ABFM ITE EXAM ACTUAL EXAM 300 REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+

ABFM ITE EXAM 2023-2024 ACTUAL EXAM 300 REAL

EXAM QUESTIONS AND CORRECT DETAILED

ANSWERS WITH RATIONALES (VERIFIED ANSWERS)

|ALREADY GRADED A+

A 45-year-old female comes to your office for an annual health maintenance visit.

She has a family history of type 2 diabetes in her mother and a personal history of

obesity for many years.

If verified with a second test, which one of the following would confirm a

diagnosis of diabetes

mellitus?

A) A hemoglobin A1c of 6.4%

B) A 2-hour plasma glucose level of 190 mg/dL on an oral glucose tolerance test

C) A random glucose level of 190 mg/dL

D) A fasting plasma glucose level of 130 mg/dL

ANSWER: D

A fasting plasma glucose level of 130 mg/dL

A diagnosis of type 2 diabetes can be based on any of the following test results:

a hemoglobin A1c 6.5%, a fasting plasma glucose level 126 mg/dL, a 2-hour

plasma glucose level 200 mg/dL on an oral glucose tolerance test, or a random

plasma glucose level 200 mg/dL with classic symptoms of hyperglycemia.

A 57-year-old male recently diagnosed with acute lymphoblastic leukemia presents

to the emergency department with intractable nausea, vomiting, and myalgias. His

first chemotherapy infusion was administered earlier in the day.

Which one of the following electrolyte disturbances would be consistent with

tumor lysis

syndrome?

A) Hypocalcemia

B) Hypokalemia

C) Hyponatremia

D) Hypophosphatemia

E) Hypouricemia

ANSWER: A Hypocalcemia

Tumor lysis syndrome is a common complication of chemotherapy in

hematologic malignancies, such as acute leukemia. Homeostasis is

overwhelmed with phosphorus, potassium, calcium, and uric acid released

into the bloodstream due to acute cell lysis. Hyperphosphatemia,

hyperkalemia, and hyperuricemia are

indicative of tumor lysis syndrome. Calcium levels are decreased due to

binding with free phosphorus and a depletion of calcium in the bloodstream.

Sodium electrolyte levels are not as likely to be affected

Which one of the following is needed to calculate the number needed to treat

(NNT)?

A) Number needed to harm

B) Pretest probability

C) Absolute risk reduction

D) Relative risk reduction

E) Likelihood ratio

ANSWER: C Absolute risk reduction

The number needed to treat (NNT) is calculated as: 1/absolute risk reduction

(ARR), where the ARR is expressed as a decimal. If the ARR is 5%, the NNT

= 1/0.05 = 20. This is a very important aspect of biostatistics that most family

physicians use on a daily basis. It describes the number of patients who need

to receive an intervention instead of the alternative in order for one additional

patient to benefit. The number needed to harm is the number of patients

necessary to receive an intervention instead of the

alternative in order for one additional patient to experience an adverse event.

Pretest probability is the probability of disease in a patient before a test is

performed. The relative risk reduction indicates how much the risk or

outcome was reduced in the treatment group compared to the control group.

The likelihood ratio corresponds to the clinical impression of how well a test

rules in or rules out a given disease.

A 30-year-old male comes to your office for evaluation of hand weakness. On

examination you detect weakness when he tries to bring his thumb and index finger

together. For confirmation

you ask him to try to hold on to a piece of paper between his thumb and index

finger while you try to pull it away. He is unable to resist when you pull on the

paper.

The most likely explanation for these findings is an injury to the

A) brachial plexus

B) median nerve

C) musculocutaneous nerve

D) radial nerve

E) ulnar nerve

ANSWER: E ulnar nerve

Initial general neurovascular assessment of an upper extremity injury

includes evaluating for radial pulse and digit movement and sensation.

Weakness of the thumb and index finger pincer mechanism is indicative

of an ulnar nerve injury. Weakness in the shoulder or upper arm would

indicate a potential brachial plexus injury. Symptoms related to the median

nerve generally include paresthesia of the thumb, index finger, and long

finger. Weakness of supination of the forearm would indicate a potential

musculocutaneous nerve

injury. Weakness of active wrist extension would indicate a potential radial

nerve injury.

A 30-year-old male is diagnosed with hereditary hemochromatosis. Periodic

therapeutic phlebotomy may be appropriate to prevent

A) chronic liver disease

B) chronic renal disease

C) encephalopathy

D) myelofibrosis

E) Wilson disease

ANSWER: A chronic liver disease

Hereditary hemochromatosis is a common inherited disorder of iron

metabolism. Iron deposits in the liver may lead to chronic liver disease and

hepatocellular cancer. Screening for hereditary hemochromatosis

includes serum ferritin levels, a family history, and genetic testing. Chronic

renal disease, encephalopathy,