ABFM ITE NEW UPDATE QUESTIONS AND

ABFM ITE NEW UPDATE QUESTIONS AND ANSWERS

1. A 67-year old male sees you for a Medicare annual wellness visit. He tells
you that his best friend had a stroke and he asks about his risk for stroke.
He has a family history of cardiovascular disease in his father, who had a
myocardial infarction at age 65 and died from a thrombotic stroke at age 71.
The patient exercises regularly and has a BMI of 27 kg/m2. His only current
medical condition is hyperlipidemia, and his cholesterol level is at goal on
rosuvastatin (Crestor), 10 mg daily. He also takes aspirin, 81 mg daily. His
blood pressure 125/78 mmHg.
Based on US Preventive Services Task Force guidelines, which one of the
following would be most appropriate at this time?
A. No additional testing for stroke risk
B. Auscultation for carotid bruits
C. Carotid duplex ultrasonography
D. Magnetic resonance angiography
E. CT angiography of the carotid arteries: ANSWER: A
No additional testing for stroke risk Carotid artery disease affects extra cranial
carotid arteries and is caused by atherosclerosis.
This patient is asymptomatic and has no history of an ischemic stroke, neurology
symptoms referable to the carotid arteries such as amaurosis fugal, or TIA. He
has risk factors for cardiovascular disease (age, male sex, hyperlipidemia_, but
the USPSTF recommends against specific screening asymptomatic carotid artery
stenosis (D recommendation) which a low prevalence in the general adult population. Stroke is a leading cause of disability and death in the US, but asymptomatic
carotid artery stenosis causes a relatively small portion of strokes. Auscultation of
the carotid arteries for bruits has been found to have poor accuracy for detecting
carotid stenosis and is not a reasonable screening approach.Appropriate modalities
for detecting carotid stenosis include carotid duplex ultrasonography, magnetic
resonance angiography, and computed tomography, but there are not recommended
for screening asymptomatic patients.
2. A 28 year old female presents for evaluation of nasal congestion, sneezing,
watery eyes, and postnasal drip. This has been an intermittent issue for her
every spring and she would like to manage it more effectively.
Which one of the following treatments has been shown to be the most effective
and best tole first-line therapy