ABFM Boards

Question 1

Why no anticholinergics with breastfeeding?

Answer 1

Long term, anticholinergic effects inhibit oxytocin and GH release

Question 2

What class does meclizine belong to?

Answer 2

Antihistamine

Question 3

How does progesterone affect breastfeeding?

Answer 3

Interferes with prolactin binding to alveolar breast cells

Question 4

How can reglan affect breastfeeding?

Answer 4

Reglan is a galactogogue. Will increase prolactin levels.

Question 5

X-linked ichthyosis is associated with what?

Answer 5

low/undetectable estriol level

Question 6

MOA of Alzheimer’s

Answer 6

reduced choline acetyl transferase leading to decreased ACh and cortical function

Question 7

Class of agents for initial tx. mild Alzheimer’s

Give examples (4).

Answer 7

Cholinesterase inhibitors (reduce progression and improve symptoms of disease)

Donepezil [Aricept]
Rivastigmine [Exelon]
Galantamine [Reminyl]
Tacrine [Cognex]”

Question 8

Why was Tacrine discontinued in 2012?

Answer 8

Hepatotoxicity, GI side effects

Question 9

What is treatment for MGUS?

Answer 9

Watchful waiting

Question 10

What is an indication for Rhogam in the FIRST trimester?

Answer 10

Rh negative mom with vaginal bleeding

Question 11

When is Rhogam usually given?

Answer 11

28 weeks

Question 12

erythema annularea centriguam. Description and key info?

Answer 12

can be fungi-related, can be cancer related

have a “trailing” scale

Question 13

What causes erythema chronicum migrans?

Answer 13

Lyme Disease

Question 14

What disease is erythema marginatum seen?

Answer 14

Rheumatic fever

Question 15

How long should sutures below the knee be left in place?

Answer 15

10-14 days

Question 16

At what age: rolling over back to front and crawling/creeping?

Answer 16

by 7 months

Question 17

At what age: pincer grasp (2)?

Answer 17

immature: 6-8 months
mature: 10-11 months

Question 18

At what age: pull to stand?

Answer 18

9 months

Question 19

At what age: 10 word vocab, mama, dada, 1-step commands, separation anxiety at bedtime, object permanence, beginning of self-conscious awareness?

Answer 19

18 months

Question 20

At what age: broad jump

Answer 20

36 months

Question 21

Difference between ectopic pregnancy and spontaneous abortion?

Answer 21

ectopic is painful and first trimester, whereas spontaneous is painLESS

Question 22

Addison’s Disease v. Cushing’s Disease

Answer 22

Addisons: adrenal insufficiency. Cortisol and aldosterone are decreased, but ACTH is increased.

Cushing’s: pituitary ACTH excess leading to excess cortisol. And suppression by dexamethasone.

Question 23

At what age: laugh responsively?

Answer 23

4 months

Question 24

If woman has a clot, what would be best tx. of menorrhagia?

Answer 24

Progesterone-only modality: Mirena, Depo. (No estrogen-containing products/OCPs)

Question 25

What antibiotics are contraindicated in pregnancy (5 categories)?

Answer 25

Fluoroquinolones: harm to fetus TMP (1st trimester): neural tube defects Nitrofurantoin (3rd trimester): hemolytic anemia Sulfa (3rd trimester): jaundice Tetracyclines (all trimesters): tooth discoloration

Question 26

What class of medications can commonly cause abnormal uterine bleeding/anovulation?

Answer 26

Antipsychotics (e.g. Haldol)

Question 27

Sensitivity

Answer 27

TP/(TP+FN) If a person has a disease, how often will the test be positive. If highly sensitive, and the test result is negative, person does NOT have the disease. Helps rule out disease "SNOUT"

Question 28

Specificity

Answer 28

TN/(TN+FP) If a person DOES NOT have the disease, how often will the test be negative? If test is positive, they likely have the disease. Rules in diagnosis "SPIN"

Question 29

Positive Predictive Value

Answer 29

TP/(TP + FP) What is the chance that an individual with a positive test has the disease?

Question 30

Negative Predictive Value

Answer 30

TN/(TN + FN) If the test result is negative, what are the chances that the person DOES NOT have the disease? e.g. D-Dimer (negative D-Dimer reliably excludes PE)

Question 31

Give an example of what p value and confidence interval mean in relation to each other?

