Click Study Flashcards above to open the flashcard hub — hundreds of ABIM Internal Medicine cards you can flip, match, type, or quiz yourself on. Every card is drawn from the organ systems the ABIM blueprint tests, so you study exactly what the boards measure.[1] Pair them with our free practice questions and study guide.
ABIM Flashcard Study Modes
Flip mode is the quiet first pass, front to back, one card at a time. Match turns terms and definitions into a timed pairing game. Type shows the definition and makes you produce the term cold, so a card like Light’s criteria has to come from memory. Quiz rebuilds the same cards as multiple choice for recall under answer-choice pressure.
Why Flashcards Work for the ABIM Exam
Cardiovascular Disease is the biggest block in the deck at 33 cards, mixing scores, ECG patterns, and management triggers: HFpEF, CHA₂DS₂-VASc, and the card on Pericarditis ECG are typical of the level. General IM, Geriatrics & Prevention follows with 28 cards on study interpretation, screening, and goals of care, drilling fronts such as p-value meaning, Adult immunizations, and Hospice eligibility.
Three of the 9% domains sit next to each other in size. Pulmonary & Critical Care has 26 cards on acute decisions and pleural workup, including ARDS, CURB-65, and Light’s criteria. Gastroenterology & Hepatology brings 25 cards spanning liver and luminal disease, with SBP diagnosis and Wilson disease among them. Infectious Disease adds 25 cards on syndromes and prophylaxis, such as Lyme disease and PCP prophylaxis.
Rheumatology & MSK, also 9%, carries 24 cards on crystal, autoimmune, and overlap presentations, including Gout, SLE diagnosis, and Pseudogout (CPPD). Endocrine & Metabolism matches it with 24 cards on hormone excess and metabolic emergencies, drilling SIADH, HHS vs DKA, and Thyroid storm.
The 6% domains are tighter. Hematology has 19 cards on cytopenias and anticoagulation, including TTP pentad, HIT, and Warfarin reversal. Nephrology & Acid–Base has 19 cards built around Anion gap and Prerenal vs ATN. Oncology has 18 cards on emergencies and staging logic, such as SVC syndrome and Tumor lysis syndrome.
The smaller weights finish the deck. Neurology, at 4%, has 19 cards covering Guillain-Barré and Status epilepticus. Psychiatry, also 4%, has 16 cards on toxidromes and decision-making, including Serotonin syndrome and Capacity assessment. Dermatology, at 3%, has 13 cards, with Melanoma ABCDE and Stevens-Johnson / TEN among them.
That matters on the ABIM exam, where fact sets like the four heart-failure pillars, the sepsis bundle, the oncologic emergencies, and the diagnostic criteria must be instantly available. Used alongside our practice questions and study guide, flashcards turn review time into measurable progress.
ABIM Flashcards by Topic
The cards are organized by the organ systems the ABIM blueprint tests. Most of the exam is the big six (Cardiovascular at 14%, then Pulmonary, GI, Infectious Disease, Rheumatology, and Endocrine at 9% each), so weight your time there — but make the recognizable emergencies guaranteed points:[1]
| Flashcard topic | Blueprint weight |
|---|---|
| Cardiovascular Disease | 14% (largest category) |
| Pulmonary & Critical Care | 9% |
| Gastroenterology & Hepatology | 9% |
| Infectious Disease | 9% |
| Rheumatology & Musculoskeletal | 9% |
| Endocrinology, Diabetes & Metabolism | 9% |
| Hematology | 6% |
| Medical Oncology | 6% |
| Nephrology & Acid–Base | 6% |
| Neurology | 4% |
| Psychiatry | 4% |
| Dermatology | 3% |
| General IM, Geriatrics & Prevention | Geriatrics 3% + cross-content |
Because every card is framed as the diagnosis, the first-line treatment, or the best next step, drilling the deck builds exactly the single-best-answer reflex the boards reward.
How to Get the Most Out of These Flashcards
- Start with Cardiovascular Disease. At 33 cards it is the largest section, and its scores and ECG patterns reappear inside pulmonary, nephrology, and critical care questions later in the deck.
- Type-drill the scoring rules. Cards like CHA₂DS₂-VASc and Wells criteria are the ones you either recall exactly or fumble, and typing forces the full criteria rather than vague recognition.
- Use Match on the eponyms. Rheumatology and dermatology fronts such as Sjögren syndrome and Pityriasis rosea blur together, and timed pairing exposes which name you attached to the wrong description.
- Move to the practice test once Quiz stops surprising you. When multiple choice in the 9% domains feels routine, switch to full-length questions where vignettes hide the term you memorized.
- Rotate two domains per sitting. With 289 cards, cycling a large domain plus a small one keeps Cardiovascular Disease and Dermatology from drifting weeks apart in freshness.
ABIM Flashcards FAQ
Hundreds of free ABIM Internal Medicine flashcards, spanning every major content category — Cardiovascular, Pulmonary, Gastroenterology, Infectious Disease, Rheumatology, Endocrine, Hematology, Oncology, Nephrology, Neurology, Psychiatry, Dermatology, and General Internal Medicine. They're free with no account required.
Yes. Flashcards use active recall — retrieving an answer from memory — which research shows is one of the most effective ways to make facts stick, especially in short sessions spread over several days. That matters for the high-yield rule sets the boards test: drug first-lines, diagnostic criteria, and the emergencies you must recognize on sight.
They follow the official ABIM blueprint, weighted toward the big six — Cardiovascular (14%), then Pulmonary, Gastroenterology, Infectious Disease, Rheumatology, and Endocrine (9% each) — with cards across Hematology, Oncology, Nephrology, Neurology, Psychiatry, Dermatology, and General Internal Medicine, geriatrics, prevention, and biostatistics.
Yes. Every card is written to the level the ABIM expects of a board-eligible internist — the high-yield diagnoses, the first-line treatments, the diagnostic criteria, and the oncologic and medical emergencies — framed the way the exam asks them, as single-best-answer clinical reasoning.
