INTERNAL MEDICINE COMAT REVIEW MEDICINE COURSE
2025/2026 | VERIFIED QUESTIONS AND ANSWERS
GRADED A+ | CLINICAL CASES & DISEASE MANAGEMENT
STUDY GUIDE | GUARANTEED SUCCESS
Definition of metabolic syndrome - CORRECT ANSWER - Any three of the
following five:
1. Fasting plasma glucose > 100 mg/dL (or on medical therapy for
hyperglycemia)
2. BP ≥ 130/85 mmHg (or on medical therapy for hypertension)
3. Triglycerides ≥ 150 mg/dL (or on medical therapy for hypertriglyceridemia)
4. High density lipoprotein (HDL) cholesterol < 40 mg/dL for men, < 50 mg/dL
for women (or on medical therapy for low HDL cholesterol)
5. Abdominal obesity (waist circumference > 40" for men, > 35" for women)
4 groups of ppl most likely to benefit from statin therapy - CORRECT
ANSWER - 1. current ASCVD (atherosclerotic vascular dz)
2. LDL cholesterol > 190
3. Diabetes (type 1 or 2) ages 40-75
4. Estimated 10-year ASCVD risk by pooled cohort equations >7.5%
Well's Criteria - CORRECT ANSWER - Criteria for diagnosing a DVT:
A point each for (1) localized tenderness, (2) asymmetric pitting edema, and (3)
asymmetric calf swelling
*Virchow's Triad - CORRECT ANSWER - Risk for DVT
Triad=
1. Stasis
,2. Vascular Injury
3. Hypercoagulability
Arterial Blood Gas (ABG) in a PE patient - CORRECT ANSWER - Arterial
blood gases (ABGs) in pulmonary thromboembolism usually reveal an acute
respiratory alkalosis secondary to hyperventilation.
Timeframe for acute vs chronic arthritis - CORRECT ANSWER - Acute <6
weeks
Chronic >6 weeks
Rhonchi - CORRECT ANSWER - Low-pitched, continuous sounds often
described as similar to a snoring sound. Generated by narrowing of larger
airways due to mucus from bronchitis or narrowing from asthma or COPD
Wheezes - CORRECT ANSWER - High-pitched whistling sound during
breathing when air flows through a narrowed airway, most commonly heard in
asthmatics.
Crackles - CORRECT ANSWER - Synonymous with rales. A discontinuous
sound heard more often during inhalation caused by airway opening. The
sounds are often divided into dry or moist, with the dryness being caused by
disease processes such as fibrosis and the moistness or wetness being secondary
to heart failure or pneumonia.
Antibiotic of choice for uncomplicated pneumonia - CORRECT ANSWER -
Azithromycin
What is neutropenic fever - CORRECT ANSWER - Neutropenic fever=
temperature greater than 38.3 C (101 F) & an absolute neutrophil count less
than 500.
,What antibiotics are appropriate for patients with neutropenic fever? -
CORRECT ANSWER - Antibiotics used in neutropenic fever need to treat for
pseudomonas (since it can be lethal in septic patients if left untreated)-->
ceftazadime, cefepime, piperacillin-tazobactam, meropenem, imipenem.
For persistent neutropenic fevers, after giving broad spectrum antibiotics that
cover for pseudomonas, what should be added? - CORRECT ANSWER - For
persistenet neutropenic fevers, add a broad spectrum anti-fungal agent (like
amphotericin B).
Centor Criteria for Strep Throat - CORRECT ANSWER - 4 criteria= fever,
tonsillar exudates, tender anterior cervical lymphadenopathy, absence of cough.
Score of 0/1= no test.
Score of 2= RADT (rapid antigen detection test)
Score of 3/4= not test.
Score of 0/1= no treatment
Score of 2= Penicillin V if positive RADT
Score of 3/4= Emperic Penicillin V
Causes of orthostatic hypotension - CORRECT ANSWER - Causes of
orthostatic hypotension can include medications, hypovolemia, cardiac
insufficiency, and diabetic neuropathy.
vesicular breath sounds - CORRECT ANSWER - Normal breath sounds in the
lung, characterized by a long inspiratory phase followed by a short expiratory
phase
Bronchial breath sounds - CORRECT ANSWER - Compared to vesicular
breath sounds, bronchial breath sounds have a louder, shorter inspiratory phase
, and louder, prolonged expiratory phase. This is a normal finding when heard
over the trachea. However, when bronchial breath sounds are heard in a location
other than the trachea, it is suggestive of pulmonary consolidation (meaning the
alveoli are full of something other than air such as pus, water, or blood).
What do you do if you hear decreased breath sounds upon auscultation? -
CORRECT ANSWER - When you hear decreased breath sounds, percuss out
the lungs.
Dullness to percussion in an area of decreased breath sounds suggests pleural
effusion, whereas hyperresonance suggests pneumothorax.
ECG leads representing anterior wall - CORRECT ANSWER - V1-4 (LAD)
ECG leads representing the inferior portion of the heart - CORRECT
ANSWER - II, III, and aVF (right coronary artery)
ECG leads representing the lateral myocardial wall - CORRECT ANSWER -
I, AVL, V5, & V6
When should you consider immediate diagnostic coronary angiography? -
CORRECT ANSWER - order immediate diagnostic coronary angiography for
a STEMI or new-onset Left BBB
Another name for angioplasty... - CORRECT ANSWER - Primary
In an acute inferior wall myocardial infarction, occlusion of which coronary
artery is usually implicated? - CORRECT ANSWER - Right coronary artery
Difference in sounds between COPD and pulmonary edema/interstitial lung
disease. - CORRECT ANSWER - Wheezing or rhonchi= more suggestive of
COPD
Crackles= more suggestive of pulmonary edema or interstitial lung disease.
