NSAIDs: ABFM practice questions

10 board-style questions on nsaids in the PulseMD family medicine question bank — physician-reviewed, 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 60-year-old man presents to the emergency department with melena and coffee-ground emesis. He has been taking ibuprofen 800 mg three times daily for 6 weeks for chronic knee osteoarthritis. His blood pressure is 110/70 mmHg, heart rate is 100 bpm, and hemoglobin is 9.2 g/dL. After resuscitation, upper endoscopy reveals a 1.5 cm clean-based gastric ulcer with no active bleeding or visible vessel. Rapid urease test for H. pylori is negative. What is the most important management step?

  1. Start misoprostol 200 mcg four times daily and continue ibuprofen at a lower dose
  2. Surgical consultation for ulcer excision to rule out malignancy
  3. Begin empiric H. pylori eradication therapy despite the negative rapid urease test
  4. Discontinue NSAIDs and start high-dose PPI therapy for 8 weeks

Sample question 2

A 52-year-old man presents to the clinic with acute onset of severe pain, swelling, and erythema of his right first metatarsophalangeal joint that began 12 hours ago. He has no prior history of gout and takes hydrochlorothiazide for hypertension. The joint is exquisitely tender, erythematous, and warm. Serum uric acid is 9.2 mg/dL. Joint aspiration reveals negatively birefringent, needle-shaped crystals under polarized light microscopy. He has no history of renal disease, peptic ulcer disease, or heart failure. What is the most appropriate treatment for this acute flare?

  1. Indomethacin 50 mg three times daily for 5-7 days
  2. Probenecid 500 mg twice daily
  3. Allopurinol 100 mg daily with dose titration
  4. Colchicine 1.2 mg followed by 0.6 mg one hour later, started 48 hours after symptom onset

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

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