Mix the modes: flip to learn, type to test recall, match for speed, and quiz to check yourself. Spend most of your time on the big six organ systems, and treat the recognizable emergencies — STEMI, sepsis, tumor lysis, DKA, giant cell arteritis — as guaranteed points to bank.
Yes — 100% free, all four study modes, no paywall.
ABIM flashcard bank
All 289 cards, by topic
A reference copy of every card in this deck. Each answer stays hidden until you choose to show it. To study with Flip, Match, Type and Quiz modes and track what you have mastered, use Study Flashcards at the top of the page.
Cardiovascular Disease (33)
- MONA for ACS
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Morphine, Oxygen (if hypoxic), Nitrates, Aspirin — early measures in acute coronary syndrome; add a P2Y12 inhibitor and anticoagulation.
- CHA₂DS₂-VASc
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Stroke-risk score in atrial fibrillation; ≥2 (men) or ≥3 (women) generally warrants anticoagulation.
- STEMI definition
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ST-elevation MI: new ST elevation at the J point in ≥2 contiguous leads (or new LBBB) with ischemic symptoms — needs emergent reperfusion (PCI preferred).
- NSTEMI vs unstable angina
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Both lack ST elevation; NSTEMI has elevated troponin (myonecrosis), unstable angina does not.
- First-line for STEMI reperfusion
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Primary percutaneous coronary intervention (PCI) within 90 minutes; fibrinolysis if PCI not available in time.
- HFrEF guideline therapy
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The 4 pillars: ARNI/ACEi/ARB, beta-blocker, mineralocorticoid antagonist (MRA), and SGLT2 inhibitor.
- HFpEF
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Heart failure with preserved EF (≥50%); treat volume with diuretics, control BP/comorbidities; SGLT2 inhibitors now recommended.
- BNP / NT-proBNP
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Natriuretic peptides released by ventricular stretch; elevated in heart failure, helpful to rule out HF in dyspnea.
- Atrial fibrillation management
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Rate control (beta-blocker or non-DHP CCB) or rhythm control + anticoagulation by CHA₂DS₂-VASc.
- Aortic stenosis triad
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Angina, syncope, and heart failure; harsh crescendo–decrescendo systolic murmur radiating to carotids — replace the valve once symptomatic.
- Mitral regurgitation murmur
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Holosystolic murmur at the apex radiating to the axilla.
- Aortic regurgitation
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Early diastolic decrescendo murmur, wide pulse pressure, water-hammer pulse.
- Hypertensive emergency
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Severe BP elevation with acute target-organ damage; lower MAP ~10–20% in the first hour with IV agents.
- Statin indications (ASCVD)
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Clinical ASCVD, LDL ≥190, diabetes age 40–75, or elevated 10-year risk — high-intensity statin for most ASCVD.
- Wells criteria
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Pretest probability tool for DVT/PE that guides D-dimer vs imaging.
- Long-QT danger
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Predisposes to torsades de pointes; avoid QT-prolonging drugs and correct low K⁺/Mg²⁺/Ca²⁺.
- Pericarditis ECG
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Diffuse ST elevation with PR depression; pleuritic chest pain relieved by sitting forward, with a friction rub.
- Cardiac tamponade (Beck triad)
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Hypotension, muffled heart sounds, and jugular venous distension; pulsus paradoxus is a key clue.
- Stable angina first-line
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Beta-blocker and/or nitrates for symptoms, plus aspirin and a statin; PCI/CABG for refractory or high-risk disease.
- Digoxin toxicity
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Nausea, visual halos/yellow vision, arrhythmias; worsened by hypokalemia — treat with digoxin-specific Fab if severe.
- Wolff-Parkinson-White
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Accessory pathway (delta wave, short PR); avoid AV-nodal blockers in WPW with atrial fibrillation.
- Acute decompensated HF treatment
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IV loop diuretics for congestion; vasodilators if hypertensive; treat the precipitant.
- Peripheral artery disease (ABI)
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Ankle-brachial index ≤0.90 is diagnostic; treat with exercise, statin, antiplatelet, and risk-factor control.
- Dressler syndrome
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Autoimmune pericarditis weeks after MI — fever, pleuritic chest pain, pericardial effusion; treat with NSAIDs/colchicine.
- Right ventricular MI
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Inferior MI with hypotension and clear lungs; preload-dependent — give fluids, AVOID nitrates.
- Hypertrophic cardiomyopathy murmur
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Systolic murmur that INCREASES with Valsalva/standing (less preload); risk of sudden death in young athletes.
- Mitral stenosis
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Opening snap and diastolic rumble; usually rheumatic; causes left atrial enlargement and atrial fibrillation.
- Endocarditis prophylaxis
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Antibiotics before dental procedures only for highest-risk hearts (prosthetic valve, prior endocarditis, certain congenital disease).
- DOAC vs warfarin in AF
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Direct oral anticoagulants are preferred over warfarin in non-valvular atrial fibrillation; warfarin is required for mechanical valves and rheumatic MS.
- Orthostatic hypotension
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Drop ≥20 systolic or ≥10 diastolic on standing; review volume status and medications.
- Cardiogenic shock
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Pump failure with hypotension and end-organ hypoperfusion; revascularize the cause; vasopressors/inotropes/mechanical support.
- Secondary prevention post-MI
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Aspirin, P2Y12 inhibitor, high-intensity statin, beta-blocker, and ACEi/ARB; cardiac rehab.
- Takotsubo cardiomyopathy
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Stress-induced apical ballooning mimicking ACS with normal coronaries; usually recovers.
Pulmonary & Critical Care (26)
- CURB-65
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Pneumonia severity score: Confusion, Urea >7, Respiratory rate ≥30, BP low, age ≥65 — guides admission.
- COPD vs asthma reversibility
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Asthma airflow obstruction is largely reversible with a bronchodilator; COPD is incompletely reversible (post-bronchodilator FEV1/FVC <0.70).
