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INTERNAL FAMILY MED EOR EXAM
TEST BANK WITH 415 EXAM PREP
QUESTIONS AND CORRECT ANSWERS
|EOR INTERNAL MEDICINE TEST 2025
PREP QUESTIONS WITH ANSWERS
(NEWEST EDITION!)
"A 24-year-old woman presents to the Emergency Department with fever and shortness-of- breath for the last 48 hours. Her past medical history is significant for recent IV drug abuse. On physical exam, you auscultate a pansystolic ejection murmur best heard at the left lower sternal border. You also note nontender macular lesions on the palms of her hands and soles of her feet. Laboratory analysis is significant for a white blood cell count of 20,000/mcL, erythrocyte sedimentation rate of 67 mm/hour, and C-reactive protein of 6.5 mg/L. Which imaging modality would be most appropriate to confirm your diagnosis? - CORRECT ANSWER=> TTE Infective endocarditis is an infection of the endocardium of the heart. In general, this infection occurs at one or more of the valves of the heart. Significant risk factors include advanced age, male gender, injection drug abuse, poor dentition, and prosthetic heart valves. In the setting of injection drug abuse, the tricuspid valve is most commonly affected. Signs and symptoms include fever, malaise, exercise intolerance and a new-onset heart murmur. Janeway lesions (nontender erythematous macular lesions of the palms and soles), Osler nodes (tender lesions on the pads of fingers and toes) and Roth spots (hemorrhagic retinal lesions) may also be found and are highly suggestive of infectious endocarditis. Transthoracic echocardiography is the primary imaging modality indicated for evaluation of infective endocarditis. Transthoracic echocardiography is preferred due to the non-invasive approach combined with high sensitivity and specificity. Many patients may also require transesophageal echocardiography to rule out complications such as abscess, leaflet perforation, and pseudoaneurysm. Due to its invasive approach, however, it is not generally recommended as first-line imaging."
"Diagnosis is made by 24-hour excretion of 5-hydroxyindoleacetic acid - CORRECT ANSWER=> Carcinoid Syndrome Skin flushing Diarrhea" "Blanching maculopapular rash around the wrists and ankles and has a centripetal spread toward the body. - CORRECT ANSWER=> Rocky Mountain spotted fever Rickettsia rickettsii Tx: ALWAYS doxy" "ANCA negative HIGH ESR renal or mesenteric angiography: microaneurysms with abrupt cut-off of small arteries PE: HTN, nothing on lungs, inflammation of nerve - CORRECT ANSWER=> Polyarteritis nodosa Management: corticosteroids" "Ship builder with pleural plaques, pleural thickening, interstitial fibrosis - CORRECT ANSWER=> Asbestosis" "CT= honeycomb lung, primarily lower lobes - CORRECT ANSWER=> Asbestosis" "Older M with rectal bleeding with hemorrhoid. Colonoscopy? - CORRECT ANSWER=> Yes!" "Guy with high H&H. PE finding: - CORRECT ANSWER=> splenomegaly" "Nephrotic syndrome PE - CORRECT ANSWER=> P: Proteinuria A: low Albumin L: high Lipids E: Edema" "UA= fat bodies (maltese cross shaped) - CORRECT ANSWER=> Nephrotic syndrome"
"Pt presents with DKA to ED. What kind of insulin do you give them? - CORRECT ANSWER=> Regular insulin" "CXR of emphysema - CORRECT ANSWER=> Hyperinflation: flat diaphragm, inc AP dm, dec vascular markings +/- BULLAE" "PE: hyperresonance to percussion, decreased breath sounds, decreased fremitus, increased AP diameter, pursed lip breathing - CORRECT ANSWER=> Emphysema AP diameter= barrel chest Pursed lip: pink puffer" "LT tx for pt with persistent VTach - CORRECT ANSWER=> Amiodorone Procainamide" "Biopsy for Crohn's? - CORRECT ANSWER=> Skip lesions Transmural Cobblestone appearance" "Cobblestone appearance on colonoscopy - CORRECT ANSWER=> Crohn's" "Barium flow through narrowed inflamed/scarred area due to transmural strictures - CORRECT ANSWER=> Crohn's" "IBD P-ANCA, ASCA - CORRECT ANSWER=> P-ANCA: UC ASCA: CROHN'S" "Skip lesions - CORRECT ANSWER=> Crohn's colonoscopy" "Initial management for spinal stenosis - CORRECT ANSWER=> Lumbar epidural steroid injection of CTS" "Most likely etiology of transudative pleural effusion - CORRECT ANSWER=> CHF" "What to give a pt with Lupus reaction (lesions)? - CORRECT ANSWER=> Hydroxychloroquine For arthritis: NSAIDs or APAP. +/- pulse dose: corticosteroids, cytotoxic drugs (methotrexate, cyclophosphamide)"
