ABFM Appraisal Exam Assessment Case Study Questions and Correct answers with Rationales Latest Updates 2024/2025
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Course
ABFM
Institution
ABFM
ABFM Appraisal Exam Assessment Case Study Questions and Correct answers with Rationales Latest Updates 2024/2025
1. Which one of the following treatments has been shown to improve the quality of life for a patient with tinnitus?
A) Antidepressant therapy
B) Ginkgo biloba
C) Niacin
D) Vitamin...
ABFM Appraisal Exam Assessment Case Study
Questions and Correct answers with
Rationales Latest Updates 2024/2025
1. Which one of the following treatments has been shown to
improve the quality of life for a patient
with tinnitus?
A) Antidepressant therapy
B) Ginkgo biloba
C) Niacin
D) Vitamin B12
E) Cognitive-behavioral therapy - correct answer E
Treatments to reduce awareness of tinnitus and tinnitus-related
distress include cognitive-behavioral
therapy, acoustic stimulation, and educational counseling. No
medications, supplements, or herbal
remedies have been shown to substantially reduce the severity of
tinnitus.
2. A 28-year-old female who was recently diagnosed with
polycystic ovary syndrome presents to discuss treatment of
irregular menses. She has 2-2 menstrual periods every 6 months
that happen at irregular times and can often produce heavy
bleeding. She is not obese and has no significant acne or
hirsutism. She does not desire pregnancy and her primary goal is
to decrease the heavy menstrual bleeding.
Which one of the following would be the most effective initial
recommendation?
,A) Dietary modifications aimed at weight loss
B) Clomiphene
C) Metformin (Glucophage)
D) Spironolactone (Aldactone)
E) Placement of a levonorgestrel IUD (Mirena) - correct answer
E
Polycystic ovary syndrome can significantly affect multiple organ
systems, and menstrual irregularities
from anovulatory cycles are very common. Treatment should be
based on the patient's goals and modified
based on her desire for fertility. In a patient who is not interested
in near-term fertility and whose goal is
to control menstrual irregularities, a levonorgestrel IUD is most
likely to reduce the frequency, duration,
and volume of bleeding. Metformin is used to treat insulin
resistance, dietary modifications are used to
treat obesity, spironolactone can be used to treat hirsutism or
acne, and clomiphene is used to induce
ovulation and fertility.
2. A 6-month-old male is brought to the urgent care center with a
2-day history of rhinorrhea, cough, and increased respiratory
effort. His temperature is 27.5°C (99.5°F), his heart rate is 120
beats/min, his respiratory rate is 42/min, and his oxygen
saturation is 96% on room air. On examination the child appears
well hydrated with clear secretions from his nasal passages,
there is diffuse wheezing heard bilaterally, and there is no nasal
flaring or retractions. The mother states that the child has a
decreased appetite but is drinking a normal amount of fluids.
,Which one of the following would be the most appropriate
management for this patient?
A) Supportive therapy only
B) Bronchodilators
C) A corticosteroid taper
D) Epinephrine
E) Nebulized hypertonic saline - correct answer A
This patient's symptoms and the examination suggest viral
bronchiolitis. Supportive therapy, including
adequate hydration, is recommended for treatment. Treatment
with bronchodilators, epinephrine,
hypertonic saline, or corticosteroids is not indicated (SOR A).
4. In asymptomatic patients with sarcoidosis, which one of the
following organ systems should be examined yearly to detect
extrapulmonary manifestations of the disease?
A) Cardiac
B) Neurologic
C) Ocular
D) Integumentary - correct answer C
Sarcoidosis has numerous extrapulmonary manifestations.
Because inflammation of the eye can result in permanent
impairment and is often asymptomatic, patients require yearly
eye examinations as well as additional monitoring with disease
flares. Although skin involvement is common it is usually readily
apparent and rarely has serious sequelae. Cardiac sarcoidosis
can potentially lead to progressive heart failure and sudden
death, but evaluation is needed only in patients who are
symptomatic. Similarly,
, evaluation for neurologic involvement is needed only in patients
who are symptomatic.
5. In addition to a thorough history and physical examination, the
routine evaluation of patients
presenting with syncope should include
A) a CBC, comprehensive metabolic panel, TSH level, and
urinalysis
B) orthostatic blood pressure measurements and an EKG
C) cardiac stress testing
D) echocardiography and Doppler ultrasonography of the carotid
arteries
E) CT or MRI of the brain - correct answer B
Orthostatic blood pressure measurement and an EKG are
indicated in the routine evaluation of patients with
syncope. All other testing should be directed by findings obtained
in the history and on the physical
examination.
6. A 67-year-old male presents for a Medicare wellness visit. He
underwent basic laboratory work prior to the office visit. He is
feeling well and does not have any concerns or symptoms. His
blood pressure is 127/76 mm Hg, his heart rate is 64 beats/min,
and he is afebrile. A comprehensive metabolic panel is
unremarkable. A CBC shows the following results:
WBCs 7500/mm2 (N 4100-10,900)
RBCs 4.05 million/mm2
(N 4.70-6.10)
Hemoglobin 12.9 g/dL (N 14.0-18.0)
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