- Asthma stepwise therapy
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Inhaled corticosteroid is the controller cornerstone; add LABA, then escalate. SABA for rescue (or ICS-formoterol as both).
- COPD exacerbation management
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Bronchodilators, systemic corticosteroids, and antibiotics if increased sputum purulence; consider NIPPV for respiratory failure.
- PE diagnosis
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CT pulmonary angiography is the test of choice; D-dimer rules out if pretest probability is low/moderate.
- Massive PE treatment
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Hemodynamic instability → systemic thrombolysis (or embolectomy) plus anticoagulation.
- Light's criteria
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Distinguishes exudative from transudative pleural effusion (pleural/serum protein or LDH ratios, or pleural LDH).
- ARDS
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Acute hypoxemic respiratory failure with bilateral infiltrates not from cardiac edema; treat with low-tidal-volume (lung-protective) ventilation.
- Sepsis bundle
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Early lactate, blood cultures before antibiotics, broad-spectrum antibiotics within 1 hour, and 30 mL/kg crystalloid for hypotension/lactate ≥4.
- Septic shock vasopressor
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Norepinephrine is first-line after fluid resuscitation.
- Idiopathic pulmonary fibrosis
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Progressive restrictive ILD; honeycombing/UIP pattern on HRCT; antifibrotics (pirfenidone, nintedanib) slow decline.
- Solitary pulmonary nodule
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Risk-stratify by size, growth, and patient risk; compare with old films; biopsy/PET for intermediate-to-high risk.
- Obstructive sleep apnea
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Repetitive upper-airway collapse causing daytime sleepiness; diagnosed by polysomnography; treat with CPAP.
- Pulmonary hypertension
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Mean PA pressure ≥20 mmHg; right heart catheterization confirms; classify into 5 WHO groups.
- Spontaneous pneumothorax
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Sudden pleuritic dyspnea; tension pneumothorax (hypotension, tracheal deviation) needs immediate needle/finger decompression.
- Restrictive vs obstructive PFTs
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Obstructive: low FEV1/FVC. Restrictive: normal/high ratio with low total lung capacity.
- Hospital-acquired pneumonia
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Pneumonia ≥48 h after admission; cover Pseudomonas and MRSA per local risk/antibiogram.
- Sarcoidosis
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Non-caseating granulomas; bilateral hilar adenopathy, elevated ACE/calcium; many resolve, steroids for organ involvement.
- Asthma severity by control
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Step up if symptoms/rescue use are frequent or there are exacerbations; reassess and step down when stable.
- Alpha-1 antitrypsin deficiency
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Early panacinar (basilar) emphysema in a young non-smoker, often with liver disease.
- Obesity hypoventilation
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Daytime hypercapnia in obesity without another cause; treat with weight loss and positive-airway-pressure therapy.
- Exudative effusion causes
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Infection (parapneumonic/empyema), malignancy, PE, and inflammatory disease.
- Transudative effusion causes
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Heart failure, cirrhosis, and nephrotic syndrome (low oncotic / high hydrostatic pressure).
- Aspiration pneumonia
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Right lower/middle lobe predilection; risk with impaired swallow/consciousness; cover anaerobes/oral flora.
- Methacholine challenge
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Provocation test for asthma when spirometry is normal but asthma is suspected.
- Massive hemoptysis
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Airway protection, position bleeding side down, and urgent bronchoscopy/bronchial artery embolization.
Gastroenterology & Hepatology (25)
- GERD alarm features
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Dysphagia, odynophagia, weight loss, bleeding, anemia, or age >60 with new symptoms → endoscopy.
- Peptic ulcer cause
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H. pylori and NSAIDs are the leading causes; test-and-treat H. pylori.
- H. pylori triple therapy
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A PPI plus clarithromycin and amoxicillin (or quadruple therapy with bismuth in high-resistance areas).
- Upper vs lower GI bleed
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Upper (proximal to ligament of Treitz): melena, high BUN/Cr ratio. Lower: hematochezia.
- Ulcerative colitis vs Crohn
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UC: continuous, mucosa-only, rectum-up, colon only. Crohn: skip lesions, transmural, mouth-to-anus, with fistulae/granulomas.
- C. difficile treatment
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Oral vancomycin or fidaxomicin first-line; stop the offending antibiotic; fecal transplant for recurrence.
- Acute pancreatitis diagnosis
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2 of 3: characteristic epigastric pain, lipase/amylase ≥3× upper limit, or imaging findings; gallstones and alcohol are top causes.
- Cirrhosis complications
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Varices, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, and hepatorenal syndrome.
- SBP diagnosis
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Ascitic fluid neutrophils (PMNs) ≥250/µL; treat empirically with a third-generation cephalosporin.
- Hepatic encephalopathy treatment
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Lactulose (titrate to 2–3 stools/day) ± rifaximin; identify the precipitant.
- Acute liver failure (acetaminophen)
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N-acetylcysteine is the antidote; use the Rumack-Matthew nomogram to guide treatment.
- Hemochromatosis
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HFE iron overload; elevated transferrin saturation and ferritin; treat with phlebotomy.
- Celiac disease
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Gluten-sensitive enteropathy; anti-tissue-transglutaminase IgA screen, confirm with duodenal biopsy (villous atrophy).
- Colorectal cancer screening
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Begin at age 45 for average risk (colonoscopy or stool-based tests).
- Diverticulitis
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Left-lower-quadrant pain, fever; CT confirms; uncomplicated cases may be managed with or without antibiotics.
- IBS diagnosis
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Recurrent abdominal pain related to defecation with altered stool form/frequency; a clinical (Rome) diagnosis after excluding alarm features.
- Zollinger-Ellison syndrome
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Gastrinoma causing refractory/multiple peptic ulcers and diarrhea; check fasting gastrin.
- Hepatocellular carcinoma surveillance
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Ultrasound (± AFP) every 6 months in cirrhosis and chronic hepatitis B.
- Wilson disease
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Copper overload in young patients: liver disease, neuropsychiatric signs, Kayser-Fleischer rings, low ceruloplasmin.
