NSAIDs: ABFM practice questions

10 board-style questions on nsaids 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 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?

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

Sample question 2

A 35-year-old warehouse worker presents with low back pain for 3 days after lifting heavy boxes. The pain is localized to the lumbar paraspinal muscles, worsens with movement, and improves with rest. He denies radiating leg pain, numbness, weakness, bowel or bladder dysfunction, fever, and weight loss. Neurologic examination is normal. What is the most appropriate initial management?

Prescribe oxycodone for pain control and strict bed rest for 1 week
Refer to orthopedic surgery for evaluation
Order lumbar spine MRI to rule out disc herniation
Advise continued activity as tolerated, NSAIDs, and reassurance with expected recovery within 4-6 weeks

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

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