"Syndrome that causes hypokalemia - CORRECT ANSWER=> Adrenal adenoma" "UA shows epithelial cells casts and muddy brown casts, low SG, hyperkalemia, increased phosp
- CORRECT ANSWER=> ATN" "HTN, edema, azotemia, UA shows hematuria RBC cast, proteinuria, dysmorphic RBC casts - CORRECT ANSWER=> GN" "MC murmur after MI - CORRECT ANSWER=> Mitral Regurgitation" "Shigellosis tx - CORRECT ANSWER=> Bactrim" "DOC for Legionella - CORRECT ANSWER=> Levofloxacin or Azithromycin PER PAEasy: 1st line: Erythromycin or Doxycycline. Levo or Azithro alternatives or for severe dz!" "Girl with GERD. Avoid mint of give h2blockers? - CORRECT ANSWER=> Avoid mint stage 1: lifestyle modifications stage 2: PRN H2 receptor antagonists stage 3: PPI ALARM sxs: dysphagia, odynophagia, weight loss, bleeding" "Man with asthma and on beta agonist using 3-5 times per week. Next? - CORRECT ANSWER=> Add inhaled corticosteroid Beclomethasone, Flunisolide, Triamcinolone" "Tx for Raynauds - CORRECT ANSWER=> Nifedipine" "Best drug to prevent remodeling of heart after MI - CORRECT ANSWER=> BB" "Adding an ACEI to person with diabetes protects against what - CORRECT ANSWER=> Kidney problems"
"DM1 vs DM2 - CORRECT ANSWER=> DM1: pancreatic beta cell destruction (pt can't produce insulin). Onset <30yo DM2: insulin resistance and relative impairment of insulin secretion. Weight gain and decreased physical activity. Overweight >40yo" "What lab test do you order before giving PTU - CORRECT ANSWER=> LFTs" "Woman with stiffness in bilateral shoulders, elbows, wrists, fingers, and tender over MCP joint. Diagnosis? - CORRECT ANSWER=> Rheumatoid Arthritis" "Tx for RA - CORRECT ANSWER=> DMARDs: methotrexate" "Confirm pericardial effusion - CORRECT ANSWER=> Echo" "Pt with ulcer on foot, but its numb. What condition does this pt have? - CORRECT ANSWER=> Diabetes, venous stasis ulcer???????? Venous insufficiency: leg pain/color worse with prolonged standing/sitting; improved with leg elevation and walking" "Pt with deviated tongue, CN? - CORRECT ANSWER=> XII" "Small cell carcinoma will present with what pulmonary finding on xray - CORRECT ANSWER=> Central" "20 old with PNA sxs, healthy, what type? - CORRECT ANSWER=> Mycoplasma" "Positive cold agglutinin - CORRECT ANSWER=> Mycoplasma PNA Treatment: macrolide" "Pt lives in Arizona. Fever, night sweats, decreased weight, cough. CXR shows single pulmonary nodule. What med will best alleviate sxs? - CORRECT ANSWER=> Octreotide????????????" "Arizona, sob - CORRECT ANSWER=> sarcoidosis"
"Pt has 75% blockage of L main coronary artery. Tx? - CORRECT ANSWER=> CABG (if LMA involvement, >70% stenosis, 3-vessels dx of s;ic, EF <40%)" "Pt on h2 blocker which relieves his sxs slightly. Aside from lifestyle modification, pt to begin.. - CORRECT ANSWER=> PPI" "Pt with pain in 14 different points. What med? - CORRECT ANSWER=> TCA SNRI: duloxetine SSRI: fluoxetine Gabapentin, PREGABALIN" "only non-statin lipid-lowering agent that has proven to have additive effects on the prevention of cardiovascular adverse events - CORRECT ANSWER=> ezetimibe" "Polydipsia, polyuria, weight loss, fatigue, polyphagia, frequent mycotic infections, neuropathy and blurry vision + random plasma glucose test above 200. - CORRECT ANSWER=> DM diagnosis" "Total parenteral nutrition can be considered as an alternative to what in Crohn's? - CORRECT ANSWER=> chronic low-dose glucocorticoids." "Asymptomatic patients may also be diagnosed with diabetes mellitus if they have a fasting plasma glucose level of 126 mg/dL or higher, a hemoglobin A1C of 6.5 percent or higher, or a two-hour oral glucose tolerance test plasma glucose of 200 mg/dL or higher. - CORRECT ANSWER=> OK" "midsystolic click and late systolic murmur - CORRECT ANSWER=> mitral valve prolapse" "Meds for UC and Crohn's - CORRECT ANSWER=> UC: sulfasalazine Aminosalicylates (sulfasalazine, mesalamine) -> corticosteroids -> immune modifying agents (azathioprine, 6-mercaptoprine, cyclosporine) ASA helpful AMINOSALICYLIC ACID: anti-inflammatory agent. good for flares and remission CORTICOSTEROIDS: rapid acting antiinflammatory drugs used for acute flares only.