2025/2026 | VERIFIED QUESTIONS AND ANSWERS
GRADED A+ | CLINICAL CASES & DISEASE MANAGEMENT
STUDY GUIDE | GUARANTEED SUCCESS
Definition of metabolic syndrome - CORRECT ANSWER - Any three of the
following five:
1. Fasting plasma glucose > 100 mg/dL (or on medical therapy for
hyperglycemia)
2. BP ≥ 130/85 mmHg (or on medical therapy for hypertension)
3. Triglycerides ≥ 150 mg/dL (or on medical therapy for hypertriglyceridemia)
4. High density lipoprotein (HDL) cholesterol < 40 mg/dL for men, < 50 mg/dL
for women (or on medical therapy for low HDL cholesterol)
5. Abdominal obesity (waist circumference > 40" for men, > 35" for women)
4 groups of ppl most likely to benefit from statin therapy - CORRECT
ANSWER - 1. current ASCVD (atherosclerotic vascular dz)
2. LDL cholesterol > 190
3. Diabetes (type 1 or 2) ages 40-75
4. Estimated 10-year ASCVD risk by pooled cohort equations >7.5%
Well's Criteria - CORRECT ANSWER - Criteria for diagnosing a DVT:
A point each for (1) localized tenderness, (2) asymmetric pitting edema, and (3)
asymmetric calf swelling
*Virchow's Triad - CORRECT ANSWER - Risk for DVT
Triad=
1. Stasis
,2. Vascular Injury
3. Hypercoagulability
Arterial Blood Gas (ABG) in a PE patient - CORRECT ANSWER - Arterial
blood gases (ABGs) in pulmonary thromboembolism usually reveal an acute
respiratory alkalosis secondary to hyperventilation.
Timeframe for acute vs chronic arthritis - CORRECT ANSWER - Acute <6
weeks
Chronic >6 weeks
Rhonchi - CORRECT ANSWER - Low-pitched, continuous sounds often
described as similar to a snoring sound. Generated by narrowing of larger
airways due to mucus from bronchitis or narrowing from asthma or COPD
Wheezes - CORRECT ANSWER - High-pitched whistling sound during
breathing when air flows through a narrowed airway, most commonly heard in
asthmatics.
Crackles - CORRECT ANSWER - Synonymous with rales. A discontinuous
sound heard more often during inhalation caused by airway opening. The
sounds are often divided into dry or moist, with the dryness being caused by
disease processes such as fibrosis and the moistness or wetness being secondary
to heart failure or pneumonia.
Antibiotic of choice for uncomplicated pneumonia - CORRECT ANSWER -
Azithromycin
What is neutropenic fever - CORRECT ANSWER - Neutropenic fever=
temperature greater than 38.3 C (101 F) & an absolute neutrophil count less
than 500.
,What antibiotics are appropriate for patients with neutropenic fever? -
CORRECT ANSWER - Antibiotics used in neutropenic fever need to treat for
pseudomonas (since it can be lethal in septic patients if left untreated)-->
ceftazadime, cefepime, piperacillin-tazobactam, meropenem, imipenem.
For persistent neutropenic fevers, after giving broad spectrum antibiotics that
cover for pseudomonas, what should be added? - CORRECT ANSWER - For
persistenet neutropenic fevers, add a broad spectrum anti-fungal agent (like
amphotericin B).
Centor Criteria for Strep Throat - CORRECT ANSWER - 4 criteria= fever,
tonsillar exudates, tender anterior cervical lymphadenopathy, absence of cough.
Score of 0/1= no test.
Score of 2= RADT (rapid antigen detection test)
Score of 3/4= not test.
Score of 0/1= no treatment
Score of 2= Penicillin V if positive RADT
Score of 3/4= Emperic Penicillin V
Causes of orthostatic hypotension - CORRECT ANSWER - Causes of
orthostatic hypotension can include medications, hypovolemia, cardiac
insufficiency, and diabetic neuropathy.
vesicular breath sounds - CORRECT ANSWER - Normal breath sounds in the
lung, characterized by a long inspiratory phase followed by a short expiratory
phase
Bronchial breath sounds - CORRECT ANSWER - Compared to vesicular
breath sounds, bronchial breath sounds have a louder, shorter inspiratory phase
, and louder, prolonged expiratory phase. This is a normal finding when heard
over the trachea. However, when bronchial breath sounds are heard in a location
other than the trachea, it is suggestive of pulmonary consolidation (meaning the
alveoli are full of something other than air such as pus, water, or blood).
What do you do if you hear decreased breath sounds upon auscultation? -
CORRECT ANSWER - When you hear decreased breath sounds, percuss out
the lungs.
Dullness to percussion in an area of decreased breath sounds suggests pleural
effusion, whereas hyperresonance suggests pneumothorax.
ECG leads representing anterior wall - CORRECT ANSWER - V1-4 (LAD)
ECG leads representing the inferior portion of the heart - CORRECT
ANSWER - II, III, and aVF (right coronary artery)
ECG leads representing the lateral myocardial wall - CORRECT ANSWER -
I, AVL, V5, & V6
When should you consider immediate diagnostic coronary angiography? -
CORRECT ANSWER - order immediate diagnostic coronary angiography for
a STEMI or new-onset Left BBB
Another name for angioplasty... - CORRECT ANSWER - Primary
In an acute inferior wall myocardial infarction, occlusion of which coronary
artery is usually implicated? - CORRECT ANSWER - Right coronary artery
Difference in sounds between COPD and pulmonary edema/interstitial lung
disease. - CORRECT ANSWER - Wheezing or rhonchi= more suggestive of
COPD
Crackles= more suggestive of pulmonary edema or interstitial lung disease.
