Family Medicine Board Review

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Ace the ABFM Board Exam with Med-Challenger's proven Family Medicine Board Review. Featuring over 3,000 ABFM Exam Review questions with detailed explanations and rationales following the American Board of Family Medicine Exam Blueprint, board exam simulation, adaptive learning features and hundreds of built-in CME credits, Med-Challenger's ABFM exam review is the best way to prepare for family medicine boards.

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"Awesome family medicine exam review. Scored high on my ABFM boards, convenient for CME and keeps me informed. Big recommend to any family medicine physician."
Tom Berg, MD

#1 ABFM board review, MOC, CME, and more anytime, anywhere, any device.

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Med-Challenger is the most effective, easiest to use Family Medicine board review question bank for the American Board of Family Medicine certification and MOC examinations. Med-Challenger's family medicine exam review with over 3000 family medicine practice questions and intelligent FM self-assessment provides everything you need to pass the ABFM exam and fulfill other family medicine continuing certification requirements like KSAs, AMA PRA Category 1, and AAFP Prescribed CME credits, all in one powerful, effective, and convenient access point online.

Our pass-guaranteed Family Medicine board review course gets you prepared for ABFM boards fast, thanks to our constantly updated Family Medicine review questions, detailed answer explanations, and intelligent FM board exam simulators. Plus, our online ABFM board review course keeps serving you after exams too. Certification or recertification – Family Practice board review has never been so easy, effective, or efficient.

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Our #1 family medicine question bank for ABFM exam prep is intelligent, automatically targeting weaker areas of knowledge, saving your time.

Over 3000 Family Medicine Exam Review Questions & Answers

High-Yield Family Medicine Board Review Questions mapped to the ABFM exam blueprint.

Using authoritative resources such as Rakel's family medicine textbook, our family medicine physician editors ensure our ABFM prep course is always current and covers the latest ABFM exam blueprint. The Med-Challenger Family Medicine Board Review is 100% pass-guaranteed and used by the National Family Medicine Review live course, GME programs and healthcare organizations world-wide.

Earn Required CMEs

The MOST AMA & AAFP CME credits you'll find in any online ABFM review.

250

AMA Category 1 CME Credits

250

AAFP Prescribed Credits

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Produce CME certificates whenever you need annually. Useful year after year.

Family Medicine Course Information

Family Medicine Review Course Information

Cardiovascular Disease

Congenital Heart Disease in the Adult
Congestive Heart Failure
Dysrhythmias/Conduction Defects
Endocarditis
Hypertension
Ischemic Heart Disease
Myocardial Disease
Pediatric Cardiovascular Disorders
Pericardial Disease
Valvular Heart Disease
Vascular Disease

Gastrointestinal Disorders

Biliary Tract Disease
Colonic and Anorectal Disease
Esophageal Disorders
Liver Disease
Pancreatic Disease
Small Intestinal Disease
Stomach or Duodenum
Pediatric Gastrointestinal Disorders

Endocrinology, Diabetes, and Metabolism

Adrenal Disorders
Diabetes Mellitus
Disorders of Calcium Metabolism and Bone
Hypoglycemia
Lipid Disorders
Obesity
Thyroid Disorders
Pediatric Endocrine Disorders

Allergy and Immunology

Auto-Immune Collagen Vascular Disorders
Drug Allergy
Food Allergy
Hypersensitivity Reactions
Primary Immunodeficiency Disorders
The Immunocompromised / Solid-Organ Transplant Patient
Pediatric Allergy and Immunology

Eye, Ear, Nose, and Throat

Eye: Assessment
Eye: Glaucoma
Eye: Inflammation and Infection
Eye: Pharmacology
Eye: Vascular Disorders
Nose: Infection and Inflammation
Oral Cavity: Medical Disorders
Otologic Infections
Otologic Signs, Symptoms, Presentations
Throat and Soft Tissue Neck: Medical Disorders
Pediatric Eye, Ear, Nose, and Throat Disorders

Hematology and Oncology

Anemia
Bone Tumors
Breast Cancer
Coagulopathies
Disseminated Intravascular Coagulation
Gastrointestinal or Hepatic Cancer Gynecologic Cancer
Hematologic Malignancies
Lung Cancer
Management of Malignant Pain
Neoplasms of the Head and Neck
Oncologic Emergencies
Sickle Cell Disease
Transfusion Medicine (Principles and Complications)
Urological Cancer
Pediatric Hematology and Oncology

