ABFM Assessment and Evaluation 2

Question 1

A 58-year-old male with hypertension presents for routine follow-up. His office BP is 148/92 mmHg on two readings. Which approach best confirms a diagnosis of sustained hypertension before intensifying therapy?

Accepted Answer

Order ambulatory blood pressure monitoring (ABPM)

Answer

ABPM is the gold standard for confirming sustained hypertension and ruling out white-coat hypertension before escalating therapy.

Question 2

When using the PHQ-9 to screen for depression, which score indicates moderately severe depression requiring prompt clinical action?

Accepted Answer

15–19

Answer

PHQ-9 scores of 15–19 indicate moderately severe depression, warranting active treatment initiation such as pharmacotherapy and/or psychotherapy.

Question 3

A family physician administers a Mini-Cog to an elderly patient. The patient recalls 1 of 3 words and draws a normal clock. How should this result be interpreted?

Accepted Answer

Positive screen — further dementia evaluation warranted

Answer

On the Mini-Cog, recalling 1–2 words with a normal clock is a positive screen (score ≤2 triggers further evaluation).

Question 4

Which spirometry pattern is most consistent with COPD on pulmonary function testing?

Accepted Answer

FEV1/FVC <0.70 post-bronchodilator with air trapping

Answer

COPD is defined by a post-bronchodilator FEV1/FVC <0.70, and air trapping (elevated RV/TLC) on full PFTs confirms obstructive physiology.

Question 5

A 45-year-old woman presents with fatigue and weight gain. TSH is 8.2 mIU/L and free T4 is low. Which diagnosis does this pattern confirm?

Accepted Answer

Overt primary hypothyroidism

Answer

Overt primary hypothyroidism is defined by an elevated TSH with a low free T4, indicating inadequate thyroid hormone production.

(ABFM) American Board of Family Medicine Practice Test

(ABFM) American Board of Family Medicine Practice Test

ABFM Assessment and Evaluation 2