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

ACE inhibitors (or ARBs) are preferred in diabetic patients with hypertension due to their nephroprotective effects.

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

Proactive recall systems with standing orders allow staff to identify and contact overdue patients without requiring a physician visit.

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

For supratherapeutic INR without bleeding, holding warfarin and giving low-dose oral vitamin K is recommended to lower INR safely.

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

The PCMH model emphasizes team-based, coordinated, continuous, and accessible care centered on the whole patient across the lifespan.

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

Levothyroxine is the standard first-line treatment for primary hypothyroidism due to its long half-life and predictable conversion to T3.

(ABFM) American Board of Family Medicine Practice Test

(ABFM) American Board of Family Medicine Practice Test

ABFM Practice and Application 2