INTERNAL MEDICINE EOR PRACTICE EXAM QUESTIONS
AND ANSWERS 2025/2026 ALL RATED A+
✔✔Intermittent claudication can be managed medically, but ischemic rest pain requires
immediate what? What are the 6 P's of acute arterial occlusion. - ✔✔evaluation by a
vascular specialist, pulselessness, pallor, poikilothermia, pain, paralysis, paresthesia
✔✔What kind of disease should be considered in a young person with a thoracic
aneurysm? - ✔✔connective tissue disease - Marfan, Ehlers-Danos, bicuspid aortic
valve
✔✔Dilated Cardiomyopathy: most common cause is ____. Others? - ✔✔alcohol; may
also be idiopathic, myocarditis, or drugs (doxorubicin) -- 1 in 3 cases of heart failure are
caused by dilated cardiomyopathy
✔✔What PE and EKG changes are seen with dilated cardiomyopathy? - ✔✔PE: S3,
JVD, crackles - possible mitral regurg
EKG: nonspecific ST and T wave changes, LBBB
✔✔Hypertrophic cardiomyopathy: is due to hypertrophy of the _____? PE reveals mitral
regurgitation, a ____heart sound, and prominent left ventricular impulse. EKG reveals
LVH - ✔✔cardiac septum; S4
✔✔Restrictive cardiomyopathy: often caused by a ____process, or post-radiation or
post open-heart surgery. What is the most common first symptom? - ✔✔--infiltrative
process - amyloidosis, sarcoidosis, and hemochromatosis -- changes in myocardium
--most common first symptom is exertion intolerance and fluid retention, signs of right
heart failure
✔✔____often follows an upper respiratory infection and may present with chest pain or
signs of heart failure. EKG reveals cardiomegaly and contractile dysfunction. Treatment
includes antibiotics sensitive after myocardial biopsy or MRI. - ✔✔Myocarditis
✔✔____refers to the sudden, transient loss of consciousness and postural tone. What
are the most common etiologies? - ✔✔Syncope
1. neurally mediated (vasovagal, situational - micturition, tussive, valsalva, carotid sinus
hypersensitivity)
2. orthostatic hypotension (volume depletion, medications, postprandial)
3. primary cardiac causes - structural, arrhythmic, decreased cardiac output
✔✔____is a systemic immune process that is a sequel of beta-hemolytic strep infection
of the pharynx. Diagnosed based on Jones criteria. - ✔✔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. - ✔✔Rheumatic
heart disease
✔✔Endocarditis (or infection of the endothelial surface of the heart) is most commonly
caused by what bacteria? - ✔✔Strep Viradans, Staph Aureus, and enterococcus -- P
aeroginosa and S. Marcescens with IV Drug users
✔✔What are some PE findings in infective endocarditis? - ✔✔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 - ✔✔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)? -
✔✔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. - ✔✔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. - ✔✔decreased, increased
✔✔On percussion, _____replaces resonance when fluid or solid tissue replaces air
containing lung or occupies the pleural space beneath your percussing fingers. -
✔✔dullness
✔✔______on percussion is found in hyperinflated lungs like in COPD or asthma. -
✔✔Hyperresonsance
, ✔✔In emphysema, chronic bronchitis, & asthma, is the RV (residual volume) increased
or decreased? - ✔✔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 - ✔✔1. pneumonia or bronchitis
2. asthma
3. chronic bronchitis, bronchiectasis, or tumor
✔✔What are four physiologic changes that result from COPD? - ✔✔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. - ✔✔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? - ✔✔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. -
✔✔Asthma
✔✔Meds to treat asthma:
1. inhaled corticosteroids
2. cromlyn & nedocromil - blunt effects of bronchospastic triggers
3. theophylline - useful for nocturnal symptoms
4. leukotriene modifier - modify inflammatory mediators
5. po steroids - ✔✔Asthma is treated depending on frequency of exacerbations.
