100+ Free ABFM Geriatric Medicine Practice Questions

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An 82-year-old woman is evaluated at an outpatient visit. She has lost 5 kg (11 lb) unintentionally over the past year, reports feeling exhausted, has a slow gait (>7 seconds to walk 4 meters), low grip strength, and is sedentary most of the week. By Fried criteria, how should she be classified?

Robust

Pre-frail

Frail

Sarcopenic only

to track

2026 Statistics

Key Facts: ABFM Geriatric Medicine Exam

~220

Max MCQ Questions

Single-best-answer format

1 Day

Exam Length

Computer-based at Pearson VUE (~10 hours)

~$2,475

Initial Exam Fee

Plus annual CAQ maintenance fee

12 mo

Required Fellowship

ACGME-accredited Geriatric Medicine

10 yr

CAQ Cycle

Maintained via recertification exam or LKA

Joint

ABFM + ABIM

Single shared examination

The ABFM Geriatric Medicine CAQ is a 1-day computer-based exam with up to ~220 single-best-answer MCQs, administered jointly by ABFM and ABIM at Pearson VUE. Candidates must hold continuous primary ABFM (or ABIM) certification and have completed a 12-month ACGME Geriatric Medicine fellowship. Content spans frailty and functional assessment (Fried, EWGSOP2, CGA, PPS), falls (STEADI) and osteoporosis (FRAX, bisphosphonates, denosumab, romosozumab), cognitive disorders (CAM, dementia subtypes, lecanemab/donanemab, APOE ε4), polypharmacy (2023 Beers, STOPP/START, anticholinergic burden), geriatric syndromes (NPIAP staging, incontinence types, MEALS ON WHEELS), mental health (PHQ-9/GDS), and end-of-life care (hospice, POLST, capacity, MAID). Initial fee approximately $2,475; CAQ maintained over 10-year cycle via recertification exam or LKA.

Sample ABFM Geriatric Medicine Practice Questions

Try these sample questions to test your ABFM Geriatric Medicine exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1An 82-year-old woman is evaluated at an outpatient visit. She has lost 5 kg (11 lb) unintentionally over the past year, reports feeling exhausted, has a slow gait (>7 seconds to walk 4 meters), low grip strength, and is sedentary most of the week. By Fried criteria, how should she be classified?

A.Robust

B.Pre-frail

C.Frail

D.Sarcopenic only

Explanation: Fried's phenotype defines frailty by 5 criteria: unintentional weight loss >10 lb/year, self-reported exhaustion, weakness (low grip strength), slow walking speed, and low physical activity. 3 or more = frail; 1-2 = pre-frail; 0 = robust. She meets all 5. Exam Tip: Frailty is a distinct syndrome with increased vulnerability to stressors and higher mortality; screening in primary care predicts hospitalization and falls.

2Which assessment is most consistent with the EWGSOP2 (2019) definition of sarcopenia?

A.Low appendicular lean mass alone on DEXA

B.Low muscle strength (e.g., grip strength) as the primary criterion, confirmed by low muscle quantity/quality

C.BMI less than 22 kg/m² in an older adult

D.Unintentional weight loss of 5% in 6 months

Explanation: EWGSOP2 revised the definition in 2019 to make low muscle strength the primary defining characteristic of sarcopenia (probable sarcopenia). Confirmed sarcopenia requires both low strength and low muscle quantity/quality; severe sarcopenia adds low physical performance (e.g., gait speed). Exam Tip: SARC-F is a validated 5-item screen (Strength, Assistance walking, Rise from chair, Climb stairs, Falls).

3A 78-year-old independent woman completes the Timed Up and Go (TUG) test in 14 seconds. What does this result suggest?

A.Normal mobility and low fall risk

B.Increased fall risk; further multifactorial assessment is warranted

C.Diagnostic of sarcopenia

D.An indication for immediate hospitalization

Explanation: A TUG of ≥12 seconds is associated with increased fall risk per the CDC STEADI initiative. It prompts a multifactorial fall assessment (medications, vision, orthostasis, footwear, home hazards, strength/balance). Exam Tip: Gait speed <0.8 m/s similarly predicts adverse outcomes including mortality and disability.

4According to the CDC STEADI algorithm, which sequence is the initial fall-risk screening?