Dermatology

Acne/Rosacea
Dermatitis (Eczemas)
Dermatologic Immunology
Disorders of Hair & Nails
Nodules and Tumors of the Skin
Papulosquamous Dermatoses
Photosensitivity Dermatoses
Pigment Disorders
Skin and Soft Tissue Infections
Vascular Dermatoses
Vesiculobullous Dermatoses
Pediatric Dermatology

Rheumatology, Musculoskeletal Disorders, and Sports Medicine

Bone and Joint Infections
Crystal-Induced Arthropathy
Deep Soft Tissue Infections
Disorders of Muscles
Infectious, Inflammatory, and Reactive Arthritis
Neck and Back Pain
Osteoarthritis
Rheumatoid Arthritis
Sports Injuries / Trauma
Systemic Lupus Erythematosus
Systemic Sclerosis
Vasculitis
Pediatric Rheumatology and Musculoskeletal Disorders

Infectious Diseases

Coronavirus (SARS-COV-2, COVID-19)
COVID-19 During Pregnancy
Diphtheria, Pertussis, Tetanus
Hantavirus
HIV and AIDS
Influenza, Mononucleosis, Herpes
Meningococcemia, Pneumococcemia
MRSA, VRE, ESBL
Parasitic Infections
Rabies
Sepsis Syndromes
Systemic Fungal Infections
Tick-Borne Illnesses
Tuberculosis
Pediatric Infectious Diseases

Nephrology and Urology

Acute Renal Failure
Chronic Kidney Disease
Glomerular Disorders
Nephrolithiasis
Prostate Disorders
Urinary Incontinence
Urinary Tract Infections
Water and Electrolyte Balance
Pediatric Nephrology and Urology

Neurologic Disorders

Central Nervous System Infections
Delirium and Dementia
Demyelinating/Inflammatory Diseases
Diseases of Movement Control
Headache Disorders Seizures Selected
Cranial Nerve Disorders Spinal Cord Syndromes
Stroke: Epidemiology and Presentation
Stroke: Initial Work-Up
Stroke: Preventive Care
Stroke: Treatment
Neurologic Assessment
Neuromuscular Junction Disease
Peripheral Neuropathies
Pediatric Neurologic Disorders

Psychiatric Disorders

Anxiety Disorders
Eating Disorders
Factitious Disorders
Mood Disorders
Personality Disorders
Psychological Factors Affecting Medical Disorders
Schizophrenia and Delusional (Paranoid) Disorders
Somatoform Disorders
Pediatric Psychiatric Disorders

Respiratory Disorders

Interstitial Lung Disease
Lower Respiratory Tract Infections
Asthma and Other Obstructive Lung Disease
Occupational and Environmental Lung Disease
Pleural Disease
Pulmonary Vascular Disease
Sleep Medicine
Upper Respiratory Tract Infections
Pediatric Respiratory Disorders

Women's Health and Maternity Care

Acute Complications of Pregnancy
Chronic Medical Illness During Pregnancy
Contraception
General Approach to the Pregnant Patient
Gynecological Assessment
Menopause and Hormone Therapy
Screening and Regular Health Care in Adult Women
Sexual Assault
Sexually Transmitted Infections: Female

Male Reproductive System Disorders

Penile Disorders
Sexually Transmitted Infections - Male
Testicular Disorders

Child and Adolescent Care

Anticipatory Guidance
Childhood Immunizations
Development Milestones
Disease Prevention
Failure to Thrive
Female Pubertal Development
Gynecologic Health Care
Male Pubertal Development
Normal Growth
Obesity
Periodic Health Examination / Screening
Pregnancy and Contraception
Self-Identity and Family Influence
Sexuality and Emotional Development
Sexually Transmitted Infections

Geriatrics

Physical Impairment in the Elderly
Bowel and Bladder Function
Common Issues in the Elderly
Neurological Issues in the Elderly
Other Primary Geriatrics
Geriatrics: Medical Conditions
Geriatrics: Pharmacotherapy
Geriatrics: Special Problems of the Elderly
Geriatrics: Urinary Incontinence

Emergent/Urgent Care

Advanced Airway: Adult
Airway: Pediatric
Breathing: Ventilatory Support (Adult/Pediatrics)
Disaster Preparedness
Environmental Disorders
Perioperative Care
Postoperative Complications
Procedural Sedation: Adult
Procedural Sedation: Pediatric
Resuscitation: Adult Cardiac
Resuscitation: Brain (After Cardiac Arrest)
Resuscitation: Neonatal
Resuscitation: Pediatric
Resuscitation: Shock
Resuscitation: Trauma
Toxicologic Disorders
Traumatic Disorders
Wound Management

