INTERNAL MEDICINE STUDY GUIDE | INTERNAL MEDICINE PRACTICE QUESTIONS
& ANSWERS | COMPREHENSIVE BOARD REVIEW 2026/2027
Top two causes CRF - ANS ✔✔1. HTN 2. DM
Prominent A Wave - ANS ✔✔Tricuspid Insufficiency
Canon A Wave - ANS ✔✔Heart Block
Soft P2 - ANS ✔✔Pulmonary Stenosis
2 Causes Webbed Neck - ANS ✔✔1. Turner's (coarctation) 2. Noonan's (pulm stenosis)
Signs Constrictive Pericarditis - ANS ✔✔1. X and Y descent 2. Square Root Sign 3. Calcification
Beck's Triad for Cardiac Tamponade - ANS ✔✔1. Distant Heart Sounds 2. Hypotension 3. JVD
MCC HTN young people - ANS ✔✔women: OCPs men: alcohol
Most important cause of chronic glomerulonephritis - ANS ✔✔DM
MC kidney stones - ANS ✔✔1. Calcium oxolate 80% increased urine pH radiopaque 2. Uric Acid 5%
Decreased urine pH Radiolucent 3. Struvite 15% Mg ammonium phosphate Proteus radiopaque
HyperCalcemia Causes - ANS ✔✔VITAMIN TRAPS -Vitamin A and D intox -Immobilization -Thyrotoxicosis
-Addison's/Acidosis -Milk Alkali -Inflammatory disorders -Neoplastic disease -Thiazides -Rhabdo -Aids -
Paget's/Parenteral Nutrition/ParaTH dz -Sarcoid
HyperCalcemia Sx's - ANS ✔✔Bones, Stones, Groans, Moans
RTA with abnormal H+ secretion and kidney stones - ANS ✔✔Type I (distal) RTA
RTA with abnormal HCO3- and rickets - ANS ✔✔Type II (proximal) RTA
RTA with aldosterone defect - ANS ✔✔Type IV (distal) RTA
Hypervolemic Hyponatremia - ANS ✔✔1. Cirrhosis 2. CHF 3. nephritic syndrome
Hyperkalemia EKG - ANS ✔✔Peaked T waves and widened QRS
Hypokalemia EKG - ANS ✔✔T waves flatten; U waves
ARF with FeNa <1% - ANS ✔✔PreRenal
Nephritic Syndrome - ANS ✔✔1. Hematuria 2. HTN 3. Oliguria
, MC nephritic Syndrome - ANS ✔✔Membranous Glomerulonephritis
MC form glomerulonephritis - ANS ✔✔IgA nephropathy (Berger's)
Glomerulonephritis with deafness - ANS ✔✔Alport's
Glomerulonephritis with hemoptysis - ANS ✔✔Wegener's or Goodpasture's
salicylate ingestion - ANS ✔✔anion gap acidosis and primary resp alkalosis due to central resp
stimulation
AntiCentromere Ab's - ANS ✔✔Scleroderma (CREST)
ANA - ANS ✔✔SLE
Antihistone - ANS ✔✔Drug Induced Lupus
Anti IgG - ANS ✔✔Rheumatoid
Antimitochondrial - ANS ✔✔Primary Biliary Cirrhosis
Aschoff Bodies - ANS ✔✔Rheumatic Fever
Mamillary Body Atrophy - ANS ✔✔Wernicke's
BUN : Creatinine Elevation - ANS ✔✔Azotemia Bledding (GI) Catabolic state Diet (high protein, TPN)
A Fib Causes - ANS ✔✔PIRATES Pulmonary: PE, COPD Iatrogenic Rheumatic heart (mitral regurg)
Atherosclerosis: MI, CAD Thyroid(hyper) Endocarditis Sick Sinus
Atherosclerosis RF's - ANS ✔✔SHIFT MAID Smoking/ HTN/ (n)IDDM/ Fam hx/ Triglyerides/ Male/ Age/
Inactivity/ Diet and drinks
RSR' in V1 - ANS ✔✔RBBB
1st degree AV block - ANS ✔✔PR >200msec NO TRX
Second degree AV block Type 1 - ANS ✔✔PR gradually increases until dropped beat/ Caused by drugs
(digoxin, beta blockers, CCBs) or vagal increase, STOP DRUG
Second degree AV block Type II - ANS ✔✔PR doesn't change, unexpected dropped beat PACER!