"Pt has trouble standing from chair and walking upstairs. What do they have? - CORRECT ANSWER=> Polymyositis" "Synovial fluid analysis in RA - CORRECT ANSWER=> Neutrophils predominance inflammation (white blood cell [WBC] count >2000/μL, generally in the range of 5000-50,000/μL). Usually, neutrophil predominance (60-80%) is observed in the synovial fluid (in contrast with mononuclear cell predominance in the synovium). Because of a transport defect, glucose levels of synovial fluids (as well as pleural and pericardial fluids) in patients with RA are often low compared with serum glucose levels." "Pt education on oral iron supplements - CORRECT ANSWER=> Stool will turn different color GI upset (N.V.C.cramps)" "ECG with LVH - CORRECT ANSWER=> Increased QRS amplitude, T wave inversion You see LVH with hypertrophic cardiomyopathy" "TOC for sick sinus syndrome - CORRECT ANSWER=> permanent pacemaker if sx'ic" "Withdrew glucocorticoids too soon - CORRECT ANSWER=> Addison's dz" "Shock- primary manifestation, hypotension, hypovolemia, abd pain, N/V/F, weakness, lethargy, coma - CORRECT ANSWER=> Adrenal Crisis- abrupt worsening of adrenal insufficiency due to stressful event (sx, trauma, MI...)" "What size blood vessels does polyarteritis nodosum? - CORRECT ANSWER=> Small and medium vessels" "Positive bifringement rhomboid shaped CPPD crystals - CORRECT ANSWER=> Pseudogout" "MOA of Graves disease - CORRECT ANSWER=> AI; circulating TSH ab cause increase TSH and thyroid gland growth-worse with stress" "Pt with PNA has pleural effusion. How to diagnose and treat? - CORRECT ANSWER=> CXR and thoracentesis, CT
Tx: underlying cause" "Test ordered to differentiate ATN and Prerenal azotemia - CORRECT ANSWER=> ???????" "5th MCP punching - CORRECT ANSWER=> Boxer's Tx: ulnar gutter splint. Check for bite wounds (Augmentin)" "Scaphoid fracture - CORRECT ANSWER=> Pain along radial surface of wrist w/ snuffbox tenderness Tx: thumb spica" "Maintenance therapy for person with AFib - CORRECT ANSWER=> Warfarin ASA" "HIV pt with injection in eye and decreased vision. Dx - CORRECT ANSWER=> CMV" "50 yo M non-smoker construction worker. Solitary pulm nodule - CORRECT ANSWER=> Lung CA" "+ Anti-HbIgm
- HbsAg
- HbcAg - CORRECT ANSWER=> Acute" "Girl returns from india, ate food from street vendor - CORRECT ANSWER=> Hep A" "Pt has watery diarrhea for past 24 hs. On PE she is mildly dehydrated. Tx - CORRECT ANSWER=> Replenish fluids" "Jaundice associated with increased direct bili????? - CORRECT ANSWER=> ?????" "Difference between IDA and anemia of chronic dz - CORRECT ANSWER=> IDA: low ferritin, high TIBC, microcytic hypochromic chronic: high ferritin, low TIBC, normocytic, normochromic"
"Broad waxy casts - CORRECT ANSWER=> CKD" "What meds cause acute interstitial nephritis - CORRECT ANSWER=> NSAIDs, PCN, sulfa drugs cephalosporins, ciprofloxacin, rifampin, allopurinol" "What med should be avoided in pts with gout - CORRECT ANSWER=> Diuretics (thiazides, loop) ACEI, Pyrazinamide, Ethambutol, ASA, ARBs" "Decreased fremitus, dull to percussion, decreased breath sounds - CORRECT ANSWER=> Pleural effusion" "Tx for pyelonephritis - CORRECT ANSWER=> Cipro" "Uncomplicated cystitis - CORRECT ANSWER=> Nitrofurantoin FQ Bactrim" "Complicated cystitis - CORRECT ANSWER=> FQ or aminoglycoside" "Pregnant cystitis - CORRECT ANSWER=> Amoxicillin or nitrofurantoin, cephalexin" "Tx for thyroid CA - CORRECT ANSWER=> <1cm: lobectomy with isthmectomy
