Practice Test GeeksABIM - American Board of Internal Medicine Practice Test
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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 66-year-old man with atrial fibrillation and CHA₂DS₂-VASc score of 4 is on warfarin (INR 2.4). He develops hematuria and hemoglobin drops from 13 to 10 g/dL. What is the most appropriate management of anticoagulation?

    Answer: Hold warfarin and reverse with vitamin K; resume after source identified and treated

    Significant bleeding warrants holding anticoagulation and identifying the source; warfarin should be resumed once hemostasis is achieved given his high stroke risk.

  2. A 29-year-old woman presents with amenorrhea, galactorrhea, and a serum prolactin of 180 ng/mL. MRI shows a 12-mm pituitary lesion. Which treatment is most appropriate?

    Answer: Cabergoline

    Cabergoline is the preferred dopamine agonist for macroprolactinomas due to superior efficacy and tolerability compared to bromocriptine.

  3. A 70-year-old man with COPD (FEV₁ 45% predicted) is admitted with acute exacerbation. After 48 hours of bronchodilators and systemic corticosteroids, he remains hypercapnic (PaCO₂ 68 mmHg, pH 7.28). Which intervention has been shown to reduce mortality and need for intubation in this setting?

    Answer: Noninvasive positive-pressure ventilation (NIPPV)

    NIPPV reduces intubation rates, ICU length of stay, and mortality in COPD exacerbations with hypercapnic respiratory failure.

  4. A 48-year-old woman with rheumatoid arthritis on methotrexate and prednisone presents with subacute onset of fever, non-productive cough, and dyspnea. CT shows bilateral ground-glass opacities. LDH is elevated. Which pathogen is most likely?

    Answer: Pneumocystis jirovecii

    Immunosuppressed patients on chronic corticosteroids are at high risk for Pneumocystis jirovecii pneumonia, which presents with bilateral ground-glass opacities and elevated LDH.

  5. A 55-year-old man with known coronary artery disease has an LDL of 95 mg/dL on high-intensity statin therapy. What is the most appropriate next step to further reduce his cardiovascular risk?

    Answer: Add ezetimibe

    Ezetimibe added to statin therapy was shown in IMPROVE-IT to further reduce major cardiovascular events in high-risk patients, making it the preferred add-on agent.

  6. A 34-year-old woman presents with symmetric proximal muscle weakness, elevated CK (3,200 U/L), and a heliotrope rash. EMG shows myopathic changes. What is the most important next diagnostic step?

    Answer: Malignancy screening

    Dermatomyositis is strongly associated with occult malignancy (especially in adults >40), making cancer screening a priority after diagnosis.

  7. A 61-year-old man with type 2 diabetes (HbA1c 8.4%) and CKD stage 3 (eGFR 42 mL/min) presents for glucose management optimization. Which agent provides cardiovascular and renoprotective benefits supported by outcomes trials in this population?

    Answer: Empagliflozin

    SGLT2 inhibitors like empagliflozin have demonstrated cardiovascular mortality reduction and slowed CKD progression in outcome trials (EMPA-REG, CREDENCE, DAPA-CKD).

Test Flashcards — ABIM Study Cards with Answers