INTERNAL MEDICINE EOR FINAL PAPER
2026 FULL Q&A STUDY GUIDE GRADED A+
◉Where is the needle decompression performed for a tension
pneumothorax? Answer: second intercostal space, mid clavicular
line
◉What are the physical exam findings with signs of consolidation?
Answer: bronchial breath sounds, egophony (E to A changes),
dullness to percussion, increased tactile fremitus
◉Explain how the CURB65 score should be used? Answer: C -
confusion
U - BUN >20
R - RR>30
B - bp Systolic <90, diastolic<60
65 - age>65
◉Pneumonia CXR findings and associated bacteria:
1. Strep Pneumo, H Flu, and Klebsiella have ____consolidations.
2. Staph Aureus, Legionella, and Mycoplasma appear ___.
, 3. Pneumocystitis jiroveci is common in AIDS patients and appears
_____. Answer: lobar; patchy; diffuse interstitial and alveolar
infiltrates
◉Pneumonia treatment inpatient vs. outpatient? Answer: Inpatient:
--3rd generation cephalosporin - ceftriaxone
--macrolide - azithromycin
--vancomycin - if MRSA is a concern
Outpatient:
--macrolide - azithromycin
--Fluoroquinolone - levofloxacin
◉A ____is a round opacity outlined by normal lung and not
associated with infiltrate, atelectasis, or adenopathy. Often
asymptomatic or present w s/s of underlying malignancy. Monitor
closely. >35yo, consider potentially malignant and resect. Answer:
solitary pulmonary nodule
◉Lung Cancer:
Small cell - 100% associated with smoking. Consider metastatic at
time of diagnosis. Metastasizes rapidly. Where are mass usually
found first? Answer: centrally
◉Lung Cancer:
,Non small cell - discrete masses that can spread to regional lymph
nodes and metastasize to distant sites. What are the three types?
Answer: Squamous - central airways
Large cell - central or peripheral
Adenocarcinoma - periphery
◉Lung cancer is more likely to produce active substances that result
in a variety of paraneoplastic syndromes. Give some examples of
some. Answer: hypercalcemia, SIADH, hypercoagulable state,
superior vena cava syndrome, Horner's syndrome, Pancoast's tumor
◉A ____is a low-grade malignant neoplasm that is slow-growing and
rarely metastasize. symptoms include hemoptysis, cough, wheezing,
and recurrent pneumonia. ___syndrome of flushing, diarrhea, and
hypotension. Surgery is treatment of choice. Answer: Carcinoid
tumor; carcinoid syndrome
◉____is abnormal dilation of the large conducting airways often due
to cystic fibrosis or alpha-1 antitrypsin deficiency. Treat underlying
disorder. Answer: Bronchiectasis
◉____is when often obese patients fail to breath rapidly or deeply
enough resulting in low oxygen or high carbon dioxide levels.
Answer: Hypoventilation syndrome
, ◉GI: The abdominal plain film may show free intraperitoneal air,
seen under the diaphragm on an upright film, indicating what?
Answer: perforation of a hollow viscus
◉Hyperkalemia is seen in bowel infarction and represents what?
Answer: tissue necrosis
◉LFT's show marked elevations in ______in hepatitis and elevation of
_____in cholecystitis. LFTs may be normal in biliary colic. Answer:
amylase; alkaline phosphatase
◉Osmotic diarrhea usually ____(improves or worsens) with fasting
whereas secretory diarrhea ____(improves or worsens) during
fasting. Answer: improves; persists
◉____is defined as a syndrome characterized by chronic abdominal
pain and altered bowel habits (can be either diarrhea or
constipation). Treat w diet modifications, addition of fiber,
antispasmodics, stress reduction Answer: Irritable bowel syndrome
Rome Criteria - pain at least 3 days over the last 3 months w 2 or
more of the following:
1. relieved w defecation
2. associated w change in frequency of stool
3. associated w change in form of stool
2026 FULL Q&A STUDY GUIDE GRADED A+
◉Where is the needle decompression performed for a tension
pneumothorax? Answer: second intercostal space, mid clavicular
line
◉What are the physical exam findings with signs of consolidation?