MCC 2* dilated cardiomyopathy - ANS ✔✔1. ischemia 2. Long standing HTN
S3 gallop - ANS ✔✔dilated cardiomyopathy
S4 - ANS ✔✔stiff ventricle "atrial kick" maybe hypertrophic cardiomyopathy
& ANSWERS | COMPREHENSIVE BOARD REVIEW 2026/2027
Top two causes CRF - ANS ✔✔1. HTN 2. DM
Prominent A Wave - ANS ✔✔Tricuspid Insufficiency
Canon A Wave - ANS ✔✔Heart Block
Soft P2 - ANS ✔✔Pulmonary Stenosis
2 Causes Webbed Neck - ANS ✔✔1. Turner's (coarctation) 2. Noonan's (pulm stenosis)
Signs Constrictive Pericarditis - ANS ✔✔1. X and Y descent 2. Square Root Sign 3. Calcification
Beck's Triad for Cardiac Tamponade - ANS ✔✔1. Distant Heart Sounds 2. Hypotension 3. JVD
MCC HTN young people - ANS ✔✔women: OCPs men: alcohol
Most important cause of chronic glomerulonephritis - ANS ✔✔DM
MC kidney stones - ANS ✔✔1. Calcium oxolate 80% increased urine pH radiopaque 2. Uric Acid 5%
Decreased urine pH Radiolucent 3. Struvite 15% Mg ammonium phosphate Proteus radiopaque
HyperCalcemia Causes - ANS ✔✔VITAMIN TRAPS -Vitamin A and D intox -Immobilization -Thyrotoxicosis
-Addison's/Acidosis -Milk Alkali -Inflammatory disorders -Neoplastic disease -Thiazides -Rhabdo -Aids -
Paget's/Parenteral Nutrition/ParaTH dz -Sarcoid
HyperCalcemia Sx's - ANS ✔✔Bones, Stones, Groans, Moans
RTA with abnormal H+ secretion and kidney stones - ANS ✔✔Type I (distal) RTA
RTA with abnormal HCO3- and rickets - ANS ✔✔Type II (proximal) RTA
RTA with aldosterone defect - ANS ✔✔Type IV (distal) RTA
Hypervolemic Hyponatremia - ANS ✔✔1. Cirrhosis 2. CHF 3. nephritic syndrome
Hyperkalemia EKG - ANS ✔✔Peaked T waves and widened QRS
Hypokalemia EKG - ANS ✔✔T waves flatten; U waves
ARF with FeNa <1% - ANS ✔✔PreRenal
Nephritic Syndrome - ANS ✔✔1. Hematuria 2. HTN 3. Oliguria
, MC nephritic Syndrome - ANS ✔✔Membranous Glomerulonephritis
MC form glomerulonephritis - ANS ✔✔IgA nephropathy (Berger's)
Glomerulonephritis with deafness - ANS ✔✔Alport's
Glomerulonephritis with hemoptysis - ANS ✔✔Wegener's or Goodpasture's
salicylate ingestion - ANS ✔✔anion gap acidosis and primary resp alkalosis due to central resp
stimulation
AntiCentromere Ab's - ANS ✔✔Scleroderma (CREST)
ANA - ANS ✔✔SLE
Antihistone - ANS ✔✔Drug Induced Lupus
Anti IgG - ANS ✔✔Rheumatoid
Antimitochondrial - ANS ✔✔Primary Biliary Cirrhosis
Aschoff Bodies - ANS ✔✔Rheumatic Fever
Mamillary Body Atrophy - ANS ✔✔Wernicke's
BUN : Creatinine Elevation - ANS ✔✔Azotemia Bledding (GI) Catabolic state Diet (high protein, TPN)
A Fib Causes - ANS ✔✔PIRATES Pulmonary: PE, COPD Iatrogenic Rheumatic heart (mitral regurg)
Atherosclerosis: MI, CAD Thyroid(hyper) Endocarditis Sick Sinus
Atherosclerosis RF's - ANS ✔✔SHIFT MAID Smoking/ HTN/ (n)IDDM/ Fam hx/ Triglyerides/ Male/ Age/
Inactivity/ Diet and drinks
RSR' in V1 - ANS ✔✔RBBB
1st degree AV block - ANS ✔✔PR >200msec NO TRX
Second degree AV block Type 1 - ANS ✔✔PR gradually increases until dropped beat/ Caused by drugs
(digoxin, beta blockers, CCBs) or vagal increase, STOP DRUG
Second degree AV block Type II - ANS ✔✔PR doesn't change, unexpected dropped beat PACER!
MCC 2* dilated cardiomyopathy - ANS ✔✔1. ischemia 2. Long standing HTN
S3 gallop - ANS ✔✔dilated cardiomyopathy
S4 - ANS ✔✔stiff ventricle "atrial kick" maybe hypertrophic cardiomyopathy
