INTERNAL MEDICINE EOR CERTIFICATION
SCRIPT 2026 COMPLETE QUESTIONS AND
CORRECT ANSWERS
◉____is a systemic immune process that is a sequel of beta-hemolytic
strep infection of the pharynx. Diagnosed based on Jones criteria.
Answer: Rheumatic fever
Jones - 2 major or 1major and 2minor
Major = carditis, polyarthritis, chorea, erythema marginatum,
subcutaneous nodules
Minor = fever, arthralgia, previous Rheum fever, leukocytosis, ESR,
CRP, prolonged PR
◉____ results from single or repeated attacks of rheumatic fever that
produce rigidity and deformity of valve cusps, fusion of the
commissures, or shortening and fusion of the chordae tendineae.
The mitral valve is affected in 50-60% of cases. Answer: Rheumatic
heart disease
◉Endocarditis (or infection of the endothelial surface of the heart)
is most commonly caused by what bacteria? Answer: Strep
Viradans, Staph Aureus, and enterococcus -- P aeroginosa and S.
Marcescens with IV Drug users
,◉What are some PE findings in infective endocarditis? Answer:
Roth spots - small white spots on retina surrounded by hemorrhage
Osler nodes - small tender lesions on fat pads of fingers and toes
Janeway lesions - painless, reddish, macular lesions on hands or feet
◉Duke Criteria for dx of infective endocarditis
Dx with 2 major or 1 major and 3 minor Answer: Major
a. positive blood cultures
b. endocardial involvelment on echo
Minor
a. predisposing condition: cardiac or IV drug use
b. fever
c. vascular phenomenon
d. immunologic phenomenon
◉PULMONOLOGY: Which lung disease has an increased TLC (total
lung capacity)? Answer: emphysema - remember flattened
diaphragms
◉From the hospital: You normally here COPD or asthma on
____wheezing. You normally here pleural effusion or right heart
failure on _____wheezing. Answer: expiratory wheezing = COPD
,inspiratory wheezing = pleural effusion
◉In pleural effusion, pneumothorax, neoplasm, there is ____fremitus
or transmitted voice sounds. In pneumonia, there is ____fremitus or
transmitted voice sounds due to increased transmission through
consolidated tissue. Answer: decreased, increased
◉On percussion, _____replaces resonance when fluid or solid tissue
replaces air containing lung or occupies the pleural space beneath
your percussing fingers. Answer: dullness
◉______on percussion is found in hyperinflated lungs like in COPD or
asthma. Answer: Hyperresonsance
◉In emphysema, chronic bronchitis, & asthma, is the RV (residual
volume) increased or decreased? Answer: increased bc of air
trapping
◉SPUTUM: What is the likely diagnosis if...
1. mostly WBC's
2. mostly eosinophils and mucous casts
3. mostly RBC's Answer: 1. pneumonia or bronchitis
2. asthma
3. chronic bronchitis, bronchiectasis, or tumor
, ◉What are four physiologic changes that result from COPD?
Answer: V/Q mismatches, pulmonary hypertension, abnormal
ventilator responses, and right heart failure.
◉____is a complication of pulmonary hypertension. Right sided heart
failure where the RV has a hard time pumping blood into the lungs.
Causes: COPD, chronic PE, cystic fibrosis. Answer: Cor Pumonale
◉Explain how each of the following treatments for COPD helps to
alleviate symptoms:
1. anticholinergics - ipratropium bromide, tiotropium
2. B-agonists - albuterol
3. Methylxanthines - theophylline
What is the only treatment proven to improve survival and quality of
life? Answer: 1. bronchodilation - helps with bronchospasm
2. additional bronchodilation
3. infrequently used -- in some cases, it is useful for nocturnal
symptoms
OXYGEN
◉_____is an episodic disease characterized by abnormally heightened
responsiveness of the tracheobronchial tree, leading to expiratory
airflow obstruction. Answer: Asthma
SCRIPT 2026 COMPLETE QUESTIONS AND
CORRECT ANSWERS
◉____is a systemic immune process that is a sequel of beta-hemolytic
strep infection of the pharynx. Diagnosed based on Jones criteria.
