Practice Test GeeksABIM - American Board of Internal Medicine Practice Test
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Test 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 25-year-old woman is referred for evaluation of iron-deficiency anemia unresponsive to oral iron supplementation. She reports loose stools and a 10-pound weight loss. IgA anti-tissue transglutaminase antibody is markedly elevated. What is the gold-standard confirmatory test?

    Answer: Small bowel biopsy via upper endoscopy

    Duodenal biopsy showing villous atrophy, crypt hyperplasia, and intraepithelial lymphocytosis remains the gold standard for confirming celiac disease.

  2. A 78-year-old man with hypertension and prior stroke is started on apixaban for new atrial fibrillation. His creatinine is 1.8 mg/dL. What is the correct dose of apixaban?

    Answer: 2.5 mg twice daily

    Dose reduction to 2.5 mg twice daily is required when at least 2 of 3 criteria are met: age ≥80, weight ≤60 kg, or serum creatinine ≥1.5 mg/dL; this patient meets age and creatinine criteria.

  3. A 52-year-old man presents with progressive dyspnea and bilateral lower extremity edema. Echo shows EF of 65% with E/e' ratio of 16 and left atrial enlargement. NT-proBNP is 1,200 pg/mL. What is the most likely diagnosis?

    Answer: Heart failure with preserved ejection fraction (HFpEF)

    Preserved EF with elevated filling pressures (elevated E/e' ratio), elevated natriuretic peptides, and left atrial enlargement in a symptomatic patient defines HFpEF.

  4. A 40-year-old HIV-positive man (CD4 count 80 cells/µL, viral load detectable) develops confusion, fever, and nuchal rigidity. CSF shows elevated opening pressure, 20 WBC/µL (mostly lymphocytes), low glucose, and India ink stain is positive. What is the treatment of choice?

    Answer: Amphotericin B deoxycholate plus flucytosine for 2 weeks

    IDSA guidelines recommend amphotericin B deoxycholate plus flucytosine for 2 weeks as induction therapy for cryptococcal meningitis in HIV-infected patients.

  5. A 67-year-old woman with a 40 pack-year smoking history has a 6-cm abdominal aortic aneurysm discovered incidentally on ultrasound. She is asymptomatic with no hemodynamic instability. What is the most appropriate management?

    Answer: Endovascular aortic repair (EVAR) electively

    AAAs ≥5.5 cm in women (and ≥5.5 cm in men) require repair; EVAR is the preferred approach when anatomy is suitable, performed electively in stable patients.

  6. A 33-year-old woman at 10 weeks gestation develops palpitations, tremor, and heat intolerance. TSH is undetectable and free T4 is elevated. She is diagnosed with Graves' disease. Which treatment is preferred in the first trimester?

    Answer: Propylthiouracil (PTU)

    PTU is preferred in the first trimester because methimazole is associated with teratogenic effects (aplasia cutis, choanal atresia) during organogenesis.

  7. A 59-year-old man presents with progressive symmetric distal lower extremity weakness, hyporeflexia, and a stocking-glove pattern of sensory loss. He was treated for lymphoma 6 months ago. Nerve conduction studies show axonal sensorimotor neuropathy. What is the most likely cause?

    Answer: Vincristine-induced neuropathy

    Vincristine causes a length-dependent axonal sensorimotor polyneuropathy that typically manifests during or after chemotherapy for lymphoma.