- Primary biliary cholangitis
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Middle-aged women with pruritus and fatigue; high alkaline phosphatase, anti-mitochondrial antibody; treat with ursodiol.
- Ascending cholangitis (Charcot triad)
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Fever, jaundice, and RUQ pain; biliary obstruction with infection — antibiotics and urgent biliary drainage (ERCP).
- Acute mesenteric ischemia
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Severe pain out of proportion to exam in an at-risk patient; surgical emergency.
- Microscopic colitis
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Chronic watery diarrhea with normal-appearing colon; diagnosed on biopsy; often drug-associated.
- NAFLD management
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Weight loss, control diabetes/lipids; the leading chronic liver disease in the developed world.
- Variceal bleed management
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Octreotide, antibiotics (prophylaxis), and endoscopic band ligation; non-selective beta-blocker for prevention.
Infectious Disease (25)
- Community-acquired pneumonia outpatient
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Amoxicillin or doxycycline (or a respiratory fluoroquinolone) for healthy outpatients without comorbidities.
- Infective endocarditis (Duke criteria)
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Combines positive blood cultures and echo vegetations with minor criteria to diagnose; get 3 blood-culture sets before antibiotics.
- MRSA coverage
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Vancomycin, linezolid, or daptomycin (not daptomycin for pneumonia — inactivated by surfactant).
- Neutropenic fever
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ANC <500 with fever; start empiric anti-pseudomonal beta-lactam (e.g., cefepime) immediately.
- HIV when to start ART
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Start antiretroviral therapy in everyone with HIV regardless of CD4 count.
- PCP prophylaxis
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TMP-SMX when CD4 <200 (or thrush/AIDS-defining illness).
- Latent TB treatment
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Positive IGRA/PPD with no active disease → isoniazid, rifampin, or combination short-course therapy.
- Active TB regimen (RIPE)
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Rifampin, Isoniazid, Pyrazinamide, Ethambutol for the initial 2-month phase.
- Meningitis empiric therapy
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Vancomycin + ceftriaxone; add ampicillin for Listeria if >50 or immunocompromised; dexamethasone for pneumococcal.
- Pyelonephritis
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Flank pain, fever, pyuria; treat with a fluoroquinolone or third-gen cephalosporin per local resistance.
- Cellulitis vs necrotizing fasciitis
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Necrotizing infection: pain out of proportion, rapid spread, crepitus, systemic toxicity — a surgical emergency.
- Sepsis source control
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Drain abscesses, remove infected lines/devices, debride necrotic tissue alongside antibiotics.
- Hepatitis B serologies
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HBsAg = infection; anti-HBs = immunity; anti-HBc IgM = acute; HBeAg = high infectivity.
- Hepatitis C
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Screen all adults once; direct-acting antivirals cure most patients.
- Antibiotic stewardship
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Narrow therapy once cultures return, use the shortest effective duration, and de-escalate to limit resistance.
- Septic arthritis
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Acute mono-arthritis; arthrocentesis (WBC often >50,000) before antibiotics; drain the joint.
- Syphilis stages
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Primary chancre, secondary rash (palms/soles), latent, and tertiary (gummas, neuro, cardiovascular); treat with penicillin.
- Lyme disease
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Erythema migrans bull's-eye rash; doxycycline for early disease; can cause carditis/Bell palsy/arthritis.
- Clostridial myonecrosis (gas gangrene)
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Crepitus, severe pain, systemic toxicity — emergent debridement plus penicillin/clindamycin.
- Osteomyelitis
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Bone infection; MRI is most sensitive; bone biopsy/culture guides prolonged antibiotics.
- Fever of unknown origin
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Fever ≥3 weeks without diagnosis after workup; causes: infection, malignancy, and connective-tissue disease.
- Catheter-related bloodstream infection
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Remove the line; blood cultures from line and periphery; Staph aureus and Candida need source control.
- Immune reconstitution syndrome
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Paradoxical worsening of an infection after starting ART as immunity recovers.
- Asymptomatic bacteriuria
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Do NOT treat (except in pregnancy or before urologic procedures) to avoid resistance.
- Influenza antiviral
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Oseltamivir is most effective within 48 hours of symptom onset, especially in high-risk patients.
Rheumatology & MSK (24)
- Rheumatoid arthritis
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Symmetric small-joint (MCP/PIP) inflammatory arthritis with morning stiffness >1 h; anti-CCP and RF positive.
- RA first-line DMARD
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Methotrexate is the anchor disease-modifying drug.
- SLE diagnosis
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Multisystem autoimmune disease; ANA is sensitive (screen), anti-dsDNA and anti-Smith are specific.
- Lupus nephritis monitoring
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Follow anti-dsDNA, complement (C3/C4 fall with flares), urinalysis; biopsy guides therapy.
- Gout
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Monosodium urate crystals — negatively birefringent, needle-shaped; acute treat with NSAIDs, colchicine, or steroids.
- Gout urate-lowering
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Allopurinol (xanthine oxidase inhibitor) for recurrent attacks/tophi; target urate <6 mg/dL.
- Pseudogout (CPPD)
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Calcium pyrophosphate crystals — positively birefringent, rhomboid; chondrocalcinosis on X-ray.
- Giant cell arteritis
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Headache, jaw claudication, vision loss, high ESR in age >50; start high-dose steroids immediately, then biopsy.
- Polymyalgia rheumatica
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Proximal shoulder/hip girdle pain and stiffness with high ESR; dramatic response to low-dose steroids; associated with GCA.
- Seronegative spondyloarthritis
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Ankylosing spondylitis, psoriatic, reactive, IBD-associated; HLA-B27, inflammatory back pain, enthesitis.
- Ankylosing spondylitis
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Young adult inflammatory low back pain improving with exercise; sacroiliitis; 'bamboo spine'.
- Systemic sclerosis
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Skin thickening, Raynaud, anti-Scl-70 (diffuse) or anti-centromere (limited/CREST); watch renal crisis and PAH.
