Internal Medicine ABIM/AOBIM Exam Question Bank

40 CME Credits / 40 MOC Credits


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Course Benefits:

  • One-year access to over 900 internal medicine questions mapped to the Internal Medicine Board Recertification Exams (ABIM and AOBIM)
  • Complete both your CME and MOC requirements quickly and easily
  • Earn up to 40.00 AMA PRA Category 1 CME CreditsTM and 40 ABIM MOC points simultaneously
  • Correct your answers as you go with evidence-based rationales for the correct answers
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Internal Medicine Sample Questions:

Question 1

A 20-year-old man who is HIV positive (last CD4 count = 180; undetectable viral load) and on HAART therapy comes to your office for a routine health-maintenance screening in late October. He has a history of Candida esophagitis 2 years ago and no other opportunistic infections. He is sexually active with male partners only. He cannot recall receiving any immunizations in the recent past. He has no history of chickenpox as a child. What vaccines should he be given for preventive care?

A) Hepatitis A, hepatitis B, influenza, pneumovax, Tdap
B) Hepatitis A, hepatitis B, influenza, pneumovax, Tdap, varicella
C) Hepatitis A, hepatitis B, influenza, pneumovax, Tdap, meningococcal vaccine, haemophilus influenzae
D) Hepatitis B, influenza, pneumovax, Tdap

Answer
A) Hepatitis A, hepatitis B, influenza, pneumovax, Tdap


Explanation
Correct: (A) Hepatitis A, hepatitis B, influenza, pneumovax, Tdap. Explanation: The vaccines recommended for HIV patients include hepatitis B, influenza, pneumonia, and Tdap. Immunization for hepatitis A is also recommended among HIV patients with the following risk factors for acquiring the disease: men who have sex with men, patients with hepatitis C, and IV-drug abusers. The varicella vaccine, a live vaccine, is contraindicated among immunosuppressed patients, including those with HIV. Both meningococcal and haemophilus influenzae vaccines are not recommended routinely in HIV patients. Also consider meningococcal vaccination for those who will be traveling to endemic areas, military recruits, dormitory residents, or those with functional or anatomic asplenia. Haemophilus influenzae vaccination is not recommended because the vaccine is not protective for most infecting strains in HIV patients.

Reference
Wolters Kluwer Health Lippincott Williams & Wilkins. The Cleveland Clinic Foundation Intensive Review of Internal Medicine Sixth Edition. Copyright 2014 All rights reserved.


Question 2

A 26-year-old female complains of headache. She states that these headaches are normal for her. She generally gets them when she is stressed out. Her mother has a history of headaches too. She says that she usually sees spots with these headaches. Which of the following is this patient suffering from?

A) Migraine without aura
B) Classic migraine
C) Cluster headache
D) Trigeminal neuralgia
E) Sinus thrombosis

Answer
B) Classic migraine


Explanation
Correct: (B) Classic migraine. Explanation: Migraines are common types of headaches and account for millions of ED visits. Patients may experience incapacitating headaches that can last from 4-72 hours. They typically occur in women more than men and start in the 2nd decade of life. Classic migraines, or migraines with aura, account for 20% of cases and are generally preceded by neurologic symptoms such as visual changes (scotomas, fortification spectrums, etc). Other less common auras include language or cognitive disorders, tingling, numbness or motor disturbances. (A) Migraines without aura are the most common type of migraine, accounting for approximately 80% of cases. (C) A cluster headache is a headache syndrome that affects young-to-middle aged men most. It occurs with little warning and in multiple episodes lasting from 15 minutes to 3 hours. It is described as one-sided, sharp or stabbing behind the eye. Additionally, ipsilateral autonomic symptoms may manifest as ptosis, miosis and sweating. (D) Trigeminal neuralgia is a painful unilateral facial phenomenon that is described as quick, sharp, shock-like pains that manifest along the distribution of the trigeminal nerve. Pain can be exacerbated by minor sensations such as wind, washing, shaving or subtle movements. Each attack is brief and lasts a few seconds. (E) Sinus thrombosis needs to be a strong consideration in any differential diagnosis for headache. Symptoms of sinus thrombosis are nonspecific such as headache, seizure, somnolence and/or focal neurological deficits. Common findings with cavernous sinus thrombosis include cranial nerve deficits, especially ocular muscle dysfunction. Risk factors include hypercoagulability (pregnancy, genetic disorders, oral contraceptives, etc.), systemic inflammatory disorders, and/or vasculitis.

Reference
Kwaitkowski T & Friedman BW. Chapter 103. Headache Disorders. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2012.

Questions taken from the BoardVitals Internal Medicine ABIM/AOBIM Exam Question Bank.

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