Practice Test GeeksABIM - American Board of Internal Medicine Practice Test
← All ABIM Flashcard Decks

Pulmonology Flashcards

6 cards from real ABIM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 6 Pulmonology flashcards as text

  1. A 62-year-old smoker presents with a 3.5 cm spiculated lung nodule on CT. PET scan shows hypermetabolic activity. What is the next step?

    Answer: CT-guided biopsy or surgical resection

    A spiculated >3 cm pulmonary nodule with PET hypermetabolic activity in a smoker is highly suspicious for malignancy and requires tissue diagnosis via biopsy or surgical resection.

  2. A patient presents with unilateral pleural effusion. Thoracentesis shows: protein 4.5 g/dL (serum protein 7.0 g/dL), LDH 280 U/L (serum LDH 200 U/L). What type of effusion is this?

    Answer: Exudate

    By Light's criteria, an exudate is diagnosed when pleural fluid/serum protein ratio >0.5, pleural fluid/serum LDH ratio >0.6, or pleural LDH >2/3 upper limit of normal serum LDH.

  3. A 50-year-old woman with obstructive sleep apnea (OSA) has an AHI of 28 events/hour. She is symptomatic with daytime sleepiness. What is the first-line treatment?

    Answer: Continuous positive airway pressure (CPAP)

    CPAP is the first-line treatment for moderate-to-severe OSA (AHI >15) and is the most effective therapy for reducing apnea events and improving symptoms.

  4. A 38-year-old woman with systemic sclerosis develops progressive dyspnea. Echocardiography shows RSVP of 55 mmHg. Right heart catheterization confirms mean PAP of 32 mmHg with normal PCWP. What is the diagnosis?

    Answer: Pulmonary arterial hypertension (Group 1)

    Pulmonary arterial hypertension (Group 1 WHO) is defined by mean PAP ≥25 mmHg with normal PCWP (≤15 mmHg) and pulmonary vascular resistance >3 WU, common in connective tissue diseases.

  5. A patient with community-acquired pneumonia (CAP) is admitted to the hospital (non-ICU). Blood cultures are negative. What is the preferred antibiotic regimen?

    Answer: Beta-lactam plus macrolide, or respiratory fluoroquinolone

    IDSA/ATS guidelines recommend a beta-lactam plus macrolide combination or a respiratory fluoroquinolone monotherapy for hospitalized non-ICU CAP.

  6. A 45-year-old man with HIV (CD4 count 60 cells/µL) presents with progressive dyspnea, dry cough, and LDH of 580 U/L. Chest X-ray shows bilateral interstitial infiltrates. What is the most likely diagnosis?

    Answer: Pneumocystis jirovecii pneumonia (PCP)

    PCP is the most common opportunistic pulmonary infection in HIV patients with CD4 <200 cells/µL, presenting with subacute dyspnea, dry cough, and elevated LDH.