ABIM Certification Exam Practice Exam PRACTICE
QUESTIONS AND VERIFIED ANSWERS 2026 Q&A
|INSTANT DOWNLOAD PDF
1. A 65-year-old man presents with fatigue and pallor. His hemoglobin
is 8 g/dL, MCV is 72 fL, and ferritin is low. What is the most likely
cause?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Anemia of chronic disease
D. Thalassemia
Correct answer: B. Iron deficiency anemia — The patient has microcytic
anemia (low MCV) with low ferritin, consistent with iron deficiency.
2. A 55-year-old woman has sudden onset chest pain radiating to her
left arm. ECG shows ST elevation in leads II, III, and aVF. What is the
next best step?
A. Administer aspirin and anticoagulation, then urgent PCI
B. Start thrombolytics at home
C. Schedule outpatient stress test
D. Begin beta-blockers only
Correct answer: A. Administer aspirin and anticoagulation, then urgent
PCI — ST elevation in inferior leads indicates STEMI; urgent reperfusion
therapy is indicated.
3. Which of the following medications is first-line for chronic
management of heart failure with reduced ejection fraction (HFrEF)?
A. Calcium channel blockers
B. ACE inhibitors
C. Thiazide diuretics
,D. Digoxin
Correct answer: B. ACE inhibitors — ACE inhibitors reduce morbidity and
mortality in HFrEF and are recommended as first-line therapy.
4. A 45-year-old man presents with sudden onset of unilateral,
painless vision loss. Fundoscopy shows a pale retina with a cherry-red
spot. What is the most likely diagnosis?
A. Central retinal artery occlusion
B. Retinal detachment
C. Acute glaucoma
D. Optic neuritis
Correct answer: A. Central retinal artery occlusion — The cherry-red
spot is classic for CRAO.
5. Which of the following is the preferred initial test for suspected
pulmonary embolism in a hemodynamically stable patient?
A. Ventilation-perfusion scan
B. Chest X-ray
C. CT pulmonary angiography
D. MRI of the chest
Correct answer: C. CT pulmonary angiography — CTA is the imaging
modality of choice for suspected PE in stable patients.
6. A 60-year-old patient has type 2 diabetes with persistent
proteinuria. Which medication class is most beneficial in slowing
progression of diabetic nephropathy?
A. Beta-blockers
B. ACE inhibitors or ARBs
C. Calcium channel blockers
D. Loop diuretics
Correct answer: B. ACE inhibitors or ARBs — These reduce
, intraglomerular pressure and slow the progression of diabetic
nephropathy.
7. A patient presents with sudden severe headache, neck stiffness,
and photophobia. The best initial diagnostic test is:
A. Non-contrast CT head
B. MRI brain
C. Lumbar puncture immediately
D. EEG
Correct answer: A. Non-contrast CT head — This rules out intracranial
hemorrhage before performing a lumbar puncture.
8. A 30-year-old woman presents with weight gain, cold intolerance,
and constipation. Lab tests show elevated TSH and low free T4. What
is the most likely diagnosis?
A. Hyperthyroidism
B. Hypothyroidism
C. Subclinical hyperthyroidism
D. Thyroid storm
Correct answer: B. Hypothyroidism — Elevated TSH and low free T4 are
diagnostic of primary hypothyroidism.
9. Which of the following vaccines is recommended annually for all
adults?
A. Tdap
B. Influenza
C. Hepatitis B
D. Pneumococcal
Correct answer: B. Influenza — Annual influenza vaccination is
recommended for all adults.
10. A 70-year-old man has sudden onset confusion, right-sided
weakness, and slurred speech. CT scan shows a hypodense area in the
QUESTIONS AND VERIFIED ANSWERS 2026 Q&A
|INSTANT DOWNLOAD PDF
1. A 65-year-old man presents with fatigue and pallor. His hemoglobin
is 8 g/dL, MCV is 72 fL, and ferritin is low. What is the most likely
cause?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Anemia of chronic disease
D. Thalassemia
Correct answer: B. Iron deficiency anemia — The patient has microcytic
anemia (low MCV) with low ferritin, consistent with iron deficiency.
2. A 55-year-old woman has sudden onset chest pain radiating to her
left arm. ECG shows ST elevation in leads II, III, and aVF. What is the
next best step?
A. Administer aspirin and anticoagulation, then urgent PCI
B. Start thrombolytics at home
C. Schedule outpatient stress test
D. Begin beta-blockers only
Correct answer: A. Administer aspirin and anticoagulation, then urgent
PCI — ST elevation in inferior leads indicates STEMI; urgent reperfusion
therapy is indicated.
3. Which of the following medications is first-line for chronic
management of heart failure with reduced ejection fraction (HFrEF)?
A. Calcium channel blockers
B. ACE inhibitors
C. Thiazide diuretics
,D. Digoxin
Correct answer: B. ACE inhibitors — ACE inhibitors reduce morbidity and
mortality in HFrEF and are recommended as first-line therapy.
4. A 45-year-old man presents with sudden onset of unilateral,
painless vision loss. Fundoscopy shows a pale retina with a cherry-red
spot. What is the most likely diagnosis?
A. Central retinal artery occlusion
B. Retinal detachment
C. Acute glaucoma
D. Optic neuritis
Correct answer: A. Central retinal artery occlusion — The cherry-red
spot is classic for CRAO.
5. Which of the following is the preferred initial test for suspected
pulmonary embolism in a hemodynamically stable patient?
A. Ventilation-perfusion scan
B. Chest X-ray
C. CT pulmonary angiography
D. MRI of the chest
Correct answer: C. CT pulmonary angiography — CTA is the imaging
modality of choice for suspected PE in stable patients.
6. A 60-year-old patient has type 2 diabetes with persistent
proteinuria. Which medication class is most beneficial in slowing
progression of diabetic nephropathy?
A. Beta-blockers
B. ACE inhibitors or ARBs
C. Calcium channel blockers
D. Loop diuretics
Correct answer: B. ACE inhibitors or ARBs — These reduce
, intraglomerular pressure and slow the progression of diabetic
nephropathy.
7. A patient presents with sudden severe headache, neck stiffness,
and photophobia. The best initial diagnostic test is:
A. Non-contrast CT head
B. MRI brain
C. Lumbar puncture immediately
D. EEG
Correct answer: A. Non-contrast CT head — This rules out intracranial
hemorrhage before performing a lumbar puncture.
8. A 30-year-old woman presents with weight gain, cold intolerance,
and constipation. Lab tests show elevated TSH and low free T4. What
is the most likely diagnosis?
A. Hyperthyroidism
B. Hypothyroidism
C. Subclinical hyperthyroidism
D. Thyroid storm
Correct answer: B. Hypothyroidism — Elevated TSH and low free T4 are
diagnostic of primary hypothyroidism.
9. Which of the following vaccines is recommended annually for all
adults?
A. Tdap
B. Influenza
C. Hepatitis B
D. Pneumococcal
Correct answer: B. Influenza — Annual influenza vaccination is
recommended for all adults.
10. A 70-year-old man has sudden onset confusion, right-sided
weakness, and slurred speech. CT scan shows a hypodense area in the
