ABPS Medical Knowledge & Clinical Practice Standards 3

Question 1

A 35-year-old woman presents with symmetric arthritis of small joints of her hands, morning stiffness lasting >1 hour, and positive anti-CCP antibodies. Which disease-modifying agent is the current first-line treatment?

Accepted Answer

Methotrexate

Answer

Methotrexate remains the anchor DMARD and standard first-line therapy for rheumatoid arthritis due to its efficacy, safety profile, and extensive evidence base.

Question 2

Which electrocardiographic finding is pathognomonic for hyperkalemia at a serum potassium level typically >6.5 mEq/L?

Accepted Answer

Peaked T-waves progressing to sine wave pattern

Answer

Severe hyperkalemia produces peaked T-waves, then PR prolongation, QRS widening, and ultimately a sine wave pattern that can precede fatal arrhythmias.

Question 3

A 62-year-old male smoker presents with a new persistent cough and hemoptysis. CT shows a 3.2 cm spiculated pulmonary mass. What is the most appropriate next step?

Accepted Answer

Bronchoscopy or CT-guided biopsy for tissue diagnosis

Answer

A spiculated mass >3 cm with this presentation has high suspicion for malignancy and requires tissue diagnosis via bronchoscopy or CT-guided biopsy before staging or treatment.

Question 4

Which of the following best describes the mechanism of action of glucagon-like peptide-1 (GLP-1) receptor agonists in type 2 diabetes?

Accepted Answer

Stimulate insulin secretion in a glucose-dependent manner and suppress glucagon

Answer

GLP-1 receptor agonists enhance glucose-dependent insulin secretion, suppress glucagon, slow gastric emptying, and promote satiety through GLP-1 receptor activation.

Question 5

A patient presents with sudden-onset severe headache described as 'the worst headache of my life.' CT head is negative. What is the most critical next step?

Accepted Answer

Lumbar puncture for xanthochromia

Answer

A thunderclap headache with negative CT requires lumbar puncture to detect xanthochromia, which confirms subarachnoid hemorrhage missed by CT in up to 5-10% of cases.

(ABPS) American Board of Physician Specialties Certification Practice Test

(ABPS) American Board of Physician Specialties Certification Practice Test

ABPS Medical Knowledge & Clinical Practice Standards 3