Page 1 of 168
ABIM ITE Internal Medicine Boards EXAM QUESTIONS
AND VERIFIED ANSWERS WITH RATIONALES JUST
RELEASED
ABIM Internal Medicine Boards & ITE Practice Exam
QUESTION 1
A 48-year-old woman asks about screening mammography. What is the minimum life expectancy
required to benefit from screening mammography?
| ○ A. 3 years |
| ○ B. 5 years |
| ● C. 10 years |
| ○ D. 15 years |
Correct Answer: C
Rationale: A life expectancy of at least 10 years is expected to benefit from screening mammography.
This is a key consideration when deciding whether to initiate screening in older adults or those with
significant comorbidities.
QUESTION 2
, Page 2 of 168
A 32-year-old woman with primary dysmenorrhea has not responded to ibuprofen. What is the most
appropriate next step in management?
| ○ A. Naproxen twice daily |
| ○ B. Acetaminophen as needed |
| ● C. Oral contraceptive pills (OCP) |
| ○ D. Transcutaneous electrical nerve stimulation (TENS) |
Correct Answer: C
Rationale: For primary dysmenorrhea not controlled with NSAIDs, oral contraceptive pills are the next
line of treatment. OCPs reduce prostaglandin production by suppressing ovulation and endometrial
growth.
QUESTION 3
Which intervention has been shown to reduce the risk of pressure ulcers in at-risk patients?
| ○ A. Repositioning every 4 hours |
| ○ B. Egg crate foam mattresses |
| ● C. Advanced static mattresses or overlays |
| ○ D. Massage of bony prominences |
, Page 3 of 168
Correct Answer: C
Rationale: Advanced static mattresses or overlays reduce pressure ulcer risk by redistributing pressure
more effectively than standard mattresses. Repositioning every 2 hours is recommended, not 4 hours.
QUESTION 4
A 67-year-old woman without prior fractures should be screened for osteoporosis with DEXA if she
has which risk factor?
| ○ A. BMI of 28 |
| ○ B. History of smoking |
| ● C. Fracture risk of 9.3% or higher |
| ○ D. Family history of osteoporosis |
Correct Answer: C
Rationale: Women aged 65 and older AND younger women with fracture risk of 9.3% or higher should
be screened for osteoporosis with DEXA. This is based on the USPSTF recommendation using FRAX or
other risk assessment tools.
QUESTION 5
, Page 4 of 168
A 24-year-old woman presents with recurrent episodes of binge eating followed by self-induced
vomiting. Her BMI is 22. What is the most likely diagnosis?
| ○ A. Anorexia nervosa, binge-eating/purging type |
| ● B. Bulimia nervosa |
| ○ C. Binge eating disorder |
| ○ D. Avoidant/restrictive food intake disorder |
Correct Answer: B
Rationale: Bulimia nervosa is characterized by frequent episodes of binge eating (>1/week) followed by
inappropriate compensatory behaviors (vomiting, laxatives, enema) due to fear of gaining weight.
Normal or overweight BMI distinguishes it from anorexia nervosa.
QUESTION 6
A 19-year-old woman has a BMI of 17.2, amenorrhea, and intense fear of gaining weight. What is the
most likely diagnosis?
| ○ A. Bulimia nervosa |
| ● B. Anorexia nervosa |
| ○ C. Avoidant/restrictive food intake disorder |
| ○ D. Major depressive disorder |
ABIM ITE Internal Medicine Boards EXAM QUESTIONS
AND VERIFIED ANSWERS WITH RATIONALES JUST
RELEASED
ABIM Internal Medicine Boards & ITE Practice Exam
QUESTION 1
A 48-year-old woman asks about screening mammography. What is the minimum life expectancy
required to benefit from screening mammography?
| ○ A. 3 years |
| ○ B. 5 years |
| ● C. 10 years |
| ○ D. 15 years |
Correct Answer: C
Rationale: A life expectancy of at least 10 years is expected to benefit from screening mammography.
This is a key consideration when deciding whether to initiate screening in older adults or those with
significant comorbidities.
QUESTION 2
, Page 2 of 168
A 32-year-old woman with primary dysmenorrhea has not responded to ibuprofen. What is the most
appropriate next step in management?
| ○ A. Naproxen twice daily |
| ○ B. Acetaminophen as needed |
| ● C. Oral contraceptive pills (OCP) |
| ○ D. Transcutaneous electrical nerve stimulation (TENS) |
Correct Answer: C
Rationale: For primary dysmenorrhea not controlled with NSAIDs, oral contraceptive pills are the next
line of treatment. OCPs reduce prostaglandin production by suppressing ovulation and endometrial
growth.
QUESTION 3
Which intervention has been shown to reduce the risk of pressure ulcers in at-risk patients?
| ○ A. Repositioning every 4 hours |
| ○ B. Egg crate foam mattresses |
| ● C. Advanced static mattresses or overlays |
| ○ D. Massage of bony prominences |
, Page 3 of 168
Correct Answer: C
Rationale: Advanced static mattresses or overlays reduce pressure ulcer risk by redistributing pressure
more effectively than standard mattresses. Repositioning every 2 hours is recommended, not 4 hours.
QUESTION 4
A 67-year-old woman without prior fractures should be screened for osteoporosis with DEXA if she
has which risk factor?
| ○ A. BMI of 28 |
| ○ B. History of smoking |
| ● C. Fracture risk of 9.3% or higher |
| ○ D. Family history of osteoporosis |
Correct Answer: C
Rationale: Women aged 65 and older AND younger women with fracture risk of 9.3% or higher should
be screened for osteoporosis with DEXA. This is based on the USPSTF recommendation using FRAX or
other risk assessment tools.
QUESTION 5
, Page 4 of 168
A 24-year-old woman presents with recurrent episodes of binge eating followed by self-induced
vomiting. Her BMI is 22. What is the most likely diagnosis?
| ○ A. Anorexia nervosa, binge-eating/purging type |
| ● B. Bulimia nervosa |
| ○ C. Binge eating disorder |
| ○ D. Avoidant/restrictive food intake disorder |
Correct Answer: B
Rationale: Bulimia nervosa is characterized by frequent episodes of binge eating (>1/week) followed by
inappropriate compensatory behaviors (vomiting, laxatives, enema) due to fear of gaining weight.
Normal or overweight BMI distinguishes it from anorexia nervosa.
QUESTION 6
A 19-year-old woman has a BMI of 17.2, amenorrhea, and intense fear of gaining weight. What is the
most likely diagnosis?
| ○ A. Bulimia nervosa |
| ● B. Anorexia nervosa |
| ○ C. Avoidant/restrictive food intake disorder |
| ○ D. Major depressive disorder |