- Sjögren syndrome
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Dry eyes and mouth; anti-Ro (SSA)/anti-La (SSB); increased lymphoma risk.
- Osteoarthritis vs inflammatory
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OA: worse with use, brief (<30 min) stiffness, no systemic signs; treat with exercise, weight loss, and analgesics.
- ANCA-associated vasculitis
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GPA (c-ANCA/PR3) and MPA (p-ANCA/MPO); pulmonary–renal syndrome; induce remission with steroids + rituximab/cyclophosphamide.
- Fibromyalgia
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Chronic widespread pain, fatigue, and unrefreshing sleep with normal labs; treat with exercise, sleep, and SNRIs/gabapentinoids.
- Antiphospholipid syndrome
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Recurrent thrombosis and/or pregnancy loss with antiphospholipid antibodies; anticoagulate.
- Polyarteritis nodosa
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Medium-vessel vasculitis sparing the lungs; associated with hepatitis B; renal/GI/skin involvement.
- Reactive arthritis
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Post-infectious triad: arthritis, conjunctivitis, urethritis ('can't see, pee, or climb a tree'); HLA-B27.
- Drug-induced lupus
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Anti-histone antibodies; from hydralazine, procainamide, isoniazid; resolves after stopping the drug.
- Dermatomyositis
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Proximal weakness with Gottron papules and heliotrope rash; elevated CK; screen for underlying malignancy.
- Adult-onset Still disease
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Quotidian fevers, salmon-colored rash, arthritis, very high ferritin.
- Septic vs gout joint
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Always tap an acute hot joint; Gram stain/culture and crystal analysis — septic arthritis can coexist with crystals.
- Methotrexate monitoring
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Check CBC, liver enzymes, and creatinine; supplement folic acid; avoid in pregnancy.
Endocrine & Metabolism (24)
- Type 2 diabetes first-line
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Metformin plus lifestyle; add GLP-1 RA or SGLT2 inhibitor (proven cardiorenal benefit) based on comorbidities.
- Diagnosing diabetes
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Fasting glucose ≥126, A1c ≥6.5%, 2-h OGTT ≥200, or random ≥200 with symptoms (confirm).
- DKA management
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IV fluids, insulin infusion, and potassium repletion; treat the precipitant; close the anion gap before stopping insulin.
- HHS vs DKA
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Hyperosmolar hyperglycemic state: very high glucose, high osmolality, minimal ketosis/acidosis — usually type 2.
- Hypothyroidism
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Fatigue, weight gain, cold intolerance; high TSH, low free T4; treat with levothyroxine.
- Hyperthyroidism (Graves)
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Low TSH, high free T4, TSI antibodies, diffuse goiter, orbitopathy; treat with methimazole, radioiodine, or surgery.
- Thyroid storm
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Life-threatening thyrotoxicosis; beta-blocker, thionamide, iodine (after thionamide), and steroids.
- Adrenal insufficiency
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Fatigue, hypotension, hyponatremia, hyperkalemia; low cortisol with high ACTH (primary); treat with hydrocortisone (stress-dose in illness).
- Cushing syndrome workup
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Confirm hypercortisolism (late-night salivary cortisol, 24-h urinary free cortisol, low-dose dexamethasone suppression), then localize.
- Pheochromocytoma
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Episodic headache, sweating, palpitations, hypertension; plasma/urine metanephrines; alpha-blockade before beta-blockade.
- Primary hyperaldosteronism
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Hypertension with hypokalemia; high aldosterone/renin ratio; the most common secondary HTN cause.
- Hypercalcemia causes
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Primary hyperparathyroidism (outpatient) and malignancy (inpatient) are the top two.
- Osteoporosis treatment
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Bisphosphonates are first-line; ensure calcium/vitamin D; T-score ≤ −2.5 or fragility fracture.
- Diabetic kidney protection
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ACEi/ARB and SGLT2 inhibitors slow progression of diabetic nephropathy with albuminuria.
- SIADH
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Euvolemic hyponatremia with concentrated urine and low serum osmolality; treat with fluid restriction (and the cause).
- Hyperlipidemia in diabetes
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Statin therapy for most adults with diabetes age 40–75 to reduce ASCVD risk.
- Subclinical hypothyroidism
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High TSH with normal free T4; treat if TSH >10, symptomatic, or pregnant/planning pregnancy.
- Thyroid nodule workup
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Ultrasound and TSH; fine-needle aspiration for suspicious features or size criteria.
- Hypoglycemia (Whipple triad)
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Low glucose, consistent symptoms, and relief with glucose; evaluate for insulinoma vs medication.
- Diabetes monitoring target
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A1c goal commonly <7% for most adults, individualized for frailty/hypoglycemia risk.
- Acromegaly
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Excess growth hormone (pituitary adenoma); check IGF-1, confirm with oral glucose tolerance test.
- Prolactinoma
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Most common pituitary tumor; galactorrhea, amenorrhea; first-line is a dopamine agonist (cabergoline).
- Diabetic foot care
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Annual monofilament exam; treat ulcers with offloading, debridement, and infection control.
- Hyperparathyroidism
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High calcium with high/inappropriately normal PTH; parathyroidectomy for symptoms or end-organ effects.
Nephrology & Acid–Base (19)
- AKI categories
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Prerenal (low perfusion), intrinsic (ATN, GN), and postrenal (obstruction) — urine studies and FENa help differentiate.
- Prerenal vs ATN
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Prerenal: FENa <1%, high urine osmolality, bland sediment. ATN: FENa >2%, muddy-brown casts.
- CKD staging
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By GFR (G1–G5) and albuminuria (A1–A3); slow progression with BP control, ACEi/ARB, SGLT2i.
- Hyperkalemia ECG/treatment
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Peaked T waves → calcium gluconate (membrane stabilization), then insulin+glucose/albuterol to shift, then remove (diuresis, K-binders, dialysis).
