American Board of Family Medicine

Which one of the following diabetes mellitus medications is MOST likely to cause weight gain?

A. Empagliflozin (Jardiance)
B. Glimepiride (Amaryl)
C. Liraglutide (Victoza)
D. Metformin (Glucophage)
E. Sitagliptin (Januvia)

In our most recent issue, this original research article highlights a decrease in primary care visit volume is partially offset by increasing telehealth use for all patients during the COVID-19 pandemic, but the magnitude of these changes varied significantly across all patient characteristics.

American Board of Family Medicine
The Center for Professionalism and Value

📰 - https://www.annfammed.org/content/22/4/294

ABFM research study highlights how disruptions in primary care and the rapid transition to telehealth during the COVID-19 pandemic disproportionately impacted certain groups of patients. Read the study: https://bit.ly/4dgD5JZ

Post-COVID issues, including what's being called Long COVID, are of great interest to policymakers and family physicians, but how much of a burden they represent isn't known. This study is the first to quantify the burden of post-COVID conditions among adult patients diagnosed with COVID-19 (2020-2021) across the United States. Read the study: https://bit.ly/4figheK

Discover the impact of the Family Medicine Factbook, published by ABFM and the Center for Professionalism & Value in Health Care! Dr. Andrea Anderson and Dr. Emmeline Ha are leveraging its insights to advocate for family medicine education and policy change. Read their inspiring story here: https://bit.ly/4bZgpws

Findings from a new study examining post-COVID conditions demonstrate the moderate burden of these conditions in primary care, including breathing difficulties, fatigue, sleep disturbances, and type 2 diabetes. Using real-world data from the American Board of Family Medicine PRIME registry, the study provides a different picture of the prevalence and impact of post-COVID conditions compared to specialty or hospital settings.

💡 Read the full study here: https://www.annfammed.org/content/22/4/279

This study was conducted by researchers from Stanford Medicine, Stanford Department of Epidemiology & Population Health, CDC, American Board of Family Medicine, and the Institute for Healthcare Policy and Innovation at the University of Michigan.

Recent ABFM study illustrates how the rise in telehealth use has partially balanced the decrease in primary care visits during COVID-19. Yet the impact differs significantly between patient demographics, calling for improved telehealth infrastructure, especially in rural and underserved areas. Read the study: https://bit.ly/4dgD5JZ

Using real-world data from ABFM’s PRIME Registry, a recent study published in Annals of Family Medicine, provides a different picture of the prevalence and impact of post-COVID conditions compared to specialty or hospital settings, and is the first to quantify the burden of post-COVID conditions among adult patients across the U.S. Read the study: https://bit.ly/4figheK

An 84-year-old female with severe dementia due to Alzheimer’s disease is a resident of a long-term care facility. She has been hitting the staff while receiving personal care and recently had an altercation with another resident. Behavioral interventions have been unsuccessful in managing her symptoms and you suggest to the patient’s family that she be started on low-dose risperidone (Risperdal). They ask about appropriate use of the drug and the potential for side effects.

Which one of the following would be appropriate advice?

A. Extrapyramidal side effects are more common compared to typical antipsychotics
B. Dementia-related psychosis is an FDA-approved indication
C. No monitoring will be necessary
D. The risk of diabetes mellitus is decreased
E. The risk of mortality is increased

A 20-year-old football player presents with pain in the proximal fifth metatarsal. The pain was initially present only after practices, but now it causes push-off pain during practice. There is tenderness to palpation. Plain films show no signs of fracture.

Which one of the following would be most appropriate at this point?

A. Start NSAIDs and allow him to continue practicing as tolerated
B. Place him at non–weight bearing for 2 weeks and repeat the plain films
C. Place him in a hard shoe for 3 weeks and then reexamine
D. Order MRI of the foot
E. Order a bone scan of the foot

Following med school, residency training, and possibly a fellowship, family physicians can subsequently participate as educators through roles in medical school curriculum teaching, clinical precepting of trainees, and residency/fellowship programming and development. About 1 in 3 ABFM Diplomates serve in a faculty role of some form and, of this faculty group, 1 in 3 serve as core or salaried faculty. Learn more in the Factbook: https://bit.ly/4eSl4Dr

The U.S. Preventive Services Task Force recommends routine universal screening for gestational diabetes mellitus no sooner than

A. 16 weeks gestation
B. 20 weeks gestation
C. 24 weeks gestation
D. 32 weeks gestation

You suspect a 45-year-old female may have irritable bowel syndrome. She has a 6-month history of crampy, diffuse abdominal pain associated with defecation. Her symptoms occur several days per week.

