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In-Training Exam

Family Medicine Board Practice Questions


Just like the actual exam

Aligned with the American Board of Family Medicine format. Authored & peer-reviewed by faculty, clinicians, and program directors.

Each question is written to resemble the format and topics on the exam, meaning you won’t see any negatively phrased questions, no “all of the following except,” no “A and B”…you know what we mean. Most importantly, all questions include selective distractors (incorrect answer choices), which will help you think critically.

  • Must address important content
  • Must be well structured


A 58-year-old man presents to the clinic with bilateral hand and wrist pain that has been progressively worsening for 6 months. He says the pain is accompanied by morning stiffness that now lasts up to 45 minutes, which slows him down when getting up for work. On physical exam, you note the proximal joints of both hands are swollen and tender. Which of the following is the most likely diagnosis?
A Fibromyalgia
B Osteoarthritis
C Reactive arthritis
D Rheumatoid arthritis
Correct Answer Distractors
Rheumatoid arthritis is considered an autoimmune disease that presents with symmetrical, inflammatory polyarthritis, often associated with morning stiffness lasting over 30 minutes. Rheumatoid arthritis commonly affects the proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints. The joints are described as swollen and boggy, secondary to synovial hypertrophy or effusion. X-rays consistent with rheumatoid arthritis show bony erosions or subchondral cysts or both. The diagnosis can be confirmed with anti-cyclic citrullinated protein antibodies, with or without a positive rheumatoid factor. ESR and CRP are both nonspecific to rheumatoid arthritis but are likely to be elevated secondary to inflammation. Arthritis presenting for less than a few weeks should prompt further workup for alternate causes, as rheumatoid arthritis is a chronic condition and considered appropriate when symptoms have been present for 6 weeks or more.


Written with a purpose

Understanding why an answer choice is incorrect is just as important as knowing why one is correct. That’s why every Rosh Review question includes detailed explanations for the correct and incorrect answer choices. These comprehensive summaries link the most important components of a topic—from risk factors to diagnostics and treatment—giving you the context to build relationships between them.

  • Created for optimal learning and recall
  • Help reinforce your knowledge
  • Focus on the essential information


Created to enhance learning

Custom illustrations and tables help further clarify the core concepts. When information is presented visually, you can focus on meaning, easily reorganize and group similar ideas, and make better use of your memory.

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One Step Further

Taking your learning to the next level

After each explanation is a straightforward question with a simple, memorizable answer that reinforces the corresponding topic.

  • Strengthens your knowledge
  • Stands alone from the main explanation so you’re not rereading content


What is first line in the treatment of early-onset rheumatoid arthritis?

Reveal Answer

Rheumatoid Arthritis

  • More common in women and those aged 40–50 years
  • Morning stiffness lasting > 30 minutes
  • PE will show symmetrical soft, red, tender swelling in joints (MCP, PIP)
  • Bilateral ulnar deviation at MCP, boutonnière deformity, and swan-neck deformity
  • Labs will show positive RF, anti-cyclic citrullinated peptide antibodies
  • Most commonly caused by autoimmune destruction of synovial joints
  • Treatment is DMARDs

Rapid Review

Keeping things simple

These bulleted reviews focus on condensed, high-yield concepts about the main topic, from patient presentation to preferred management.

  • Cover the fundamentals in one list
  • Allow you to quickly scan the must-know information


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Matthew DeAugustinis, MD

Attending Physician

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