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ITE Internal Medicine In-Training VIP Practice Exam II
ITE — The Internal Medicine In-Training Examination (ITE) is administered annually by the American College of Physicians (ACP) to internal medicine residents; it consists of approximately 240 questions over 240 minutes and serves as a formative educational assessment covering all major domains of internal medicine — no official passing score exists, so 70% is used here as a representative competency benchmark.
29
Questions
90m
Time Limit
70.00%
To Pass
Question 1 of 29👑 VIP
A 67-year-old woman with a long history of hypertension and type 2 diabetes presents with progressive exertional dyspnea over four months. She denies orthopnea or PND. Examination reveals an S4 gallop, trace bilateral ankle edema, and a blood pressure of 158/94 mmHg. Chest X-ray shows mild pulmonary vascular congestion without cardiomegaly. Echocardiogram demonstrates an ejection fraction of 60%, impaired early diastolic relaxation (E/A ratio 0.7), and elevated E/e' ratio of 16. BNP is 380 pg/mL. Which of the following is the MOST appropriate initial management strategy?
Questions 2–29 and full explanations are VIP-exclusive.