Population-Based Care

Bioterror
Cancer Prevention and Screening
Diet and Prevention
Evidence-Based Medicine
Exercise and Prevention
Medical Law
Pain Management and Addiction Medicine
Prescribing Controlled Substances
Prevention of Cardiovascular Disease
Prevention of Infectious Disease

Patient-Based Systems

Clinical Decision-Making
Medical Error Prevention
Medical Ethics
Communication, Family, and Cultural Issues
End-of-Life Care
Patient Safety

Sample Question 1

A 35-year-old homeless gentleman complains of cough and right-sided chest discomfort. He has been living in and out of homeless shelters for the past six months.

He has had subjective fever and night sweats and has lost more than 15 pounds over the past few monthsHe has received 2 different courses of oral antibiotics from a walk-in clinic, without any improvement.

Findings on chest x-ray show right-sided pleural effusion.

Which of the following laboratory values would the pleural fluid analysis show?

eosinophils > 10%
pH 5.82, glucose 460 mg/dL, amylase 280 IU/L
milky fluid, chylomicrons detected
pH 7.22, glucose 48, no mesothelial cells
protein 3 g/dL, lactate dehydrogenase 110 IU/L

This patient complains of fever, cough, night sweats, and weight loss. These symptoms, along with homelessness, which according to the CDC remains a risk factor,strongly suggest pulmonary tuberculosis (TB).

The pleural effusion seen on chest x-ray in a case of TB is likely tuberculous pleural effusion after primary exposure to TB. In general, tuberculous pleural effusions are exudates with serous, nonbloody appearance. They tend to be lymphocyte-predominant. Elevated eosinophiles (> 10%) or mesothelial cells (> 5%) make the diagnosis unlikely.

The low pH and glucose levels are also consistent with tuberculous pleural effusion. Values of pH 5.82, glucose 460 mg/dL, and amylase 280 IU/L indicate esophageal rupture because of the low pH and elevated glucose and amylase levels. A protein level of 3 g/dL and a lactate dehydrogenase level of 110 IU/L is indicative of transudative pleural effusion.

Pleural fluid eosinophilia is defined by a eosinophil content above 10% and this is not usually seen in tuberculous pleural effusion. Milky fluid with detectable chylomicrons is typical of chylous pleural effusion.

Sample Question 2

A 63-year-old woman with diabetes complicated by peripheral neuropathy has a 1.5-cm ulceration on the plantar surface of her foot at the first metatarsal head. She has no fever, but her white blood count is elevated at 14,000/mm³. She feels fatigued, and her blood glucose level is elevated at 359 mg/dL. There is some cellulitis surrounding the ulcer and some devitalized skin. Plain x-ray does not show any gas in the soft tissue and there are no clear-cut bone erosions.

Which of the following is the most appropriate pathogen to be covered when selecting antimicrobial therapy for this diabetic foot infection?

Bacteroides species
Pseudomonas aeruginosa
Clostridium species
Staphylococcus and Streptococcus species

Educational Objective:

Describe how to treat patients with diabetic foot ulcers.

Key Point:

Staphylococcus and Streptococcus are the most common pathogens causing diabetic foot ulcers.

Explanation:

Species of Staphylococcus and Streptococcus are the most common pathogens that cause diabetic foot ulcers and should be targeted with empiric antibiotic therapy. The rising prevalence of methicillin-resistant S aureus makes it prudent to cover that entity as well. The other pathogens listed are potential pathogens in diabetic foot ulcers, but they are much less common than Staphylococcus and Streptococcus species. It is generally not helpful to obtain superficial wound cultures, because they are likely to yield many species present on the skin surface.

Reference:

Powers A. Diabetes mellitus: complications. In: Kasper D, et al, eds. Harrison’s Principles of Internal Medicine. 19th ed., 2015:2428-2429.

Sample Question 3

A 12-month-old infant is admitted for chronic enteritis, failure to thrive, and eczematous lesions over the perioral and perianal regions (see figure).

What is an accurate statement regarding the diagnosis in this child?

The condition depicted is inherited in an autosomal dominant pattern.
Treatment with high-dose zinc and close monitoring of levels is indicated.
Therapy with acyclovir is indicated.
After confirmation of celiac disease, treatment in this infant will include a gluten-free diet.
No therapy is indicated for this infant who likely has Gianotti-Crosti syndrome.

