FREE Ultimate ABIM Test Question and Answers

Question 1

A 69-year-old woman with no history of illness shows up with a terrible headache and a temperature of up to 104°F after just one day.
She also reports sporadic episodes of expressive aphasia, nausea, and phono- and phonophobia.
A physical examination is noteworthy for a lady who appears sick and has a fever of 103.8°F orally, a blood pressure of 150/70, and a pulse of 100.
She keeps her eyes closed, seems to be slightly uncomfortable with the headache, and fights off passive neck flexion.
The motor and sensory system exams are routine and show no signs of papilledema.
The patient has a "normal" head CT after taking two blood cultures and starting therapy. 380 mg/dL of protein, 35 mg/dL of glucose, 400 WBC, 42% neutrophils, 35% lymphocytes, and 6% monocytes can all be found in the hazy CSF obtained through lumbar puncture.
Few polymorphonuclear cells and Gram-positive bacilli are seen in the CSF Gram stain.
What would be a risk factor for meningitis in this patient?

Accepted Answer

Age>50 and consumption of soft cheese

Answer

Exposure to 2-year old granddaughter who is unvaccinated against Haemophilus influenza type b

Answer

Lack of vaccination to Neisseria meningitidis

Answer

Age>65 and lack of immunization against Strep. Pneumoniae

Question 2

An emergency department (ED) referral brings a 24-year-old patient in for a diagnosis of shortness of breath. Reviewing the ED data revealed that the patient had minor respiratory distress, intermittent stridor, and frequent episodes of shortness of breath over the previous four months. At each presentation, oxygen saturation levels were normal. Intramuscular epinephrine and albuterol administered as empiric therapy did not affect the symptoms. The symptoms always went away on their own. The patient's prior medical history is uneventful, and they are taking no drugs. The vital signs and physical exams are also typical right now. Which of the subsequent diagnoses is more likely?

Accepted Answer

Paradoxical vocal cord motion

Answer

Chronic rhinosinusitis

Answer

Reactive airways disease

Answer

Angioedema

Answer

Laryngospasm

Question 3

A 30-year-old man with a piece of steak lodged in his throat arrives at the emergency room. He claims that this has now occurred twice. He claims that he just received a diagnosis of eosinophilic esophagitis. Which of the following statements is accurate for eosinophilic esophagitis (EOE)?

Accepted Answer

One must rule out reflux-induced eosinophilia prior to diagnosis of EOE

Answer

We can determine which foods are causing EOE by patch testing

Answer

We can determine which foods are causing EOE by skin prick testing

Answer

Besides diet elimination, there is no other treatment for EOE

Question 4

The best method for determining a food allergy is:

Accepted Answer

Skin testing only

Answer

History and lhE bloodwork

Answer

History and skin testing

Answer

lgE bloodwork only

Answer

Oral challenge

Question 5

You are meeting a 20-year-old male complaining for the previous two months about "puffy eyes" and "swollen ankles." Additionally, he says that his pee "sort of looks frothy and foamy." His vital signs during the examination are within normal ranges, and the funduscopy is uneventful but for minor bilateral edema 2+ in the bilateral feet to the ankle. He has never experienced any health issues or operations. His tests show an average serum creatinine level and a considerable 4-plus protein level without blood or bacteria in the urine. He has a kidney biopsy, which on light microscopy appears normal, but, on electron microscopy, reveals widespread podocyte effacement. Negative immunofluorescence results. Which medical intervention is ideal for this patient?

Accepted Answer

Corticosteroids

Answer

Rituximab

Answer

Tacrolimus

Answer

Cyclophosphamide

Answer

Cyclosporine

Question 6

The COPD symptom that frequently develops several years before the onset of airflow restriction is:

Accepted Answer

Dyspnea

Answer

Cough

Answer

Cyanosis

Answer

Chest pain

Question 7

During an asthma attack, confusion, bradycardia, and paradoxical breathing signify:

Accepted Answer

Imminent respiratory arrest

Answer

Moderate exacerbation

Answer

Impending stroke

Answer

Co-existing myocardial infarction