ABFM ITE 2024 EXAM 2 NEWEST VERSIONS (VERSION A & B) 300 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+

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ABFM ITE 2024 EXAM 2 NEWEST VERSIONS

(VERSION A & B) 300 QUESTIONS AND

CORRECT DETAILED ANSWERS WITH

RATIONALES (VERIFIED ANSWERS) |ALREADY

GRADED A+

ABFM ITE 2024 EXAM VERSION A

A 62-year-old male with hypertension presents to your office with

substernal chest pain radiating into his left arm for the past 20 minutes.

He also has diaphoresis and nausea. He has a blood pressure of 156/96

mm Hg, a pulse rate of 84 beats/min, and an oxygen saturation of 93%

on room air. An EKG shows ST-segment elevations in leads V1 and V2.

Your medical assistant calls 911 for immediate transport to the local

hospital's emergency department. While awaiting the ambulance's arrival

you give the patient low-dose aspirin and sublingual nitroglycerin.

Which one of the following would be most appropriate regarding

oxygen therapy at this time?

A) No oxygen therapy

B) Oxygen via nasal cannula at 2 L/min

C) Oxygen via nasal cannula at 6 L/min

D) 100% oxygen with a regular mask

E) 100% oxygen with a nonrebreathing mask - ANSWER- ANSWER: A

Rationale: While oxygen supplementation is routinely initiated for

patients who are suspected of having acute coronary syndrome,

evidence does not support a benefit from this unless the patient is

hypoxic. Oxygen supplementation is recommended if the patient has

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an oxygen saturation <90>

or if the patient is in respiratory distress.

You see an 89-year-old female with advanced dementia who has stopped

eating. The patient's daughter asks you about the role of tube feeding in

this situation. You discuss the risks and benefits.

In patients with advanced dementia who have a feeding tube placed,

there is evidence of increased

A) nutritional status

B) healing of pressure ulcers

C) quality of life

D) survival

E) emergency department visits - ANSWER- ANSWER: E

Rationale: Eating problems in patients with advanced dementia are

common and include oral dysphagia, pharyngeal dysphagia

including aspiration, the inability to feed oneself, and refusal to eat.

Patients with these symptoms should be examined for reversible

causes such as dental problems. In the absence of a reversible cause,

conservative measures such as altering food texture or offering

small portions and high-calorie supplements may promote weight

gain, although none of these interventions improve function or

survival.

Tube feeding patients who have advanced dementia has not been

compared to hand feeding in randomized, controlled trials.

Observational studies have shown no difference in survival, quality

of life, nutritional status, functional status, the prevention of

aspiration, or the prevention and healing of pressure ulcers between

the two groups. Risks associated with feeding tubes include the risks

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associated with placement of the tube, including the chemical and

physical restraint of patients who attempt to remove the tube. Once

the tube is in place, tube blockages and dislodgments are common

reasons for transfer to an emergency department (ED) for care, and

in one study accounted for 47% of all ED visits by nursing home

residents with advanced dementia.

A 55-year-old male with a BMI of 32 kg/m2 presents to your office to

discuss weight management. He has moderately well controlled type 2

diabetes and hypertension. He prefers not to modify his diet and would

like to know if he can expect significant weight loss from exercising. He

plans to walk briskly for 45 minutes daily.

Which one of the following would be the best advice for this patient?

A) Moderate exercise alone is ineffective for weight loss

B) Moderate exercise alone is superior to dietary changes for weight loss

C) Moderate exercise alone is moderately beneficial for weight loss

D) Adding moderate exercise to dietary changes substantially increases

weight loss - ANSWER- ANSWER: C

Rationale: Exercise alone does have some substantial benefits,

including improved insulin and glycemic control in diabetes, a

beneficial effect on blood pressure, a reduction of cardiovascular

risks, and a maintenance of weight loss. However, it is only

moderately beneficial for promoting weight loss, including when

exercise is added to diet changes.

A 67-year-old female patient began taking a bisphosphonate for

treatment of osteoporosis 2 years ago after a DXA scan revealed a Tscore of -2.7. Her FRAX score showed a 10-year probability of hip

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fracture of 5%. You order a repeat DXA scan and her T-score is now -

2.3 and her FRAX score is 3.5%.

Which one of the following should you recommend to this patient

regarding the duration of treatment with a bisphosphonate?

A) Stop taking it now

B) Continue taking it for 1 more year

C) Continue taking it for 3 more years

D) Continue taking it for 7 more years

E) Continue taking it indefinitely - ANSWER- ANSWER: C

Rationale: According to the National Osteoporosis Foundation,

treatment is indicated for patients at high risk of fracture, including

those with osteoporosis, defined as a T-score of -2.5 or less, or

osteopenia, defined as a T-score of -1 to -2.5 and a 10-year

probability of hip fracture of at least 3% using the FRAX tool.

Bisphosphonates are considered first-line pharmacologic therapy.

Treatment beyond 5 years in women who do not have a persistent Tscore of -2.5 or less has not been shown to result in further decreases

in rates of clinical vertebral fractures, nonvertebral fractures, or

mortality (SOR C). In addition, there is increasing evidence that the

risk of atypical fracture of the femur increases with the use of

bisphosphonates beyond 5 years. Inappropriate prescribing of drugs

that are not discontinued after their usual effective or recommended

period is known as "legacy prescribing" and can contribute to

inappropriate polypharmacy.

A 43-year-old male presents to the emergency department with the acute

onset of sharp, stabbing chest pain when inhaling and exhaling. The pain

worsens with coughing and deep breathing. He has no significant

previous medical history but recently returned from a work trip to Japan