>2x/month - one med
>1 x/week - two meds
frequent - 3 meds are referral
AND ANSWERS 2025/2026 ALL RATED A+
✔✔Intermittent claudication can be managed medically, but ischemic rest pain requires
immediate what? What are the 6 P's of acute arterial occlusion. - ✔✔evaluation by a
vascular specialist, pulselessness, pallor, poikilothermia, pain, paralysis, paresthesia
✔✔What kind of disease should be considered in a young person with a thoracic
aneurysm? - ✔✔connective tissue disease - Marfan, Ehlers-Danos, bicuspid aortic
valve
✔✔Dilated Cardiomyopathy: most common cause is ____. Others? - ✔✔alcohol; may
also be idiopathic, myocarditis, or drugs (doxorubicin) -- 1 in 3 cases of heart failure are
caused by dilated cardiomyopathy
✔✔What PE and EKG changes are seen with dilated cardiomyopathy? - ✔✔PE: S3,
JVD, crackles - possible mitral regurg
EKG: nonspecific ST and T wave changes, LBBB
✔✔Hypertrophic cardiomyopathy: is due to hypertrophy of the _____? PE reveals mitral
regurgitation, a ____heart sound, and prominent left ventricular impulse. EKG reveals
LVH - ✔✔cardiac septum; S4
✔✔Restrictive cardiomyopathy: often caused by a ____process, or post-radiation or
post open-heart surgery. What is the most common first symptom? - ✔✔--infiltrative
process - amyloidosis, sarcoidosis, and hemochromatosis -- changes in myocardium
--most common first symptom is exertion intolerance and fluid retention, signs of right
heart failure
✔✔____often follows an upper respiratory infection and may present with chest pain or
signs of heart failure. EKG reveals cardiomegaly and contractile dysfunction. Treatment
includes antibiotics sensitive after myocardial biopsy or MRI. - ✔✔Myocarditis
✔✔____refers to the sudden, transient loss of consciousness and postural tone. What
are the most common etiologies? - ✔✔Syncope
1. neurally mediated (vasovagal, situational - micturition, tussive, valsalva, carotid sinus
hypersensitivity)
2. orthostatic hypotension (volume depletion, medications, postprandial)
3. primary cardiac causes - structural, arrhythmic, decreased cardiac output
✔✔____is a systemic immune process that is a sequel of beta-hemolytic strep infection
of the pharynx. Diagnosed based on Jones criteria. - ✔✔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. - ✔✔Rheumatic
heart disease
✔✔Endocarditis (or infection of the endothelial surface of the heart) is most commonly
caused by what bacteria? - ✔✔Strep Viradans, Staph Aureus, and enterococcus -- P
aeroginosa and S. Marcescens with IV Drug users
✔✔What are some PE findings in infective endocarditis? - ✔✔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 - ✔✔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)? -
✔✔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. - ✔✔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. - ✔✔decreased, increased
✔✔On percussion, _____replaces resonance when fluid or solid tissue replaces air
containing lung or occupies the pleural space beneath your percussing fingers. -
✔✔dullness
✔✔______on percussion is found in hyperinflated lungs like in COPD or asthma. -
✔✔Hyperresonsance
, ✔✔In emphysema, chronic bronchitis, & asthma, is the RV (residual volume) increased
or decreased? - ✔✔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 - ✔✔1. pneumonia or bronchitis
2. asthma
3. chronic bronchitis, bronchiectasis, or tumor
✔✔What are four physiologic changes that result from COPD? - ✔✔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. - ✔✔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? - ✔✔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. -
✔✔Asthma
✔✔Meds to treat asthma:
1. inhaled corticosteroids
2. cromlyn & nedocromil - blunt effects of bronchospastic triggers
3. theophylline - useful for nocturnal symptoms
4. leukotriene modifier - modify inflammatory mediators
5. po steroids - ✔✔Asthma is treated depending on frequency of exacerbations.
>2x/month - one med
>1 x/week - two meds
frequent - 3 meds are referral