Answer: bronchial breath sounds, egophony (E to A changes),
dullness to percussion, increased tactile fremitus
◉Explain how the CURB65 score should be used? Answer: C -
confusion
U - BUN >20
R - RR>30
B - bp Systolic <90, diastolic<60
65 - age>65
◉Pneumonia CXR findings and associated bacteria:
1. Strep Pneumo, H Flu, and Klebsiella have ____consolidations.
2. Staph Aureus, Legionella, and Mycoplasma appear ___.
, 3. Pneumocystitis jiroveci is common in AIDS patients and appears
_____. Answer: lobar; patchy; diffuse interstitial and alveolar
infiltrates
◉Pneumonia treatment inpatient vs. outpatient? Answer: Inpatient:
--3rd generation cephalosporin - ceftriaxone
--macrolide - azithromycin
--vancomycin - if MRSA is a concern
Outpatient:
--macrolide - azithromycin
--Fluoroquinolone - levofloxacin
◉A ____is a round opacity outlined by normal lung and not
associated with infiltrate, atelectasis, or adenopathy. Often
asymptomatic or present w s/s of underlying malignancy. Monitor
closely. >35yo, consider potentially malignant and resect. Answer:
solitary pulmonary nodule
◉Lung Cancer:
Small cell - 100% associated with smoking. Consider metastatic at
time of diagnosis. Metastasizes rapidly. Where are mass usually
found first? Answer: centrally
◉Lung Cancer:
,Non small cell - discrete masses that can spread to regional lymph
nodes and metastasize to distant sites. What are the three types?
Answer: Squamous - central airways
Large cell - central or peripheral
Adenocarcinoma - periphery
◉Lung cancer is more likely to produce active substances that result
in a variety of paraneoplastic syndromes. Give some examples of
some. Answer: hypercalcemia, SIADH, hypercoagulable state,
superior vena cava syndrome, Horner's syndrome, Pancoast's tumor
◉A ____is a low-grade malignant neoplasm that is slow-growing and
rarely metastasize. symptoms include hemoptysis, cough, wheezing,
and recurrent pneumonia. ___syndrome of flushing, diarrhea, and
hypotension. Surgery is treatment of choice. Answer: Carcinoid
tumor; carcinoid syndrome
◉____is abnormal dilation of the large conducting airways often due
to cystic fibrosis or alpha-1 antitrypsin deficiency. Treat underlying
disorder. Answer: Bronchiectasis
◉____is when often obese patients fail to breath rapidly or deeply
enough resulting in low oxygen or high carbon dioxide levels.
Answer: Hypoventilation syndrome
, ◉GI: The abdominal plain film may show free intraperitoneal air,
seen under the diaphragm on an upright film, indicating what?
Answer: perforation of a hollow viscus
◉Hyperkalemia is seen in bowel infarction and represents what?
Answer: tissue necrosis
◉LFT's show marked elevations in ______in hepatitis and elevation of
_____in cholecystitis. LFTs may be normal in biliary colic. Answer:
amylase; alkaline phosphatase
◉Osmotic diarrhea usually ____(improves or worsens) with fasting
whereas secretory diarrhea ____(improves or worsens) during
fasting. Answer: improves; persists
◉____is defined as a syndrome characterized by chronic abdominal
pain and altered bowel habits (can be either diarrhea or
constipation). Treat w diet modifications, addition of fiber,
antispasmodics, stress reduction Answer: Irritable bowel syndrome
Rome Criteria - pain at least 3 days over the last 3 months w 2 or
more of the following:
1. relieved w defecation
2. associated w change in frequency of stool
3. associated w change in form of stool
