Inspector General (OIG), Department of Health and Human Services

The OIG of the Department of HHS is the primary enforcement body for the Anti-Kickback Statute and issues advisory opinions and safe harbor regulations.

When counseling a patient on weight management, which strategy has the strongest evidence for sustained weight loss?

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.

What role does Continuing Medical Education (CME) play in the MOC process for family physicians?

Answer: CME activities are necessary to fulfill the educational component of MOC

Continuing Medical Education (CME) activities play a vital role in the Maintenance of Certification (MOC) process for family physicians by fulfilling its essential educational component. These activities ensure that physicians remain current with the latest medical advancements, best practices, and evolving healthcare guidelines. Engaging in CME is a mandatory requirement that supports lifelong learning and helps physicians maintain their clinical competency.

When a terminally ill patient requests physician aid in dying in a state where it is legal, the physician who objects should:

Answer: Provide information about the process and ensure timely referral

Even when objecting on moral grounds, the physician must provide neutral information and arrange a timely referral to a willing provider to protect patient access to legal care.

A patient requests an amendment to their medical record under HIPAA. The covered entity may deny the request if:

Answer: The record was not created by the covered entity

A covered entity may deny an amendment request if it did not create the record, unless the originating entity is no longer available.

Which of the following is the primary goal of the ABFM's Longitudinal Knowledge Assessment (LKA)?

Answer: To provide ongoing, low-stakes knowledge assessment spread throughout the certification cycle

The LKA delivers a small number of questions regularly over time as an alternative to the traditional high-stakes exam.

A patient with HIV requests that their diagnosis not be shared with their sexual partner. The physician should:

Answer: Counsel the patient on partner notification and follow state law on duty to warn

Physicians must balance patient confidentiality with the duty to protect third parties, counseling on partner notification and following state-specific duty-to-warn laws.

Under the ACA's Hospital Readmissions Reduction Program, which family medicine action most directly reduces CMS financial penalties for a partnering hospital?

Answer: Ensuring timely post-discharge follow-up and medication reconciliation

Timely post-discharge follow-up and medication reconciliation are evidence-based outpatient strategies that reduce 30-day readmissions.

A physician suspects a patient is in an abusive domestic relationship but the patient denies it. The most appropriate action is to:

Answer: Document observations, provide information about resources, and create a safety plan

For adult domestic violence victims, the ethical approach involves documentation, resource provision, and safety planning without overriding patient autonomy through mandatory reporting (in most states for competent adults).

Which of the following is NOT a recognized domain in the ABFM's core competency framework for family medicine?

Answer: Pharmaceutical Sales Proficiency

Pharmaceutical sales proficiency is not a recognized ABFM core competency; the framework includes patient care, medical knowledge, practice-based learning, systems-based practice, professionalism, and communication.

Which vaccine is recommended annually for all persons aged 6 months and older?

Answer: Influenza vaccine

The influenza vaccine is recommended annually for all persons ≥6 months of age due to antigenic drift of influenza strains each season.

Which type of informed consent is generally sufficient for routine physical examinations in outpatient family medicine?

Answer: Implied consent from the patient's actions

Implied consent is generally accepted for routine examinations; patients indicate consent through their actions of scheduling and attending the appointment.

A 62-year-old smoker presents with sudden severe tearing chest pain radiating to the back. Blood pressure differs by 20 mmHg between arms. What is the most likely diagnosis?

Answer: Aortic dissection

Aortic dissection classically presents with sudden tearing chest/back pain and a blood pressure differential between extremities, especially in hypertensive patients.

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.

Which approach BEST demonstrates patient-centered communication when delivering a serious diagnosis?

Answer: Sit at eye level, allow silence, and elicit the patient's initial reaction before providing information

Patient-centered communication involves attending to the patient's emotional response, using nonverbal cues like sitting at eye level, and pacing information delivery to what the patient can absorb.