Atrial Fibrillation: ABFM practice questions

12 board-style questions on atrial fibrillation in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 69-year-old woman with newly diagnosed nonvalvular atrial fibrillation presents for management. Her medical history includes hypertension, type 2 diabetes, and stable angina. She has no history of stroke, TIA, thromboembolism, or vascular disease. Her CHA2DS2-VASc score is calculated as 4 (age 65-74 = 1, female sex = 1, hypertension = 1, diabetes = 1). Renal and hepatic function are normal. What is the most appropriate stroke prevention strategy?

1. No anticoagulation or antiplatelet therapy needed
2. Dual antiplatelet therapy with aspirin and clopidogrel
3. Aspirin 81 mg daily
4. Direct oral anticoagulant such as apixaban

Sample question 2

A 73-year-old man with persistent atrial fibrillation, hypertension, and heart failure with preserved ejection fraction (EF 52%) presents for management. His resting heart rate is 112 bpm on examination. He reports mild palpitations but denies significant dyspnea, chest pain, or syncope. He has been in atrial fibrillation continuously for approximately 9 months. His current medications include apixaban and lisinopril. What is the most appropriate initial management strategy?

1. Immediate direct current cardioversion
2. Referral for catheter ablation as first-line therapy
3. Rate control with a beta-blocker or non-dihydropyridine calcium channel blocker targeting a resting heart rate under 110 bpm
4. Rhythm control with amiodarone to restore and maintain sinus rhythm

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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