- Anion gap
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Na⁺ − (Cl⁻ + HCO₃⁻); high gap acidosis mnemonic MUDPILES (methanol, uremia, DKA, etc.).
- Metabolic acidosis compensation
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Winter's formula: expected PCO₂ = 1.5 × HCO₃⁻ + 8 ± 2.
- Nephrotic vs nephritic
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Nephrotic: proteinuria >3.5 g/day, edema, hypoalbuminemia. Nephritic: hematuria, RBC casts, hypertension, mild proteinuria.
- Nephrolithiasis
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Calcium oxalate is the most common stone; non-contrast CT diagnoses; increase fluids, treat pain, may pass <5 mm spontaneously.
- Renal artery stenosis
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Secondary HTN; consider with a rise in creatinine after starting an ACEi/ARB or flash pulmonary edema.
- Hyponatremia approach
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Assess volume status and serum/urine osmolality; correct slowly (≤8 mEq/L per 24 h) to avoid osmotic demyelination.
- Contrast-associated AKI
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Risk in CKD/diabetes; hydrate; usually transient — true incidence is lower than once thought.
- Indications for dialysis (AEIOU)
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Acidosis, Electrolytes (refractory hyperkalemia), Intoxications, Overload (volume), Uremia (encephalopathy, pericarditis).
- IgA nephropathy
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Most common glomerulonephritis; hematuria days after an upper respiratory infection.
- Diabetic nephropathy
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Leading cause of ESRD; albuminuria; protect with ACEi/ARB and SGLT2 inhibitors.
- Rhabdomyolysis
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Muscle breakdown with very high CK, myoglobinuria, and AKI; aggressive IV fluids; watch potassium.
- Renal tubular acidosis
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Non-anion-gap metabolic acidosis; type 1 (distal), type 2 (proximal), type 4 (hyperkalemic, hypoaldosterone).
- Hypernatremia
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Free-water deficit; correct slowly (<10–12 mEq/L per day) to avoid cerebral edema.
- Hypokalemia ECG
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U waves, flat T waves, and risk of arrhythmia; replace potassium and correct magnesium.
- Contrast nephropathy prevention
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Use the lowest contrast volume and hydrate in at-risk patients.
Hematology (19)
- Iron-deficiency anemia
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Microcytic, low ferritin, high TIBC; find the source (GI bleed in adults); replace iron.
- Anemia of chronic disease
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Normocytic/microcytic; normal-to-high ferritin, low TIBC; treat the underlying disease.
- B12 vs folate deficiency
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Both cause macrocytic anemia; only B12 deficiency causes neurologic deficits (check methylmalonic acid).
- Hemolytic anemia clues
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High LDH and indirect bilirubin, low haptoglobin, high reticulocytes; positive Coombs in autoimmune hemolysis.
- Sickle cell crisis
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Vaso-occlusive pain; hydrate, oxygenate, analgesia; hydroxyurea reduces frequency.
- ITP
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Isolated thrombocytopenia from antiplatelet antibodies; treat with steroids/IVIG if bleeding or very low counts.
- TTP pentad
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Thrombocytopenia, microangiopathic hemolysis, neuro changes, renal injury, fever; ADAMTS13 deficiency — urgent plasma exchange.
- HIT
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Heparin-induced thrombocytopenia: platelet drop ~5–10 days after heparin with thrombosis; stop all heparin, use a non-heparin anticoagulant.
- DIC
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Consumptive coagulopathy: low platelets/fibrinogen, high PT/PTT and D-dimer; treat the cause and support.
- Von Willebrand disease
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Most common inherited bleeding disorder; mucocutaneous bleeding, prolonged bleeding time; desmopressin for type 1.
- Polycythemia vera
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JAK2 mutation, high hematocrit, pruritus, thrombosis; phlebotomy and low-dose aspirin.
- Warfarin reversal
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Vitamin K for non-urgent; 4-factor PCC (plus vitamin K) for major bleeding.
- Multiple myeloma (CRAB)
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hyperCalcemia, Renal failure, Anemia, Bone lesions; M-spike, plasma cells in marrow.
- Chronic lymphocytic leukemia
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Most common adult leukemia; smudge cells; often indolent and found incidentally.
- Acute promyelocytic leukemia
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AML M3 with t(15;17); DIC risk; treat with all-trans retinoic acid (ATRA).
- Hodgkin lymphoma
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Reed-Sternberg cells; contiguous nodal spread; highly curable.
- G6PD deficiency
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Episodic hemolysis after oxidant stress (drugs, fava beans, infection); bite cells and Heinz bodies.
- Thalassemia vs iron deficiency
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Both microcytic; thalassemia has a normal/high RBC count and normal ferritin; check hemoglobin electrophoresis.
- Hypercoagulable workup
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Consider after unprovoked or recurrent VTE — factor V Leiden, prothrombin mutation, protein C/S, antithrombin, antiphospholipid.
Oncology (18)
- Tumor lysis syndrome
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After chemo of bulky tumors: high K⁺, phosphate, uric acid; low calcium — hydrate, allopurinol/rasburicase.
- Febrile neutropenia (onc)
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Oncologic emergency — empiric anti-pseudomonal antibiotics within an hour of fever.
- Spinal cord compression
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Back pain with neuro deficits in a cancer patient → emergent MRI and steroids, then radiation/surgery.
- SVC syndrome
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Facial/arm swelling, distended neck veins from tumor compression; often small-cell lung cancer or lymphoma.
- Hypercalcemia of malignancy
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PTHrP, bone metastases, or 1,25-vitamin D; treat with IV fluids and bisphosphonates.
- Lung cancer types
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Small-cell (central, paraneoplastic, rapid) vs non-small-cell (adeno most common); smoking is the major risk.
- Breast cancer screening
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Mammography for average-risk women, generally starting at 40–50 depending on guideline.
- Prostate cancer screening
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Shared decision-making about PSA, generally ages 55–69.
- Cervical cancer screening
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Pap ± HPV co-testing starting at 21; HPV-based screening at 25–30+ per guideline.