1cm: total thyroidectomy" "Sick sinus syndrome treatment - CORRECT ANSWER=> Pacemaker" "Pt with syncopal episode with low pulse, now tachy. Tx? - CORRECT ANSWER=> ??????" "Ground glass appearance on CXR and egg shell nodal calcifications - CORRECT ANSWER=> Interstitial lung disease Could be in for eg: in sarcoidosis" "Rusty color sputum - CORRECT ANSWER=> Strep pneumoniae" "Jelly color sputum - CORRECT ANSWER=> Klebsiella"
"Green color sputum - CORRECT ANSWER=> Pseudomonas, HFlu" "Progressive PRI lengthening -> dropped QRS. Management? - CORRECT ANSWER=> Mobitz I- Wenckebach Sx'ic: atropine Asx'ic: observation" "Car accident. pt comes in tachypnic, HTN. Best diagnosis? Pointing to cardiac tamponade - CORRECT ANSWER=> Pericardiocentesis echo, cxr, us" "Flexor. Problems with cervical spinal tract or cerebral hemisphere - CORRECT ANSWER=> Decorticate" "Extensor. Problems within midbrain or pons - CORRECT ANSWER=> Decerebrate" "Spinal stenosis with pain radiating down back-1st intervention? - CORRECT ANSWER=> Lumbar epidural injection of corticosteroids" "Back pain with paresthesias on extremities, may radiate to thigh. Pain worsened with extension, relieved with flexion (sitting, walking uphill) - CORRECT ANSWER=> Spinal stenosis" "Migraines with hx of CAD. Which med is CIed? - CORRECT ANSWER=> Triptans or ergotamines bc they vasoconstrict" "Increase and decrease in tactile fremitus = which diseases? - CORRECT ANSWER=> An increase in tactile fremitus indicates denser or inflamed lung tissue, which can be caused by diseases such as pneumonia. A decrease suggests air or fluid in the pleural spaces or a decrease in lung tissue density, which can be caused by diseases such as chronic obstructive pulmonary disease or asthma." "Narrow angle glaucoma preventative for future sx - CORRECT ANSWER=> Laser iridotomy (definitive tx)" "Auer rods on bone marrow - CORRECT ANSWER=> AML
Greasy green poo" "Cr 1.6, BUN high. Which med is contraindicated? - CORRECT ANSWER=> Metformin" "Tricuspid stenosis murmur - CORRECT ANSWER=> mid-diastolic murmur @ LLS (xyphoid border) higher intensity with inspiration" "Treatment for polycythemia - CORRECT ANSWER=> Phlebotomy" "Hemochromatosis findings on PE - CORRECT ANSWER=> Liver: cirrhosis HF: cardiomyopathy, arrhythmias Hypogonadism Pancreatic insufficiency: bronze diabetes- metallic or bronze skin" "Viral URI, clear sputum cough x4 days. Tx - CORRECT ANSWER=> Supportive" "Elevated ESR plus hip and shoulder pain. Dx? - CORRECT ANSWER=> Polymyalgia rheumatica vs. Polymyositis: progressive symmetrical proximal muscle weakness, usually painless" "Pt with no RF has elevated TC, LDL, TG. Take what? - CORRECT ANSWER=> Statin Fish oil Weight loss Fibrate ????????" "IVDU tricuspid findings - CORRECT ANSWER=> Bc of endocarditis??????" "Type 1DM what do you give pt in ER if they are seizing? - CORRECT ANSWER=> Glucose" "PE finding specific to B12 - CORRECT ANSWER=> Neuro sxs: numbness, tingling of hands, gait abnormal, memory loss, dementia." "Tx for prinzmetal angina/Raynauds - CORRECT ANSWER=> CCB"
