ITE 2024 Exam Study Questions with Answers & Explanations
ITE Exam Study Questions with Answers & Explanations 2024
-A 42-year-old Asian male presents for follow-up of elevated blood pressure. He has no additional
chronic medical problems and is otherwise asymptomatic. An examination is significant for a blood
pressure of 162/95 mm Hg but is otherwise unremarkable.
Laboratory Findings
Sodium 138 mEq/L (N 135-145) Potassium 3.9 mEq/L (N 3.5-5.5) Fastingglucose 86mg/dLBUN 14
mg/dL
(N 10-20) Creatinine 0.6mg/dL(N0.6-1.3) Urinemicroalbumin negative
According to the American College of Cardiology/American Heart Association 2017 guidelines, which
one of the following would be the most appropriate medication to initiate at this time?
A) Clonidine (Catapres), 0.1 mg twice daily
B) Hydralazine, 25 mg three times daily
C) Lisinopril/hydrochlorothiazide (Zestoretic), 10/12.5 mg daily
D) Metoprolol tartrate (Lopressor), 25 mg twice daily
E) Triamterene (Dyrenium), 50 mg daily {{Correct Ans- ANSWER: C
Explanation
This patient has hypertension and according to both JNC 8 and American College of
Cardiology/American Heart Association 2017 guidelines, antihypertensive treatment should be
initiated. For the general non-African-American population, monotherapy with an ACE inhibitor, an
angiotensin receptor blocker, a calcium channel blocker, or a thiazide diuretic would be appropriate
for initial management. It is also appropriate to initiate combination antihypertensive therapy as an
initial management strategy, although patients should not take an ACE inhibitor and an angiotensin
receptor blocker simultaneously. Studies have shown that blood pressure control is achieved faster
with the initiation of combination therapy compared to monotherapy, without an increase in
morbidity. Lisinopril/hydrochlorothiazide would be an appropriate choice in this patient. -Blockers,
vasodilators, blockers, and potassium-sparing diuretics are not recommended as initial choices for the
treatment of hypertension.
,ITE 2024 Exam Study Questions with Answers & Explanations
-During rounds at the nursing home, you are informed that there are two residents on the unit with
laboratory-confirmed influenza. According to CDC guidelines, who should receive chemoprophylaxis
for influenza?
A) Only symptomatic residents on the same unit
B) Only symptomatic residents in the entire facility
C) All asymptomatic residents on the same unit
D) All residents of the facility regardless of symptoms
E) All staff regardless of symptoms {{Correct Ans- ANSWER: C
Explanation
In long-term care facilities, an influenza outbreak is defined as two laboratory-confirmed cases of
influenza within 72 hours in patients on the same unit. The CDC recommends chemoprophylaxis for all
asymptomatic residents of the affected unit. Any resident exhibiting symptoms of influenza should be
treated for influenza and not given chemoprophylaxis dosing. Chemoprophylaxis is not recommended
for residents of other units unless there are two laboratory-confirmed cases in those units. Facility
staff of the affected unit can be considered for chemoprophylaxis if they have not been vaccinated or
if they had a recent vaccination, but chemoprophylaxis is not recommended for all staff in the entire
facility.
-A 24-year-old female presents with a 2-day history of mild to moderate pelvic pain. She has had two
male sex partners in the last 6 months and uses oral contraceptives and sometimes condoms. A
physical examination reveals a temperature of 36.4°C (97.5°F) and moderate cervical motion and
uterine tenderness. Urine hCG and a urinalysis are negative. Vaginal microscopy shows only WBCs.