Answer: Rheumatic fever
Jones - 2 major or 1major and 2minor
Major = carditis, polyarthritis, chorea, erythema marginatum,
subcutaneous nodules
Minor = fever, arthralgia, previous Rheum fever, leukocytosis, ESR,
CRP, prolonged PR
◉____ results from single or repeated attacks of rheumatic fever that
produce rigidity and deformity of valve cusps, fusion of the
commissures, or shortening and fusion of the chordae tendineae.
The mitral valve is affected in 50-60% of cases. Answer: Rheumatic
heart disease
◉Endocarditis (or infection of the endothelial surface of the heart)
is most commonly caused by what bacteria? Answer: Strep
Viradans, Staph Aureus, and enterococcus -- P aeroginosa and S.
Marcescens with IV Drug users
,◉What are some PE findings in infective endocarditis? Answer:
Roth spots - small white spots on retina surrounded by hemorrhage
Osler nodes - small tender lesions on fat pads of fingers and toes
Janeway lesions - painless, reddish, macular lesions on hands or feet
◉Duke Criteria for dx of infective endocarditis
Dx with 2 major or 1 major and 3 minor Answer: Major
a. positive blood cultures
b. endocardial involvelment on echo
Minor
a. predisposing condition: cardiac or IV drug use
b. fever
c. vascular phenomenon
d. immunologic phenomenon
◉PULMONOLOGY: Which lung disease has an increased TLC (total
lung capacity)? Answer: emphysema - remember flattened
diaphragms
◉From the hospital: You normally here COPD or asthma on
____wheezing. You normally here pleural effusion or right heart
failure on _____wheezing. Answer: expiratory wheezing = COPD
,inspiratory wheezing = pleural effusion
◉In pleural effusion, pneumothorax, neoplasm, there is ____fremitus
or transmitted voice sounds. In pneumonia, there is ____fremitus or
transmitted voice sounds due to increased transmission through
consolidated tissue. Answer: decreased, increased
◉On percussion, _____replaces resonance when fluid or solid tissue
replaces air containing lung or occupies the pleural space beneath
your percussing fingers. Answer: dullness
◉______on percussion is found in hyperinflated lungs like in COPD or
asthma. Answer: Hyperresonsance
◉In emphysema, chronic bronchitis, & asthma, is the RV (residual
volume) increased or decreased? Answer: increased bc of air
trapping
◉SPUTUM: What is the likely diagnosis if...
1. mostly WBC's
2. mostly eosinophils and mucous casts
3. mostly RBC's Answer: 1. pneumonia or bronchitis
2. asthma
3. chronic bronchitis, bronchiectasis, or tumor
, ◉What are four physiologic changes that result from COPD?
Answer: V/Q mismatches, pulmonary hypertension, abnormal
ventilator responses, and right heart failure.
◉____is a complication of pulmonary hypertension. Right sided heart
failure where the RV has a hard time pumping blood into the lungs.
Causes: COPD, chronic PE, cystic fibrosis. Answer: Cor Pumonale
◉Explain how each of the following treatments for COPD helps to
alleviate symptoms:
1. anticholinergics - ipratropium bromide, tiotropium
2. B-agonists - albuterol
3. Methylxanthines - theophylline
What is the only treatment proven to improve survival and quality of
life? Answer: 1. bronchodilation - helps with bronchospasm
2. additional bronchodilation
3. infrequently used -- in some cases, it is useful for nocturnal
symptoms
OXYGEN
◉_____is an episodic disease characterized by abnormally heightened
responsiveness of the tracheobronchial tree, leading to expiratory
airflow obstruction. Answer: Asthma
