ABFM Practice and Application 2

Question 1

A 58-year-old man with type 2 diabetes presents with a blood pressure of 148/92 mmHg on three separate visits. Which antihypertensive class is preferred as first-line therapy in this patient?

Accepted Answer

ACE inhibitor

Answer

Beta-blocker

Answer

Calcium channel blocker

Answer

Alpha-blocker

Question 2

A family physician is reviewing quality metrics and notices 40% of eligible patients are overdue for colorectal cancer screening. Which practice improvement strategy is most effective for population-level screening gaps?

Accepted Answer

Implementing a proactive recall system with standing orders

Answer

Relying on patients to self-schedule colonoscopies

Answer

Increasing appointment duration to discuss screening

Answer

Delegating all screening discussions to nurses only

Question 3

A 72-year-old woman on warfarin for atrial fibrillation presents with an INR of 5.8 but no active bleeding. What is the most appropriate management?

Accepted Answer

Hold warfarin and give oral vitamin K 1–2.5 mg

Answer

Hold warfarin and administer IV vitamin K

Answer

Continue warfarin at the same dose and recheck in one week

Answer

Administer fresh frozen plasma immediately

Question 4

Which of the following best describes the role of the patient-centered medical home (PCMH) model in family medicine practice?

Accepted Answer

Coordinating comprehensive, continuous, accessible, and patient-centered care

Answer

Restricting care to episodic urgent visits only

Answer

Eliminating specialist referrals to reduce costs

Answer

Focusing exclusively on preventive care services

Question 5

A 45-year-old woman presents with a 6-month history of fatigue, weight gain, cold intolerance, and constipation. TSH is 12 mIU/L with low free T4. What is the first-line treatment?

Accepted Answer

Levothyroxine (T4) replacement

Answer

Liothyronine (T3) replacement

Answer

Methimazole

Answer

Radioactive iodine ablation

Question 6

A physician implements a point-of-care A1C testing device in the office. Which principle of practice improvement does this best represent?

Accepted Answer

Improving care through technology to enhance efficiency and same-visit decision-making

Answer

Reducing provider autonomy

Answer

Replacing laboratory services entirely

Answer

Shifting costs to the patient

Question 7

A 35-year-old pregnant woman at 28 weeks gestation screens positive on the 1-hour glucose challenge test (GCT) with a value of 155 mg/dL. What is the next step?

Accepted Answer

Perform a 3-hour 100g oral glucose tolerance test (OGTT)

Answer

Diagnose gestational diabetes and start insulin

Answer

Repeat the 1-hour GCT in 4 weeks

Answer

Initiate dietary counseling without further testing