Answer 31

for example: if p = 0.012, and the confidence interval is a range, THEN: there is a 1.2% probability of achieving the same study outcome if the null hypothesis is true

Question 32

If Lachman test has sensitivity of 85% and specificity of 94%, what does that mean? What is it good to test for?

Answer 32

Specificity: if a person has a positive Lachman test, then chances are they have the condition. Tests for ACL tears.

Question 33

Common cause of meningitis in children 1+ mo.

Answer 33

S. Pneumonia, N. meningitidis

Question 34

What are some of the mainstay drugs to treat bipolar disease?

Answer 34

Valproic acid [Depakote] | Llithium

Question 35

What is the most common US finding of ovarian torsion?

Answer 35

Ovarian enlargement. Abnormal flow is suggestive but not confirmatory.

Question 36

What are risk factors for asthma-related death?

Answer 36

``` comorbidities illicit drug use low socioeconomic status psych problems previous intubation 2+ hospitalizations/3+ ER visits in past year ```

Question 37

What PEF value indicates a severe asthma exacerbation?

Answer 37

<40%

Question 38

An oral corticosteroid given within ____ of admission to the ER has been shown to decrease the risk of hospitalization?

Answer 38

1 hr

Question 39

Over ____ % of patients with COPD have high bacterial concentrations in the lower airways

Answer 39

50

Question 40

Granulomatosis with polyangitis: kidney biopsy pattern

Answer 40

crescentic glomerulonephritis, no immune deposits (pauci-immune)

Question 41

Anti-glomerular basement membrane: kidney biopsy pattern

Answer 41

linear immune complex (Ab to Type IV collagen)

Question 42

What is the preferred anticoagulant to use in renal failure?

Answer 42

Warfarin

Question 43

What is the diagnosis and treatment for sclerodermal renal crisis?

Answer 43

DX: CBC with smear Serum Cr Estimate GFR/test urine protein:creatinine ratio Tx: ACEi

Question 44

What makes up Killian's triangle of Zenker diverticulum?

Answer 44

inferior constrictor muscles posterior hypopharynx cricopharyngeus mm

Question 45

True or false: HIV infection is not an indication for inpatient management of Pelvic Inflammatory Disease?

Answer 45

TRUE. HIV infection is NOT an indication for inpatient management of PID.

Question 46

True or false: IgE-based food allergy tests coincide with trigger foods all the time.

Answer 46

FALSE: Even if test is + for a food and you eliminate it, it might not achieve disease remission. In contrast, food elimination diet in negative allergy test patients was found to be effective.

Question 47

When does teething begin?

Answer 47

6-8 mo.

Question 48

Why should you start thyroxine 50-100 pg/day in maternal hypothyroid patients?

Answer 48

Higher risk of pre-eclampsia, abruption, lower IQ

Question 49

What is pseudohypertension?

Answer 49

Loss of elasticity/compliance of vessels prevents collapse via blood pressure cuff, so Korotkoff sounds are heard immediately and BP appears grossly elevated. Happens often in ICU settings. Often older pts.

Question 50

True or False: Breastfeeding provides adequate levels of vitamin D.

Answer 50

False. Breastfeeding does NOT provide adequate levels of Vitamin D.

Question 51

What is recommended suggestion of Vitamin D supplementation for breastfed infant? When should it start?

Answer 51

400 IU Vitamin D daily started within first 2 months

Question 52

Posterior sternoclavicular joint dislocations are a life-threatening emergency. Why?

Answer 52

Dyspnea Dysphagia Hoarseness (recurrent laryngeal n. injury) Upper extremity paresthesias

Question 53

What is commotio cordis?

Answer 53

arrhythmia caused by blow to the chest

Question 54

Sudden onset SOB in teenager who was playing sports?

Answer 54

vocal cord dysfunction

Question 55

What are the 4 Centor criteria? And what is it used for?

Answer 55

Fever Tender neck adenopathy Exudative tonsillitis NO cough Centor criteria is used to determine the likelihood of a bacterial infection in a person who complains of a sore throat.

Question 56

S&S of Kawasaki Dz. Most concerning complication of it?

Answer 56

``` "5+ day fever conjunctivitis cervical lymphadenopathy red lips/strawberry tongue/edema erythema/edema of hands and feet polymorphous rash ESR elevated medium-sized vessel vasculitis ``` Coronary Artery Disease"