Internal Medicine Board ABIM Exam 2025–2026
Accurate Real Exam Questions and Verified
Correct Answers JUST RELEASED
What level to keep bicarb in CKD? Treatment & reason - answer>>>23-29. If lower give
oral bicarb. Prevents progression
Complications of testicular cancer therapy - answer>>>Insulin resistance, HTN, HLD,
obesity, CVD
Indications for Finasteride - answer>>>Prostate >40mL, elevated PSA, and/or severe BPH
symptoms
Repeat colonoscopy in 3 years for polyps that are: - answer>>>(1) adenoma >10mm (2) 3-
10 adenomas, (3) villous component (such as a tubulovillous or villous adenoma), or (4)
high-grade dysplasia
Definitive dx of Aspergillus sinusitis - answer>>>Tissue bx with hyphae and +culture.
Galactomannan Ag helps
Colonoscopy screening for IBD with long-standing colitis - answer>>>8-10 years after
diagnosis then Q1-2y
PAH treatment if sensitive to vasocreactivity testing (inhaled NO) treat with -
answer>>>CCB (nifedipine)
PAH treatment if NOT sensitive to vasocreactivity testing (inhaled NO) treat with -
answer>>>phosphodiesterase-5 inhibitors (sildenafil, tadalafil) and endothelin receptor
antagonists (bosentan, ambrisentan)
,Estrogen-r (+) breast cancer who develop metastases limited to bone after a long disease-
free interval should be treated with - answer>>>aromatase inhibitor (anastrozole)
Testing for pre-op stating of newly diagnosed colorectal CA - answer>>>CT chest, abd,
pelvis with contrast
Adult onset Still's disease features - answer>>>Major:
High spiking fever
Rash
Arthritis
Minor:
Spleomegaly
LAD
Elevated LFTs
Not criteria but very few dz's have:
Markedly high ferritin
Gallbladder polyp-when to remove GB vs surveilance - answer>>>>1cm remove
Arterial or venous thromobosis (e.g. hepatic aka Budd-Chiari) warrants work up for ___ in
the form of ___ - answer>>>Polycythemia vera; JAK2V617F mutation
MS treatment that is renally excreted - answer>>>Dalfampridine
, Skin manifestations of sarcoidosis - answer>>>Violaceous infiltrated papules around the
nasal ala and periorbitally or periorally
Treatment for interstitial lung disease associated with diffuse cutaneous systemic
sclerosis - answer>>>Cyclophosphamide
primary central nervous system lymphoma treatment - answer>>>methotrexate-based
chemotherapy and possible whole-brain radiation
characteristic of severe tricyclic antidepressant overdose - answer>>>progressive
somnolence, hypotension, widening of the QRS interval, seizure, and anticholinergic signs
(fever, tachycardia, mydriasis, reduced bowel sounds)
Indication for breast MRI surveillance post breast cancer - answer>>>BRCA, familial
breast CA syndromes or very strong family hx
Who should get BRCA testing - answer>>><45 y/o with new breast cancer or family hx of
breast or ovarian; any age breast cancer diagnosis with 1+ 1st to 3rd degree relatives
with ovarian; triple negative before 60 y/p
Genetic test for gastric cancer; treat if + with - answer>>>HER2; trastuzumab
Genetic test for melanomas; treat if + with - answer>>>BRAF mutations; selective BRAF
inhibitors
What can alter Urea breath test - answer>>>Recent abx use or PPis. Test after 1m of abx
or 1w of PPi
Antibody for subacute cutaneous SLE - answer>>>Anti-Ro/SSA (sometimes La/SSB), and
antihistone (1/3)
Accurate Real Exam Questions and Verified
Correct Answers JUST RELEASED
What level to keep bicarb in CKD? Treatment & reason - answer>>>23-29. If lower give
oral bicarb. Prevents progression
Complications of testicular cancer therapy - answer>>>Insulin resistance, HTN, HLD,
obesity, CVD
Indications for Finasteride - answer>>>Prostate >40mL, elevated PSA, and/or severe BPH
symptoms
Repeat colonoscopy in 3 years for polyps that are: - answer>>>(1) adenoma >10mm (2) 3-
10 adenomas, (3) villous component (such as a tubulovillous or villous adenoma), or (4)
high-grade dysplasia
Definitive dx of Aspergillus sinusitis - answer>>>Tissue bx with hyphae and +culture.
Galactomannan Ag helps
Colonoscopy screening for IBD with long-standing colitis - answer>>>8-10 years after
diagnosis then Q1-2y
PAH treatment if sensitive to vasocreactivity testing (inhaled NO) treat with -
answer>>>CCB (nifedipine)
PAH treatment if NOT sensitive to vasocreactivity testing (inhaled NO) treat with -
answer>>>phosphodiesterase-5 inhibitors (sildenafil, tadalafil) and endothelin receptor
antagonists (bosentan, ambrisentan)
,Estrogen-r (+) breast cancer who develop metastases limited to bone after a long disease-
free interval should be treated with - answer>>>aromatase inhibitor (anastrozole)
Testing for pre-op stating of newly diagnosed colorectal CA - answer>>>CT chest, abd,
pelvis with contrast
Adult onset Still's disease features - answer>>>Major:
High spiking fever
Rash
Arthritis
Minor:
Spleomegaly
LAD
Elevated LFTs
Not criteria but very few dz's have:
Markedly high ferritin
Gallbladder polyp-when to remove GB vs surveilance - answer>>>>1cm remove
Arterial or venous thromobosis (e.g. hepatic aka Budd-Chiari) warrants work up for ___ in
the form of ___ - answer>>>Polycythemia vera; JAK2V617F mutation
MS treatment that is renally excreted - answer>>>Dalfampridine
, Skin manifestations of sarcoidosis - answer>>>Violaceous infiltrated papules around the
nasal ala and periorbitally or periorally
Treatment for interstitial lung disease associated with diffuse cutaneous systemic
sclerosis - answer>>>Cyclophosphamide
primary central nervous system lymphoma treatment - answer>>>methotrexate-based
chemotherapy and possible whole-brain radiation
characteristic of severe tricyclic antidepressant overdose - answer>>>progressive
somnolence, hypotension, widening of the QRS interval, seizure, and anticholinergic signs
(fever, tachycardia, mydriasis, reduced bowel sounds)
Indication for breast MRI surveillance post breast cancer - answer>>>BRCA, familial
breast CA syndromes or very strong family hx
Who should get BRCA testing - answer>>><45 y/o with new breast cancer or family hx of
breast or ovarian; any age breast cancer diagnosis with 1+ 1st to 3rd degree relatives
with ovarian; triple negative before 60 y/p
Genetic test for gastric cancer; treat if + with - answer>>>HER2; trastuzumab
Genetic test for melanomas; treat if + with - answer>>>BRAF mutations; selective BRAF
inhibitors
What can alter Urea breath test - answer>>>Recent abx use or PPis. Test after 1m of abx
or 1w of PPi
Antibody for subacute cutaneous SLE - answer>>>Anti-Ro/SSA (sometimes La/SSB), and
antihistone (1/3)
