INTERNAL MEDICINE COMAT REVIEW
LATEST 2026 ALL STUDY QUESTIONS
WITH CORRECT SOLUTIONS
GUARANTEED PASS | RATED A+
,INTERNAL MEDICINE COMAT REVIEW LATEST 2026
ALL STUDY QUESTIONS WITH CORRECT
SOLUTIONS GUARANTEED PASS | RATED A+
Enveloped shaped crystals in urinalysis in a patient with renal failure? - Answer>>> Ethylene
glycol intoxication (anion gap metabolic acidosis).
Treat w/dialysis or sodium-bicarb if pH<7.2
Indications for emergent dialysis - Answer>>> A- acidosis
E- electrolyte imbalance (esp if high K>6.5)
I- Intoxication (esp antifreeze, lithium)
Overload of vlume (symptoms of CHF or pulm edema)
U- uremia (pericarditis, altered mental status)
mechanism of reduced BP during normal inspiration - Answer>>> Normally during inspiration,
systolic BP decreases (<10 mmHg) & pulse rate goes up slightly bc inspiration makes intra-
thoracic pressure more negative relative to atmospheric pressure, which increases venous return
so more blood goes into the right side of the heart.
Also, since the intra-thoracic BP becomes more negative (aka decreases), more blood goes into
the compliant pulmonary vasculature & flow is reduced to the left side of the heart.
The slight decrease in left-heart filling during inspiration reduces stroke volume, which
manifests as a decrease in systolic BP...this decreased BP leads to a faster heart rate via the
baroreceptor reflex.
Why can TSH be helpful in diagnosing heart failure - Answer>>> Severe hypothyroidism can
cause CHF.
,Hyperthyroidism can cause high output HF.
A young, healthy patient comes in with chest pain...if it gets worse w/inspiration, better leaning
forwards, friction rub, & diffuse ST elevation, diagnosis= - Answer>>> Pericarditis
A young, healthy patient comes in with chest pain...
if worse w/palpation, diagnosis= - Answer>>> costochondritis
A young, healthy patient comes in with chest pain...if vague w/hx of viral infection & murmur,
diagnosis= - Answer>>> Myocarditis
Medications that have been shown to decrease mortality in systolic heart failure - Answer>>> -
ACE inhibitors
-ARBs (angiotensin receptor blockers)
-Beta blockers
-Aldosterone blockers
-Hydralazine & nitrates
Goal of treating hypertensive urgency - Answer>>> BP reduction of 25% in the first few hours
to day in order to avoid reducing the BP too quickly.
Acute vs chronic treatment of multiple sclerosis - Answer>>> Acute tx= steroids (3 days IV then
4 weeks PO); second line is plasma exchange.
Chronic tx= IFN-beta 1a/b, glatiramer reduces exacerbations.
first best test for a patient presenting w/dysphagia - Answer>>> Barium swallow...next best
test=endoscopy
Test of choice for achalasia - Answer>>> manometry.
What are the most typical types of esophageal carcinoma - Answer>>> Squamous cell in
smoker/drinkers in the middle 1/3
Adenocarcinoma=in ppl w/long standing GERD in distal 1/3.
, Difference in presentation btwn gastric vs duodenal ulcers - Answer>>> Gastric ulcers:
midepigastric pain is worse w/eating.
Duodenal ulcers: midepigastric pain better w/eating.
Treatment of H Pylori - Answer>>> PPI, clarithromycin, & amoxicillin for 2 weeks.
Roth spots - Answer>>> Retinal hemorrhages w/pale centers...usually seen in bacterial
endocarditis
Definition of metabolic syndrome - 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 - 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 - 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 - Answer>>> Risk for DVT
Triad=
1. Stasis
LATEST 2026 ALL STUDY QUESTIONS
WITH CORRECT SOLUTIONS
GUARANTEED PASS | RATED A+
,INTERNAL MEDICINE COMAT REVIEW LATEST 2026
ALL STUDY QUESTIONS WITH CORRECT
SOLUTIONS GUARANTEED PASS | RATED A+
Enveloped shaped crystals in urinalysis in a patient with renal failure? - Answer>>> Ethylene
glycol intoxication (anion gap metabolic acidosis).
Treat w/dialysis or sodium-bicarb if pH<7.2
Indications for emergent dialysis - Answer>>> A- acidosis
E- electrolyte imbalance (esp if high K>6.5)
I- Intoxication (esp antifreeze, lithium)
Overload of vlume (symptoms of CHF or pulm edema)
U- uremia (pericarditis, altered mental status)
mechanism of reduced BP during normal inspiration - Answer>>> Normally during inspiration,
systolic BP decreases (<10 mmHg) & pulse rate goes up slightly bc inspiration makes intra-
thoracic pressure more negative relative to atmospheric pressure, which increases venous return
so more blood goes into the right side of the heart.
Also, since the intra-thoracic BP becomes more negative (aka decreases), more blood goes into
the compliant pulmonary vasculature & flow is reduced to the left side of the heart.
The slight decrease in left-heart filling during inspiration reduces stroke volume, which
manifests as a decrease in systolic BP...this decreased BP leads to a faster heart rate via the
baroreceptor reflex.
Why can TSH be helpful in diagnosing heart failure - Answer>>> Severe hypothyroidism can
cause CHF.
,Hyperthyroidism can cause high output HF.
A young, healthy patient comes in with chest pain...if it gets worse w/inspiration, better leaning
forwards, friction rub, & diffuse ST elevation, diagnosis= - Answer>>> Pericarditis
A young, healthy patient comes in with chest pain...
if worse w/palpation, diagnosis= - Answer>>> costochondritis
A young, healthy patient comes in with chest pain...if vague w/hx of viral infection & murmur,
diagnosis= - Answer>>> Myocarditis
Medications that have been shown to decrease mortality in systolic heart failure - Answer>>> -
ACE inhibitors
-ARBs (angiotensin receptor blockers)
-Beta blockers
-Aldosterone blockers
-Hydralazine & nitrates
Goal of treating hypertensive urgency - Answer>>> BP reduction of 25% in the first few hours
to day in order to avoid reducing the BP too quickly.
Acute vs chronic treatment of multiple sclerosis - Answer>>> Acute tx= steroids (3 days IV then
4 weeks PO); second line is plasma exchange.
Chronic tx= IFN-beta 1a/b, glatiramer reduces exacerbations.
first best test for a patient presenting w/dysphagia - Answer>>> Barium swallow...next best
test=endoscopy
Test of choice for achalasia - Answer>>> manometry.
What are the most typical types of esophageal carcinoma - Answer>>> Squamous cell in
smoker/drinkers in the middle 1/3
Adenocarcinoma=in ppl w/long standing GERD in distal 1/3.
, Difference in presentation btwn gastric vs duodenal ulcers - Answer>>> Gastric ulcers:
midepigastric pain is worse w/eating.
Duodenal ulcers: midepigastric pain better w/eating.
Treatment of H Pylori - Answer>>> PPI, clarithromycin, & amoxicillin for 2 weeks.
Roth spots - Answer>>> Retinal hemorrhages w/pale centers...usually seen in bacterial
endocarditis
Definition of metabolic syndrome - 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 - 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 - 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 - Answer>>> Risk for DVT
Triad=
1. Stasis