A.Order DEXA and vitamin D level for all adults ≥65

B.Ask 3 key questions (fall in past year? unsteady? worried about falling?) and perform a gait/balance test

C.Prescribe vitamin D 2000 IU and a walker for everyone ≥65

D.Refer all older adults to physical therapy annually

Explanation: STEADI (Stopping Elderly Accidents, Deaths & Injuries) begins with the 3 key questions, then gait/balance testing (TUG, 30-second chair stand, 4-stage balance). Positive screen triggers multifactorial assessment. Exam Tip: Evidence-based fall prevention bundles include exercise with balance (Otago, Tai Chi), medication review, vision correction, vitamin D for deficient patients, and home hazard modification.

5Per USPSTF and geriatric guidelines, which vitamin D dose is appropriate for community-dwelling older adults at risk of falls who are deficient?

A.50,000 IU daily indefinitely

B.400 IU daily

C.Approximately 800 IU daily (or equivalent) when deficient

D.10,000 IU daily for all adults ≥65

Explanation: Guidelines support 800 IU/day of vitamin D supplementation when deficient; routine high-dose supplementation for fall prevention in unselected populations is not supported by USPSTF. Exam Tip: USPSTF (2024) recommends against vitamin D supplementation for primary fall prevention in community-dwelling adults ≥60 without deficiency or osteoporosis.

6An 85-year-old man admitted with pneumonia becomes acutely confused overnight with inattention, disorganized thinking, and fluctuating consciousness. Which bedside tool best confirms delirium?

A.Mini-Mental State Examination (MMSE)

B.Confusion Assessment Method (CAM)

C.Geriatric Depression Scale (GDS)

D.PHQ-9

Explanation: CAM is the most widely used bedside instrument for delirium: requires (1) acute onset/fluctuating course AND (2) inattention, plus either (3) disorganized thinking OR (4) altered consciousness. 4AT is a briefer alternative. Exam Tip: MMSE assesses cognition but is not specific for delirium; GDS/PHQ-9 screen depression.

7Which medication is most commonly implicated as a precipitating factor for delirium in older inpatients?

A.Acetaminophen

B.Diphenhydramine (anticholinergic)

C.Metformin

D.Atorvastatin

Explanation: Anticholinergics (e.g., diphenhydramine), benzodiazepines, opioids, corticosteroids, and certain antibiotics are frequent precipitants. Predisposing factors include age, cognitive impairment, sensory deficits, and comorbidity. Exam Tip: Best approach to inpatient delirium is prevention via the HELP bundle (orientation, early mobilization, sleep protocols, hydration, vision/hearing aids).

8Which feature most strongly suggests Dementia with Lewy Bodies (DLB) rather than Alzheimer disease?

A.Gradual progressive memory loss without motor symptoms

B.Recurrent, well-formed visual hallucinations plus fluctuating cognition and parkinsonism

C.Stepwise decline with focal neurologic deficits

D.Early behavioral disinhibition and executive dysfunction

Explanation: Core features of DLB include fluctuating cognition with variations in attention, recurrent visual hallucinations, REM sleep behavior disorder, and parkinsonism. Alzheimer disease typically presents with early amnestic impairment; vascular dementia is stepwise; FTD presents with behavioral/language changes. Exam Tip: Avoid typical antipsychotics in DLB — severe sensitivity reactions can occur.

9A 62-year-old executive develops progressive disinhibition, apathy, and loss of empathy with relatively preserved memory. Neuroimaging shows frontal/temporal atrophy. Most likely diagnosis?

A.Alzheimer disease

B.Vascular dementia

C.Behavioral-variant frontotemporal dementia (bvFTD)

D.Normal pressure hydrocephalus

Explanation: bvFTD often presents in the 50s-60s with early personality and behavioral changes, executive dysfunction, and relative memory sparing. Primary progressive aphasia (semantic, nonfluent) is the language variant. Exam Tip: NPH classically presents with the triad of gait apraxia, urinary incontinence, and cognitive impairment — 'wet, wobbly, wacky.'

10Which CSF biomarker pattern supports Alzheimer disease?

A.Low Aβ42, high total tau and phospho-tau (low Aβ42/Aβ40 ratio)

B.High Aβ42 and low total tau

C.Normal Aβ42 with high glucose

D.Elevated 14-3-3 protein without tau elevation

Explanation: Alzheimer disease shows decreased CSF Aβ42 (amyloid accumulates in plaques, reducing CSF levels) and increased total tau and phospho-tau. Aβ42/Aβ40 ratio is more robust than Aβ42 alone. Amyloid PET and plasma p-tau217 are emerging alternatives. Exam Tip: AT(N) biomarker framework: A=amyloid, T=tau, (N)=neurodegeneration.