This infant has inherited zinc deficiency (acrodermatitis enteropathica), which is the reason for this child’s failure to thrive. Acrodermatitis enteropathica is inherited in an autosomal recessive pattern. Treatment involves zinc replacement.

Acyclovir would not be indicated because no evidence suggests herpetic disease. Gianotti-Crosti syndrome, also known as papular acrodermatitis of childhood, is a benign, papular, self-limited exanthem that does not include symptoms of enteritis or failure to thrive. Failure to thrive secondary to celiac disease is associated with a degree of enteritis, but not the rash depicted in the figure.

Reference:

Christian CW, Blum NJ. Failure to thrive. In: Marcdante KJ, Klinegman RM, eds. Nelson Essentials of Pediatrics. 7th ed., 2015:67-74.

Sample Question 4

A 75-year-old woman without any past medical history presents to you with an episode of garbled speech and right arm weakness. Her symptoms began 12 hours before her arrival. Her speech has returned to normal and she is able to swallow, but her right arm weakness persists.

Her vital signs are as follows: temperature 37.2 °C, pulse 75 beats/minute, blood pressure 145/65 mm Hg, respiratory rate 16 breaths/minute, and oxygen saturation 99% on room air.

Her physical examination is remarkable for right upper extremity drift. Her National Institutes of Health Stroke Scale (NIHSS) score is 1.

Complete blood count is normal. Her metabolic panel is remarkable for a glucose level of 170 mg/dL. Magnetic resonance imaging reveals an area of diffusion restriction in the distribution of the left middle cerebral artery. She is given aspirin and is awaiting admission to the hospital.

Closely monitor her blood glucose levels.
Begin short-acting subcutaneous insulin.
Begin an infusion of glucose, potassium, and insulin.
Begin metformin.

Educational Objective:

Describe the management of hyperglycemia in the setting of a cerebrovascular accident.

Explanation:

Even though treatment of hyperglycemia is recommended, the degree of hyperglycemia that can be tolerated before requiring intravenous insulin treatment in patients experiencing ischemic stroke remains controversial. Recent guidelines state that "it is reasonable to treat hyperglycemia to achieve blood glucose levels in a range of 140 to 180 mg/dL and to closely monitor to prevent hypoglycemia in patients with acute ischemic stroke."

The patient in this case is within the desired range, so her condition can initially best be managed by closely monitoring her glucose level.

Both hyperglycemia and hypoglycemia can increase ischemia and worsen outcomes following stroke. However, randomized trials of insulin infusions to attain tight glucose control have not shown a benefit in acute stroke, possibly due to the harm from inadvertent hypoglycemic episodes.

Oral diabetic medications are inappropriate in someone for whom the diagnosis of diabetes has not been made (this patient had no history of diabetes mellitus).

Reference:

Powers WJ, Rabinstein AA, et al; on behalf of the American Heart Association Stroke Council 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2019; 50:e344–e418

Sample Question 5

A 67-year-old woman with a history of dementia and a recent diagnosis of dysphagia presents with a 2-week history of productive cough with foul-smelling sputum, night sweats, malaise, and fever. Her caregiver reports that she lost 10 pounds during the past 2 weeks. The patient also reports constant right-sided chest pain.

Her vital signs are: blood pressure 110/65 mm Hg, pulse 110 beats/minute, respiratory rate 25 breaths/minute, oxygen saturation 94% on room air, and temperature 102.9 °F.

Physical examination is significant for poor dentition, decreased breath sounds of the right lower lobe, and diffuse crackles. Chest x-ray demonstrates a right-sided cavitary lesion with an air-fluid level. Bronchoscopy is negative for carcinoma. Tuberculin skin testing (TST) was negative 1 week ago.

You diagnose her with bacterial lung abscess. What is the best initial treatment course for this patient?

percutaneous drainage
parenteral antibiotics followed by oral antibiotics
right lobectomy
thoracostomy

In an immunocompetent patient such as this one, parenteral antibiotics for 5 to 7 days followed by oral antibiotics for up to 8 weeks is the best treatment option. The presentation of productive cough with an indolent course with foul-smelling sputum is concerning for anaerobic lung abscess. Her history of dementia, recent diagnosis of dysphagia, and findings on physical examination of poor dentition increase her risk for aspiration pneumonia and the subsequent development of a bacterial lung abscess.