"Delta waves, what causes it - CORRECT ANSWER=> Extra electrical pathway between atria and ventricles WPW" "painless ulcer on penis - CORRECT ANSWER=> syphillis" "JONES - CORRECT ANSWER=> Rheumatic fever: infection with strep-> valvular disease Joint Oh my heart: carditis Nodules: subcutaneous Erythema marginatum Sydenham's chorea E: macular, eythematous, non-pruritic annular rash with rounded sharply demarcated borders. S: jerky, nonrhythmic movements" "Radiation puts you at high risk for what common cardiac complication? - CORRECT ANSWER=> Acute pericarditis" "Conjugated hyperbilirubinemia indicates what? - CORRECT ANSWER=> hepatobiliary disease (intra or post-hepatic) bc bilirubin already conjungated --> soluble in bile --> GB, intestine, kidney, back to liver Hyperbilirubinemia: excess direct bilirubin 2/2 dz, hemolysis, decreased bilirubin uptake, impaired conjugation, biliary obstruction, hepatitis" "Pt had clear hyperthyroid signs (palpitations, anxiety). Differentiate between subacute, graves, thryoid storm.. - CORRECT ANSWER=> Subacute: viral, painful thyroid, elevated ESR Graves: AI, circulating TSH receptor antibodies causes high thyroid hormone synthesis, release and thyroid gland growth worse with stress (pregnancy, illness)- MCC of hyperthyroidism Thyroid storm: CNS, coma Toxic multinodular goiter: iodine-deficient areas (patchy areas of both high and low uptake) in RAIU [high T3/4, low TSH]
"High specific gravity, elevated BUN, Cr. Renal bx is gold standard - CORRECT ANSWER=> Acute glomerulonephritis" "Which has highest density? - CORRECT ANSWER=> Ipoproteins????" "Triglycerides >700 - CORRECT ANSWER=> Pancreatitis" "PAD RFs - CORRECT ANSWER=> Obesity, HTN, smoking" "Smoker with lung CA - CORRECT ANSWER=> Non-small cell carcinoma: adenocarcinoma. Peripheral. MC TYPE in smokers, women, nonsmokers Non-small cell carcionma: squamous cell = centrally located" "Increased 24hr urine catecholamine or plasma fractionate free methenephrine - CORRECT ANSWER=> Pheonchromocytoma" "Cut off upper and lower GI bleed - CORRECT ANSWER=> ligament of treitz" "Pt with back pain and shrinking. Xray? Labs notable for metabolic labs - CORRECT ANSWER=> Radiolucent lines Demineralization ?????" "Someone who has no hx of DM but fasting glucose is high. Pt also hypovolemic despite giving IVF. What to do next? - CORRECT ANSWER=> ???????" "Acute glaucoma: don't give..... - CORRECT ANSWER=> Anticholinergics Sympathomimetics" "Opening snap, early mid diastolic rumble at apex esp in LLD position - CORRECT ANSWER=> Mitral stenosis" "Acute tx vs chronic management for gout - CORRECT ANSWER=> Acute: NSAID, colchicine Chronic: Allopurinol" "Peripheral lung markings - CORRECT ANSWER=> PTX"
"hyperresonance to percussion, decreased fremitus, decreased breath sound over affected area
- CORRECT ANSWER=> PTX" "Lock jaw and difficulty swallowing - CORRECT ANSWER=> Tetanus" "blowing, holosystolic murmur at apex, radiates to axilla - CORRECT ANSWER=> mitral regurgitation" "Pathophysiology of WPW - CORRECT ANSWER=> Accessory pathway preexcites ventricles --> slurred, wide QRS. Delta wave (QRS >12), short PR interval" "HTN meds for black people - CORRECT ANSWER=> CCB or BB DON'T GIVEN ACE AND ARBS, they produce less renin." "Fruity breath and coma. What kind of insulin? - CORRECT ANSWER=> Regular... but FIRST = IV FLUIDS!!!! (isotonic) DKA glucose > Kussmaul's respiration: deep continuous respirations as lung attempts to blow off excess co2 to reduce acidemia" "MCC encephalitis - CORRECT ANSWER=> viral" "Med for alcoholic liver disease - CORRECT ANSWER=> Lactulose or xifaxin" "Alcoholic comes for overdose and then has PNA 15 hrs later, what's the cause? - CORRECT ANSWER=> aspiration hospital PNA ???????????" "ACE/ARBS renal protective - CORRECT ANSWER=> slows perfusion to kidneys" "Someone has no pulse. What do you do - CORRECT ANSWER=> unsynchronized conversion" "someone with eye and scalp pain - CORRECT ANSWER=> ???????"
