SPEX Cheat Sheet 2026

The 30 highest-yield SPEX facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which finding on ultrasound is most consistent with acute cholecystitis? → Gallbladder wall thickening with a positive Murphy's sign on US
2. What is the value of continuing education in pediatrics for SPEX professionals? → It keeps professionals current with evolving standards and practices
3. What is the most important professional competency for SPEX certification in emergency medicine? → Deep knowledge combined with practical application skills
4. Which professional attribute is most valued in neurology within the SPEX field? → Accountability and commitment to standards
5. A physician prescribes digoxin for heart failure. Which electrolyte abnormality potentiates digoxin toxicity? → Hypokalemia
6. What is the mechanism of resistance when bacteria produce beta-lactamase enzymes? → They hydrolyze the beta-lactam ring
7. In SPEX practice, what is the best approach to quality improvement in obstetrics and gynecology? → Use data-driven methods with measurable outcomes
8. In the ABCDE criteria for evaluating suspicious skin lesions for melanoma, what does the 'E' stand for? → Evolution or change over time
9. What is the value of continuing education in psychiatry for SPEX professionals? → It keeps professionals current with evolving standards and practices
10. Which drug used for type 2 diabetes carries the highest risk of hypoglycemia when used as monotherapy? → Glipizide
11. Which approach best demonstrates mastery of neurology in SPEX practice? → Applying principles to novel situations with sound judgment
12. What is the value of continuing education in family medicine for SPEX professionals? → It keeps professionals current with evolving standards and practices
13. What is the value of continuing education in obstetrics and gynecology for SPEX professionals? → It keeps professionals current with evolving standards and practices
14. Which approach best demonstrates mastery of obstetrics and gynecology in SPEX practice? → Applying principles to novel situations with sound judgment
15. Which mechanism describes how warfarin exerts its anticoagulant effect? → Inhibiting vitamin K epoxide reductase
16. Which imaging modality best characterizes liver lesions detected incidentally on CT? → MRI with hepatobiliary contrast agent
17. What is the most important professional competency for SPEX certification in internal medicine? → Deep knowledge combined with practical application skills
18. What is the antidote for acetaminophen overdose? → N-acetylcysteine
19. Which oral medication for severe acne vulgaris reduces sebum production but is highly teratogenic, requiring the iPLEDGE program? → Isotretinoin
20. Which approach best demonstrates mastery of family medicine in SPEX practice? → Applying principles to novel situations with sound judgment
21. A Tzanck smear showing multinucleated giant cells is diagnostic of which infection? → Herpes simplex or varicella-zoster virus infection
22. In SPEX practice, what is the best approach to quality improvement in emergency medicine? → Use data-driven methods with measurable outcomes
23. What is the value of continuing education in surgery for SPEX professionals? → It keeps professionals current with evolving standards and practices
24. Wickham striae—fine white lacy lines on skin lesions—are pathognomonic for which dermatological condition? → Lichen planus
25. What is the first-line treatment for uncomplicated scabies in adults? → Topical permethrin 5% cream
26. Which professional attribute is most valued in psychiatry within the SPEX field? → Accountability and commitment to standards
27. Which finding on echocardiography is most consistent with cardiac tamponade? → Right ventricular diastolic collapse
28. Which professional attribute is most valued in obstetrics and gynecology within the SPEX field? → Accountability and commitment to standards
29. Which approach best demonstrates mastery of pediatrics in SPEX practice? → Applying principles to novel situations with sound judgment
30. In SPEX practice, what is the best approach to quality improvement in pediatrics? → Use data-driven methods with measurable outcomes