Reference:

Lorber B. Bacterial lung abscess. In: Bennett JE, et al. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed., 2014: 855-859.

Target Audience

Med-Challenger FM is intended for practitioners of family medicine or clinicians otherwise involved in the diagnosis and treatment of acute, emergent, or chronic medical problems.

Educational Objectives

The objective of this continuing medical education program is to provide an interactive review of the knowledge base of acute care and primary care medicine as appropriate by medical specialty. After completing this course, the participating clinician should be better equipped to:

Manage the broad spectrum of acute and chronic medical problems encountered in the practice of medicine.
Formulate appropriate differential diagnoses for patients presenting with acute medical problems of uncertain etiology.
Efficiently initiate therapeutic and diagnostic procedures for patients presenting with acute and chronic medical disorders.
Diagnose and treat acute and chronic: cardiovascular disorders; diseases of the eye, ear, nose, throat, skin and soft tissues; endocrinologic disorders; orthopedic and environmental injuries; gastrointestinal diseases; gynecologic and obstetric disorders; hematologic and oncologic problems; immunologic, allergic and rheumatologic diseases; infectious diseases; signs and symptoms; musculoskeletal disorders; pulmonary diseases; renal and urologic disorders; and intoxications and poisonings.
Demonstrate mastery of the knowledge and cognitive skills required to achieve objectives 1-4 by scoring at least 80% on all topics studied for CME credit.

Faculty

The following individuals have generously contributed to the content and/or editing of this program:

Editor-in-Chief:
Gerard Kiernan, MD

Contributing Author:
Mary Alice O'Brien, DNP, APRN, FNP-BC

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and Challenger Corporation. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Designation Statement

AMA Credit - The Postgraduate Institute for Medicine designates this enduring material for a maximum of 252 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AAFP Credit - This Enduring Material activity has been reviewed and is acceptable for up to 252 Prescribed credit(s) by the American Academy of Family Physicians. Term of approval begins 01/01/2021. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ANCC Credit - The maximum number of hours awarded for this Continuing Nursing Education activity is 252 contact hours.

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High-quality specialty review and knowledge protection
Question banks mapped to board exam specifications
Detailed answer explanations with bonus Pearls of Wisdom
Written and peer-reviewed by practicing, board-certified physician educators.
Informative content blogs and updates keep you in step with MOC and guideline changes.
Enduring material, unlike a live course you can't revisit.

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Assessment & Feedback

Do more in less time with intelligent tools.

Intelligent self-assessment and board exam simulation adapts to your knowledge needs
Learning prescriptions guide you to reinforcement in areas of difficulty
Smart exams de-emphasize content you know well so you spend time on material you don't
Flexible study modes and read-friendly answer keys
Build smart custom exams
Predictive performance analytics

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Built for Lifelong Practice

Boards and beyond, built for career MOC.

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Multiple Ways to Learn & Earn

The Med-Challenger platform gives you more than any other. It's designed for today's pressing needs and longterm knowledge quality, maintenance of certification, and hassle-free requirement fulfillment. We know that everyone's practice life and personal requirements vary. We've set everything up where you can use your content assets in multiple ways. Your content assets stay up-to-date and you have flexible and fun ways to use the resources you need to know so you stay at your best.

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Exam blueprint-based board review
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Instant feedback & remediation analysis

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Earn CME credits while you study - or anytime.

Earn CME credit while you study
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Track CME earnings
Easy CME certificate PDF generation

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Play special CME quiz games within your account
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Earn free CME credit for playing

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Family Medicine Board Review
Product Comparison

Take a look at premiere Family Medicine knowledge products from leading vendors.

FEATURE	MED-C FM	Rosh Review	True Learn	Board Vitals
ABFM Review Questions & Full Explanations	3000+	3000+	1200	2300+
AMA Cat 1 CME Credits	250	100	No CME	40
AAFP Prescribed Credits	250	0	No CME	100
Labor-free to Start	Yes	No	Yes	Yes
Exam Simulator	Yes	No	No	No
Time-saving Adaptive AI	Yes	No	No	No
"Weak Area" Guidance	Yes	No	No	Yes
Custom Exams	Yes	Only	Yes	Yes
Multi-product Single Login	Yes	No	No	Yes
Full Year of Use Standard	Yes	Yes	No	No
Low-Cost Renewal* for use every year	Yes	No	No	Yes

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FM Cert

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250 AMA & 250 AAFP CMEs
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Legal course for physicians
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