- Lung cancer screening
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Low-dose CT for adults 50–80 with a ≥20 pack-year history who currently smoke or quit within 15 years.
- Paraneoplastic SIADH
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Hyponatremia from ectopic ADH — classically small-cell lung cancer.
- Lymphoma B symptoms
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Fever, drenching night sweats, and weight loss >10% — adverse prognostic signs.
- Colorectal cancer follow-up
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Surveillance colonoscopy and CEA monitoring after curative resection.
- Testicular cancer markers
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AFP, beta-hCG, and LDH; highly curable even when metastatic.
- Prostate cancer staging
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PSA, Gleason score, and imaging; options range from active surveillance to surgery/radiation/ADT.
- Pancreatic cancer
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Painless jaundice, weight loss, CA 19-9; poor prognosis; often unresectable at diagnosis.
- Immunotherapy toxicity
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Checkpoint inhibitors cause immune-related colitis, pneumonitis, hepatitis, and endocrinopathies — treat with steroids.
- Cancer of unknown primary
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Metastatic disease without an identified source; tailor workup by histology/immunostains.
Neurology (19)
- Ischemic stroke tPA window
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IV thrombolysis within 4.5 hours of onset if no contraindication; thrombectomy for large-vessel occlusion in selected patients up to 24 h.
- Stroke vs TIA
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TIA has transient symptoms without infarction on imaging; both need urgent secondary-prevention workup.
- Status epilepticus
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Seizure >5 min or recurrent without recovery; benzodiazepine first, then a loading antiepileptic.
- Bacterial meningitis signs
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Fever, headache, neck stiffness, altered mental status; LP after imaging if indicated; do not delay antibiotics.
- Subarachnoid hemorrhage
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Thunderclap 'worst headache of life'; non-contrast CT, then LP (xanthochromia) if CT negative.
- Parkinson disease
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Resting tremor, bradykinesia, rigidity, postural instability; levodopa-carbidopa is most effective.
- Multiple sclerosis
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CNS demyelination disseminated in time and space; MRI lesions, oligoclonal bands; treat relapses with steroids.
- Guillain-Barré
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Ascending symmetric weakness with areflexia after infection; albuminocytologic dissociation; treat with IVIG or plasmapheresis; watch respiratory status.
- Myasthenia gravis
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Fatigable weakness (ptosis, diplopia); acetylcholine-receptor antibodies; treat with pyridostigmine and immunotherapy.
- Migraine vs tension headache
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Migraine: unilateral, throbbing, photophobia/phonophobia, nausea; treat acute with triptans, prevent if frequent.
- Delirium vs dementia
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Delirium is acute, fluctuating, with inattention (often reversible); dementia is chronic and progressive.
- Normal pressure hydrocephalus
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Triad: gait apraxia, urinary incontinence, dementia ('wet, wobbly, wacky'); may improve with shunting.
- Stroke secondary prevention
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Antiplatelet (or anticoagulation for AF), high-intensity statin, BP control, and carotid evaluation.
- Bell palsy
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Acute peripheral (whole-face) CN VII palsy; treat with steroids ± antivirals.
- Trigeminal neuralgia
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Brief, severe lancinating facial pain; carbamazepine is first-line.
- Essential tremor
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Action/postural tremor improving with alcohol; treat with propranolol or primidone.
- Carpal tunnel syndrome
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Median nerve compression; nocturnal hand numbness; splinting, then steroid injection or surgery.
- Cluster headache
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Severe unilateral periorbital pain with autonomic features; high-flow oxygen and triptans abort.
- Diabetic peripheral neuropathy
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Distal symmetric 'stocking-glove' sensory loss; treat pain with SNRIs, gabapentinoids, or TCAs.
Psychiatry (16)
- Major depressive disorder
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≥5 SIG-E-CAPS symptoms for ≥2 weeks including depressed mood or anhedonia; first-line is an SSRI plus psychotherapy.
- Serotonin syndrome
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Agitation, clonus, hyperreflexia, hyperthermia from serotonergic drugs; stop the agent, supportive care, cyproheptadine.
- Generalized anxiety disorder
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Excessive worry most days for ≥6 months; SSRIs/SNRIs and CBT first-line.
- Bipolar disorder caution
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Avoid antidepressant monotherapy (can precipitate mania); use mood stabilizers (lithium, valproate) or atypical antipsychotics.
- Lithium toxicity
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Tremor, ataxia, confusion; narrow therapeutic index worsened by dehydration, NSAIDs, ACEi, and thiazides.
- Alcohol withdrawal
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Tremor, tachycardia, seizures, delirium tremens; treat with benzodiazepines and thiamine (before glucose).
- Wernicke encephalopathy
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Thiamine deficiency: confusion, ataxia, ophthalmoplegia; give IV thiamine before glucose.
- Neuroleptic malignant syndrome
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Fever, rigidity, autonomic instability, elevated CK from antipsychotics; stop the drug, cool, dantrolene/bromocriptine.
- Opioid use disorder
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Treat with buprenorphine or methadone; naloxone reverses overdose.
- Capacity assessment
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A patient has decision-making capacity if they can communicate a choice, understand, appreciate, and reason about it.
- Suicide risk assessment
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Assess ideation, plan, intent, access to means, and prior attempts; ensure safety.
- PTSD
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Re-experiencing, avoidance, hyperarousal, and negative cognition after trauma; SSRIs and trauma-focused therapy.
- Panic disorder
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Recurrent unexpected panic attacks with anticipatory anxiety; CBT and SSRIs.
- Anorexia nervosa risks
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Restriction with low body weight; watch refeeding syndrome (low phosphate) and bradycardia.
- Benzodiazepine risks
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Tolerance, dependence, falls, and cognitive impairment — avoid long-term use, especially in older adults.
- Antidepressant onset
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SSRIs take 4–6 weeks for full effect; continue 6–12 months after remission of a first episode.