About the ABFM Geriatric Medicine Exam

The ABFM Geriatric Medicine Certificate of Added Qualifications (CAQ) recognizes family physicians with advanced expertise in the care of older adults. Offered jointly with the American Board of Internal Medicine (ABIM), the same examination is used by both boards. Eligibility requires continuous ABFM certification plus completion of a minimum 12-month ACGME-accredited Geriatric Medicine fellowship. The exam tests expert knowledge of frailty, delirium, dementia (including anti-amyloid therapies), falls and osteoporosis, polypharmacy (Beers/STOPP-START), incontinence, pressure injuries, sensory loss, nutrition, mental health, and end-of-life care.

Questions

220 scored questions

Time Limit

1-day computer-based exam (approximately 10 hours on-site)

Passing Score

Absolute standard (criterion-referenced)

Exam Fee

~$2,475 initial exam (plus annual CAQ maintenance fee) (American Board of Family Medicine (ABFM) — offered jointly with ABIM)

ABFM Geriatric Medicine Exam Content Outline

20%

Frailty, Functional Assessment, and Mobility

Fried criteria, EWGSOP2 sarcopenia, SARC-F, CFS, ADL/IADL (Katz, Lawton), PPS/Karnofsky, TUG ≥12s, gait speed <0.8 m/s, comprehensive geriatric assessment

18%

Falls, Osteoporosis, and Musculoskeletal

STEADI, multifactorial prevention, exercise and balance (Otago, Tai Chi), vitamin D 800 IU, medication review, vision; DEXA, FRAX, bisphosphonate duration, denosumab rebound fractures, teriparatide, romosozumab CV warning, hip fracture

20%

Cognitive Disorders: Delirium and Dementia

CAM/4AT, predisposing vs precipitating factors; AD, vascular, LBD, FTD; cholinesterase inhibitors, memantine; anti-amyloid mAbs (lecanemab Jan 2023, donanemab Jul 2024), ARIA-E/ARIA-H, APOE ε4; BPSD (non-pharm first, citalopram, brexpiprazole)

15%

Polypharmacy, Beers, STOPP/START

2023 Beers criteria (benzos, anticholinergics, H1 antihistamines, NSAIDs, glyburide, chronic PPI), STOPP/START, geriatric PK changes, anticholinergic burden, DOAC renal dosing

12%

Geriatric Syndromes

NPIAP pressure-injury staging and Braden; urge/stress/overflow/functional incontinence; presbycusis, AMD, glaucoma, cataract; MEALS ON WHEELS, MNA, weight-loss workup

Mental Health, Preventive Care, and Vaccination

Depression (PHQ-9, GDS, sertraline/escitalopram), suicide risk (older white men), AWV cognitive screening; high-dose/adjuvanted influenza ≥65, RSV ≥75, PCV20/PCV21, recombinant zoster ≥50

End-of-Life Care and Care Models

Palliative vs hospice, Medicare Hospice Benefit, POLST/MOLST, capacity (Appelbaum), MAID, double effect, palliative sedation; elder mistreatment and mandated APS reporting; PACE, hospital at home, SNF vs IRF

How to Pass the ABFM Geriatric Medicine Exam

What You Need to Know

Passing score: Absolute standard (criterion-referenced)
Exam length: 220 questions
Time limit: 1-day computer-based exam (approximately 10 hours on-site)
Exam fee: ~$2,475 initial exam (plus annual CAQ maintenance fee)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABFM Geriatric Medicine Study Tips from Top Performers

1Memorize the 5 Fried frailty criteria — unintentional weight loss, exhaustion, weakness (grip), slow gait, low activity; 3 of 5 = frail, 1-2 = pre-frail. Also know TUG ≥12s and gait speed <0.8 m/s as standard mobility cut-offs

2Know anti-amyloid monoclonal antibodies cold — lecanemab (FDA traditional approval Jul 2023; accelerated Jan 2023) and donanemab (FDA approval Jul 2024) both for early AD (MCI or mild dementia); require baseline + serial MRI for ARIA, APOE ε4 homozygosity raises ARIA risk, and anticoagulation is a strong caution