The initiation of antibiotics for treatment of pelvic inflammatory disease in this patient
A) is appropriate at this time
B) requires an elevated temperature, WBC count, or C-reactive protein level
C) should be based on the results of gonorrhea and Chlamydia testing
D) should be based on the results of pelvic ultrasonography {{Correct Ans- ANSWER: A Explanation
Pelvic inflammatory disease (PID) is a clinical diagnosis, and treatment should be administered at the
time of diagnosis and not delayed until the results of the nucleic acid amplification testing (NAAT) for
gonorrhea and Chlamydia are returned. The clinical diagnosis is based on an at-risk woman presenting
with lower abdominal or pelvic pain, accompanied by cervical motion, uterine, or adnexal tenderness
,ITE 2024 Exam Study Questions with Answers & Explanations
that can range from mild to severe. There is often a mucopurulent discharge or WBCs on saline
microscopy. Acute phase indicators such as fever, leukocytosis, or an elevated C-reactive protein level
may be helpful but are neither sensitive nor specific. A positive NAAT is not required for diagnosis and
treatment because an upper tract infection may be present, or the causative agent may not be
gonorrhea or Chlamydia. PID should be considered a polymicrobial infection. Pelvic ultrasonography
may be used if there is a concern about other pathology such as a tubo-ovarian abscess.
-A 24-year-old patient wants to start the process of transitioning from female to male. He has been
working with a psychiatrist who has confirmed the diagnosis of gender dysphoria.
Which one of the following would be the best initial treatment for this patient?
A) Clomiphene
B) Letrozole (Femara)
C) Leuprolide (Eligard)
D) Spironolactone (Aldactone)
E) Testosterone {{Correct Ans- ANSWER: E
Explanation
For patients with gender dysphoria or gender incongruence who desire hormone treatment, the
treatment goal is to suppress endogenous sex hormone production and maintain sex hormone levels
in the normal range for their affirmed gender. For a female-to-male transgender patient this is most
easily accomplished with testosterone. When testosterone levels are maintained in the normal
genetic male range, gonadotropins and ovarian hormone production is suppressed, which
accomplishes both goals for hormonal treatment without the need for additional gonadotropin
suppression from medications such as leuprolide.
Clomiphene can increase serum testosterone levels, but only in the presence of a functioning testicle.
Letrozole is an estrogen receptor antagonist, but it would not increase serum testosterone levels.
Spironolactone has androgen receptor blocking effects and would not accomplish either of the
hormone treatment goals.
-Based on American Cancer Society guidelines for cervical cancer screening, when should HPV DNA co
testing first be performed along with Papanicolaou testing?
A) At the onset of sexual activity
, ITE 2024 Exam Study Questions with Answers & Explanations
B) At age 21
C) At age 25
D) At age 30
E) At age 35 {{Correct Ans- ANSWER: D
Explanation
According to American Cancer Society guidelines for cervical cancer screening, Papanicolaou (Pap)
testing should begin at age 21 irrespective of sexual activity and should be continued every 3 years
until age 29. The preferred screening strategy beginning at age 30 is Pap testing with HPV co-testing,
which should be continued every 5 years until age 65. Cervical screening may be discontinued at that
time if the patient's last two tests have been negative and the patient was tested within the previous 5
years.
-Long-term proton pump inhibitor use is associated with an increased risk for
A) Barrett's esophagus
B) gout
C) hypertension
D) pneumonia
E) type 2 diabetes {{Correct Ans- ANSWER: D
Explanation
Acid suppression therapy is associated with an increased risk of community-acquired and health
careassociated pneumonia, which is related to gastric overgrowth by gram-negative bacteria. Long-
term treatment of Barrett's esophagus is an indication for chronic proton pump inhibitor (PPI) use. PPI
therapy does not increase the risk of gout, hypertension, or type 2 diabetes.
-An 87-year-old female comes to your office for an annual health maintenance visit. She appears
cachectic and tells you that for the past 6 months she has had a decreased appetite and generalized
muscle weakness. The patient is alert and oriented to person and place. She has a 10% weight loss,
dry mucous membranes, and tenting of the skin on the extensor surface of her hands. While
inflating the blood pressure cuff on her right arm you observe carpopedal spasms. Which one of the
following is the most likely electrolyte disturbance?