Dermatology (13)
- Stevens-Johnson / TEN
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Drug-induced mucocutaneous necrosis with sloughing (positive Nikolsky); stop the drug, supportive care (often burn unit).
- Melanoma ABCDE
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Asymmetry, Border irregularity, Color variation, Diameter >6 mm, Evolving — biopsy suspicious lesions.
- Erythema multiforme
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Target lesions, often from HSV or drugs.
- Psoriasis
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Well-demarcated plaques with silvery scale on extensor surfaces; topical steroids/vitamin D, phototherapy, or biologics.
- Cellulitis vs erysipelas
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Erysipelas is superficial with a sharply demarcated raised border (often Strep); cellulitis is deeper and less well-defined.
- Basal vs squamous cell carcinoma
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BCC: pearly papule with telangiectasias (rarely metastasizes). SCC: scaly/ulcerated, can metastasize.
- Drug reaction with eosinophilia (DRESS)
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Fever, rash, eosinophilia, and organ involvement weeks after a drug; stop the agent, supportive/steroids.
- Pemphigus vs pemphigoid
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Pemphigus vulgaris: flaccid bullae, positive Nikolsky, intraepidermal. Bullous pemphigoid: tense bullae, negative Nikolsky, subepidermal.
- Pityriasis rosea
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Herald patch followed by a 'Christmas-tree' truncal eruption; self-limited.
- Actinic keratosis
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Rough scaly sun-damaged lesions; premalignant for squamous cell carcinoma.
- Contact dermatitis
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Type IV hypersensitivity in the distribution of the allergen; topical steroids and avoidance.
- Acanthosis nigricans
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Velvety hyperpigmented skin in folds; associated with insulin resistance (and rarely GI malignancy).
- Dermatitis herpetiformis
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Intensely pruritic vesicles on extensors; associated with celiac disease.
General IM, Geriatrics & Prevention (28)
- Sensitivity vs specificity
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Sensitivity = true-positive rate (negative test rules OUT, SnNout); specificity = true-negative rate (positive test rules IN, SpPin).
- PPV depends on prevalence
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Positive predictive value rises with disease prevalence; likelihood ratios do not depend on prevalence.
- Number needed to treat
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NNT = 1 ÷ absolute risk reduction; fewer patients needed means greater benefit.
- Relative risk vs odds ratio
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RR compares incidence between groups (cohorts/RCTs); OR is used in case-control studies and approximates RR for rare outcomes.
- Confidence interval
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A 95% CI that crosses 1 (for RR/OR) or 0 (for differences) indicates a non-significant result.
- Preoperative cardiac risk
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Assess functional capacity (METs) and surgical risk; routine testing is not needed for low-risk surgery or good functional status.
- Adult immunizations
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Annual influenza; Tdap then Td/Tdap boosters; pneumococcal and RSV per age; zoster (RZV) at ≥50.
- Geriatric polypharmacy
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Review with the Beers criteria; deprescribe high-risk drugs (anticholinergics, benzodiazepines) in older adults.
- Falls in older adults
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Multifactorial; review medications, vision, gait/balance, and home hazards; strength/balance exercise reduces risk.
- Delirium prevention
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Reorient, mobilize, restore sleep, treat pain, hydrate, and remove tethers; avoid deliriogenic drugs.
- Palliative vs hospice
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Palliative care can accompany curative treatment at any stage; hospice is for a prognosis ~6 months when curative care is stopped.
- Advance directives
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A living will states wishes; a healthcare proxy/durable power of attorney names a surrogate decision-maker.
- USPSTF AAA screening
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One-time ultrasound for men 65–75 who have ever smoked.
- Osteoporosis screening
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DEXA for women ≥65 (and younger high-risk) to assess fracture risk.
- Smoking cessation
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Combine counseling with pharmacotherapy (varenicline, bupropion, or nicotine replacement) — most effective together.
- Diabetes prevention
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Intensive lifestyle change (weight loss, activity) and metformin reduce progression from prediabetes.
- Type I vs type II error
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Type I (alpha) = false positive (reject a true null); Type II (beta) = false negative; power = 1 − beta.
- p-value meaning
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The probability of results as extreme as observed if the null hypothesis were true; <0.05 is conventionally significant.
- Lead-time vs length-time bias
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Lead-time: earlier detection only seems to prolong survival; length-time: screening preferentially finds slow-growing disease.
- Intention-to-treat analysis
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Analyze participants in their assigned group regardless of adherence — preserves randomization and reduces bias.
- Cohort vs case-control
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Cohort follows exposure forward to outcome (gives incidence/RR); case-control starts from outcome backward (gives odds ratio).
- Hospice eligibility
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A prognosis of about 6 months or less if the disease runs its usual course, with a focus on comfort.
- Pressure injury prevention
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Reposition, offload, manage moisture, and optimize nutrition in immobile patients.
- Urinary incontinence types
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Stress (leak with cough), urge (overactive bladder), overflow (retention), and functional.
- Perioperative anticoagulation
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Balance bleeding vs thrombosis risk; bridge only high-risk patients; hold DOACs based on renal function and bleeding risk.
- Vaccination in immunocompromised
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Avoid live vaccines; give inactivated vaccines and pneumococcal series.
- Hypertension diagnosis
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Confirm with out-of-office (ambulatory/home) readings; stage 1 is ≥130/80 by current US guidelines.
- Obesity pharmacotherapy
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GLP-1 receptor agonists (semaglutide) and other agents added to lifestyle for BMI ≥30 (or ≥27 with comorbidity).
References
- 1.American Board of Internal Medicine (ABIM). “Internal Medicine Certification Exam Blueprint.” abim.org. ↑
- 2.American Board of Internal Medicine (ABIM). “Internal Medicine Exam Information.” abim.org. ↑
- 3.National Heart, Lung, and Blood Institute (NHLBI). “Heart Failure.” nhlbi.nih.gov. ↑
- 4.U.S. Preventive Services Task Force (USPSTF). “Colorectal Cancer: Screening.” uspreventiveservicestaskforce.org. ↑
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