32023 Beers criteria high-yield classes to avoid: long-acting benzos, first-gen antihistamines (diphenhydramine, hydroxyzine), TCAs, glyburide, skeletal muscle relaxants, oxybutynin, and PPIs >8 weeks without indication — always cross-check the anticholinergic burden

4NPIAP staging: Stage 1 (non-blanchable erythema, intact skin); Stage 2 (partial-thickness, exposed dermis); Stage 3 (full-thickness + fat); Stage 4 (bone/muscle/tendon exposed); DTPI (non-blanchable purple discoloration); Unstageable (obscured by eschar/slough) — do NOT debride stable dry heel eschar

5Medicare Hospice Benefit requires prognosis ≤6 months certified by two physicians; palliative care can coexist with curative treatment at any stage; POLST/MOLST is a portable medical order across settings, not an advance directive

6Deprescribe aggressively in frail elders: relax HbA1c to 7.5-8.5%, avoid tight BP targets, stop statins if life expectancy <1 year, stop PPIs after 8 weeks if no indication, trial non-pharm first for BPSD and insomnia, and use STOPP/START at least annually

Frequently Asked Questions

What is the ABFM Geriatric Medicine CAQ?

The Geriatric Medicine Certificate of Added Qualifications (CAQ) is a subspecialty credential offered by the American Board of Family Medicine jointly with the American Board of Internal Medicine. The same examination is used by both boards, and candidates register through their primary board. It recognizes family physicians with advanced expertise in the care of older adults.

Who is eligible to take the ABFM Geriatric Medicine exam?

Candidates must maintain continuous primary certification in Family Medicine (ABFM) in good standing, hold a valid unrestricted US medical license, and complete a minimum 12 months of full-time training in an ACGME-accredited Geriatric Medicine fellowship. The fellowship program director must attest to clinical competence. Internal medicine physicians take the same exam through ABIM.

What is the format of the ABFM Geriatric Medicine exam?

The CAQ exam is a single-day computer-based test delivered at Pearson VUE testing centers. It consists of up to approximately 220 single-best-answer multiple-choice questions organized into timed blocks with scheduled breaks (roughly 10 hours on-site total). A criterion-referenced (absolute) passing standard is applied — performance does not depend on other candidates.

How much does the ABFM Geriatric Medicine exam cost?

The initial certification exam fee is approximately $2,475 (fees are set annually by ABFM). Once certified, diplomates pay an annual CAQ maintenance fee and continuously maintain their primary Family Medicine certification. The CAQ can be maintained via a 10-year recertification examination OR the Longitudinal Knowledge Assessment (LKA).

What topics are on the ABFM Geriatric Medicine exam?

Content covers frailty and functional assessment (~20%), falls and osteoporosis (~18%), delirium and dementia (~20%), polypharmacy and Beers/STOPP-START (~15%), geriatric syndromes (pressure injuries, incontinence, sensory, nutrition — ~12%), mental health, preventive care and vaccination (~7%), and end-of-life care and care models (~8%). Expect detailed questions on anti-amyloid monoclonal antibodies (lecanemab, donanemab), 2023 Beers updates, and current ACIP recommendations for older adults.

How should I prepare for the ABFM Geriatric Medicine exam?

Use a structured board-review resource (Geriatric Review Syllabus/GRS, AGS Beers Pocket Card, UpToDate, AAFP/ABFM Knowledge Self-Assessment). Memorize Fried criteria, EWGSOP2 sarcopenia, CAM/4AT, NPIAP staging, FRAX thresholds, and 2023 Beers cold. Know the anti-amyloid mAbs (approval dates, ARIA monitoring, APOE ε4 caveats). Practice high-volume MCQ banks covering all 7 content domains and review Medicare benefits (hospice, PACE, AWV).

How long is the ABFM Geriatric Medicine CAQ valid?

The CAQ is valid on a 10-year cycle. Diplomates maintain the CAQ by continuously maintaining their primary ABFM Family Medicine certification, paying annual CAQ fees, and passing either a traditional 10-year recertification exam OR the Longitudinal Knowledge Assessment (LKA), which delivers questions over multi-year cycles.

Is the ABFM Geriatric Medicine exam the same as the ABIM exam?

Yes. ABFM and ABIM jointly sponsor a single Geriatric Medicine examination. Family physicians register through ABFM and internists register through ABIM, but both sit for the identical content, blueprint, and standards. This is why candidates commonly use board-review materials published for both ABFM and ABIM.