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 44-year-old woman presents with fatigue, constipation, and hypercalcemia (Ca 11.8 mg/dL). PTH is 98 pg/mL (elevated). Renal function is normal and she is asymptomatic. Which criterion would make parathyroidectomy indicated per current guidelines?

    Answer: Age under 50 years

    Current AACE/AAES guidelines recommend parathyroidectomy for asymptomatic primary hyperparathyroidism in patients under 50 years of age.

  2. A 71-year-old man with cirrhosis (Child-Pugh B) presents with confusion, asterixis, and a serum ammonia of 140 µmol/L. He recently started a high-protein diet. What is the most appropriate treatment?

    Answer: Lactulose titrated to 2–3 soft stools per day

    Lactulose is first-line for acute hepatic encephalopathy, acidifying colonic contents and trapping ammonia for fecal excretion; rifaximin is added for secondary prophylaxis.

  3. A 48-year-old woman presents with a 3-week history of productive cough, night sweats, and 12-pound weight loss. She emigrated from Southeast Asia 2 years ago. Chest X-ray shows right upper lobe cavitary infiltrate. AFB smear of sputum is positive. How many negative sputum cultures are required before she can be removed from airborne isolation?

    Answer: Three consecutive negative smears collected 8 hours apart

    CDC guidelines require three consecutive negative AFB smears from respiratory specimens collected at least 8 hours apart before discontinuing airborne infection isolation.

  4. A 55-year-old man with a history of peptic ulcer disease presents with melena and hemodynamic instability. After resuscitation, upper endoscopy reveals a Forrest Ia (active spurting) duodenal ulcer. What is the most appropriate endoscopic therapy?

    Answer: Combination therapy: epinephrine injection plus thermal coagulation or clip

    Combination endoscopic therapy (epinephrine injection plus a second modality such as thermal coagulation or hemoclip) is superior to monotherapy for high-risk stigmata including active spurting.

  5. A 64-year-old man with long-standing hypertension presents with sudden severe tearing chest pain radiating to the back. BP is 180/100 mmHg in the right arm and 140/85 in the left. CT angiography shows a type A aortic dissection. What is the definitive management?

    Answer: Emergency surgical repair

    Stanford type A aortic dissection involving the ascending aorta is a surgical emergency; medical management alone carries a mortality of approximately 1–2% per hour.

  6. A 38-year-old man with systemic lupus erythematosus presents with pleuritic chest pain and a friction rub. Echo shows a small pericardial effusion with no tamponade physiology. ESR is 88 mm/hr and CRP is elevated. What is the first-line treatment?

    Answer: NSAIDs plus colchicine

    NSAIDs combined with colchicine are first-line for acute pericarditis regardless of etiology, with corticosteroids reserved for refractory or autoimmune-specific cases.

  7. A 52-year-old woman with obesity and type 2 diabetes is found to have persistently elevated ALT (3× ULN) and AST (2× ULN) on two measurements 6 months apart. Liver biopsy shows macrovesicular steatosis, lobular inflammation, and ballooning hepatocyte degeneration. What pharmacologic agent has FDA approval for this condition?

    Answer: Resmetirom (Rezdiffra)

    Resmetirom (Rezdiffra) received FDA approval in March 2024 as the first pharmacologic treatment specifically approved for metabolic dysfunction-associated steatohepatitis (MASH) with moderate-to-advanced fibrosis.