According to the Rome IV criteria, an associated symptom that would help in making this diagnosis is

A. a change in stool frequency
B. increased gas and bloating
C. pain brought on by eating
D. waking up at night to defecate
E. weight loss of 5 lb (2 kg)

The deadline to complete your 2024 Q2 longitudinal assessment exam questions is just five days away! Log in to your MyABFM Portfolio to answer outstanding questions before 11:59 pm on June 30.

A 68-year-old female presents for evaluation of shortness of breath with activity for the past several weeks. She used to walk 2 miles daily for exercise but can no longer do so because of dyspnea and chest tightness. She also reports mild lower extremity edema. She has a history of a bicuspid aortic valve and aortic stenosis. Echocardiography 1 year ago showed moderately severe aortic stenosis with a mean valve area of 1.1 cm2.

Echocardiography today shows aortic stenosis with an aortic valve area of 0.9 cm2, a mean pressure gradient of 42 mm Hg, and a transaortic velocity of 4.3 m/sec. The ejection fraction is estimated to be 50%.

Which one of the following is indicated at this time?

A. Atorvastatin (Lipitor)
B. Furosemide (Lasix)
C. Lisinopril (Prinivil, Zestril)
D. Metoprolol succinate (Toprol-XL)
E. Referral for aortic valve replacement

Sound federal EHR policy requires reliable data. Diversified data sources like the ABFM’s Continuous Certification Questionnaire are necessary to understand physicians’ experience with EHRs and interoperability. Read the study: https://bit.ly/3RBZ8m1

Are you a family physician in an administrative or leadership role? The new HALM CAQ is designed to recognize your role as a leader in health care and help elevate you to influence decisions that improve patient care. Learn more & begin the application ➡️ https://bit.ly/3VLXiBj

A 46-year-old male with a 30-pack-year smoking history has had multiple episodes of coughing up blood that he describes as a “quarter size” amount. This has happened over the last couple of days. He has not had a chronic cough and has not been ill. A chest radiograph is negative. Which one of the following would be the next most appropriate management at this point?

A. Observation for one week, with no further workup unless the hemoptysis continues
B. CT of the chest
C. Referral for bronchoscopy
D. Referral for nasolaryngoscopy

ABFM Diplomate Dr. Kathryn Turner shares how she and her colleagues have updated their patient intake practices to better serve a growing and vibrant LGBTQ population. “It was important for us to know each patient’s gender identity and sexual orientation. We didn’t want to presume anything,” Dr. Turner said. “We found just asking the question made patients understand that they were important and valued." Read Dr. Turner's story now: https://bit.ly/4eukKdU

Family physicians care for children, adults, and the elderly in outpatient and inpatient settings, and for patients throughout pregnancy, birth, and the postpartum period. How does the scope of care change from early career family physicians compared to mid-or late career family physicians? Learn more in the Factbook: https://bit.ly/3Usekma

Dr. Eric Jemison has improved patient experience and reduced time spent completing EHRs by utilizing AI.

“Artificial Intelligence and Machine Learning has brought a more human element back to patient care,” said Dr. Jemison. “Being more focused on each individual is so rewarding.”

Read more about his work in our new article: https://bit.ly/3VD5KD0

A 16-year-old male sees you for a sports preparticipation examination. His height is 193 cm (76 in), his weight is 69 kg (152 lb), and he appears to have long arms. A physical examination reveals a high arched palate, kyphosis, myopia, and pectus excavatum. You order additional cardiac evaluation prior to clearing him for sports.

Which one of the following valvular abnormalities is most likely in this patient?

A. Mitral stenosis
B. Pulmonic stenosis
C. Aortic stenosis
D. Mitral valve prolapse
E. Bicuspid aortic valve

A 68-year-old male presents with a 2-month history of dyspepsia and difficulty swallowing. He also reports a 20-lb unintentional weight loss. He was previously prescribed omeprazole (Prilosec), 20 mg daily at an urgent care center, but has noted no improvement.

Which one of the following would be most appropriate at this point?

A. Increasing omeprazole to 40 mg twice daily
B. Abdominal CT
C. Barium esophagography
D. Esophageal manometry
E. Upper endoscopy

A 42-year-old male with alcohol use disorder tells you that his last drink was 7 days ago and asks if there are any medications available to help him maintain abstinence from alcohol. He has no other medical or psychological problems.

Which one of the following pharmacologic agents would be most appropriate?

A. Acamprosate
B. Amitriptyline
C. Paroxetine (Paxil)
D. Promethazine
E. Venlafaxine (Effexor XR)

On this day, ABFM remembers and honors the men and women who have selflessly lost their lives in service to our country.

ABFM offices will be closed in observance of the holiday.

In the latest ABFM Phoenix Newsletter, we share updates on the new Continuous Certification 5-Year Cycle, ABFM’s new board members and officers, our redesigned public website, the enhanced KSA platform, and more! View the full Phoenix Newsletter here: https://www.theabfm.org/all-news-insights/phoenix-newsletter/