Practice Test GeeksABIM - American Board of Internal Medicine Practice Test
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MCQ Flashcards

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

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  1. A 58-year-old man with type 2 diabetes presents with progressive exertional dyspnea and a reduced ejection fraction of 35%. His current medications include metformin and linagliptin. Which antidiabetic agent has been shown to reduce hospitalization for heart failure in this patient population?

    Answer: Empagliflozin

    SGLT2 inhibitors like empagliflozin reduce hospitalization for heart failure and cardiovascular death in patients with type 2 diabetes and established cardiovascular disease.

  2. A 45-year-old woman is found to have a serum calcium of 11.2 mg/dL on routine labs. PTH is elevated at 92 pg/mL. She is asymptomatic with a creatinine of 1.0 mg/dL and a DEXA T-score of -1.8. What is the most appropriate management?

    Answer: Observation with annual monitoring

    Asymptomatic primary hyperparathyroidism without meeting surgical criteria (T-score ≤ -2.5, age 1 mg/dL above normal, creatinine clearance <60) is managed with observation.

  3. A 72-year-old man with atrial fibrillation on warfarin presents with INR of 8.2 and no active bleeding. Which is the most appropriate immediate management?

    Answer: Hold warfarin and give oral vitamin K

    For elevated INR >8 without bleeding, holding warfarin and giving low-dose oral vitamin K (1-2.5 mg) safely and predictably reverses supratherapeutic anticoagulation.

  4. A 29-year-old woman in the third trimester of pregnancy presents with right upper quadrant pain, nausea, and hypertension of 158/104 mmHg. Labs show AST 320 U/L, platelets 85,000/µL, and LDH 950 U/L. What is the diagnosis?

    Answer: HELLP syndrome

    HELLP syndrome is characterized by hemolysis (elevated LDH), elevated liver enzymes, and low platelets in the setting of hypertensive disorders of pregnancy.

  5. A patient with chronic kidney disease stage 4 presents with hyperkalemia of 6.1 mEq/L, peaked T waves on ECG, and normal QRS duration. What is the first-line treatment to stabilize the cardiac membrane?

    Answer: Intravenous calcium gluconate

    IV calcium gluconate stabilizes the cardiac membrane within minutes and is always the first step when ECG changes are present, before any treatment to lower potassium.

  6. A 50-year-old man presents with symmetric proximal muscle weakness, elevated CK of 4,800 U/L, and an erythematous rash on his upper eyelids and knuckles. What autoantibody is most specifically associated with this condition?

    Answer: Anti-Jo-1

    Anti-Jo-1 (anti-synthetase) antibody is associated with dermatomyositis and polymyositis, often with interstitial lung disease as part of the antisynthetase syndrome.

  7. A 66-year-old man with COPD presents with a 2-day history of increased sputum production, purulent sputum, and worsening dyspnea. SpO2 is 88% on room air. ABG shows pH 7.32, PaCO2 58 mmHg, PaO2 52 mmHg. What is the most appropriate respiratory support?

    Answer: Non-invasive positive pressure ventilation (NIPPV)

    NIPPV (BiPAP) is the preferred intervention for acute hypercapnic respiratory failure in COPD exacerbations, reducing intubation rates and mortality.