Page 1 of 172
ABIM Internal Medicine Boards & ITE QUESTIONS AND
VERIFIED ANSWERS WITH RATIONALES JUST RELEASED
ABIM Internal Medicine Boards & ITE – Comprehensive Practice Questions
10 Most Tested Coverage Areas
1. Cardiovascular Medicine - Hypertension, hyperlipidemia, acute coronary syndrome, heart
failure, atrial fibrillation, valvular disease, syncope evaluation
2. Pulmonary Medicine - COPD, asthma, pneumonia, pulmonary embolism, ILD, lung cancer
screening
3. Endocrine and Metabolic Disorders - Diabetes, thyroid disorders, adrenal insufficiency,
osteoporosis, lipid disorders, obesity management
4. Gastroenterology and Hepatology - PUD, GERD, hepatitis, cirrhosis, IBD, pancreatitis, liver
disease coagulopathy
5. Infectious Diseases - CAP, meningitis, HIV/AIDS, tuberculosis, endocarditis, UTIs, tick-borne
illnesses, C. diff
6. Rheumatology and Immunology - RA, SLE, vasculitis, gout, OA, spondyloarthropathies, ANCA-
associated vasculitis, complement deficiencies
7. Nephrology and Acid-Base - AKI, CKD, glomerulonephritis, electrolyte disorders, acid-base
interpretation, RRT, stone disease
8. Hematology and Oncology - Anemia, leukemias, lymphomas, multiple myeloma,
breast/lung/colorectal cancer, thrombocytopenia, coagulopathies
9. Neurology - Stroke, seizures, headache, dementia, Parkinson's, MS, neuropathy, syncope,
vestibular disorders
10. Preventive Medicine and Screening - Cancer screening (breast, cervical, colon, lung),
immunizations, osteoporosis screening, AAA screening, smoking cessation, fall prevention
1. A 67-year-old woman with hypertension and diabetes is evaluated for fatigue. She has no chest
pain or shortness of breath. BMI is 32 kg/m². Blood pressure is 138/82 mm Hg. LDL cholesterol is 118
mg/dL. 10-year ASCVD risk is 18%. Which medication should be added to reduce cardiovascular risk?
A) Aspirin 81 mg daily
B) Atorvastatin 40 mg daily
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C) Metformin 500 mg twice daily
D) Ezetimibe 10 mg daily
Answer: B
Rationale: High-intensity statin therapy is indicated for patients with diabetes and ASCVD risk ≥7.5%.
Atorvastatin 40-80 mg or rosuvastatin 20-40 mg is recommended.
2. A 45-year-old woman with primary dysmenorrhea has not responded to ibuprofen. What is the
next best treatment option?
A) Acetaminophen
B) Combined oral contraceptive pill
C) Naproxen
D) Transcutaneous electrical nerve stimulation
Answer: B
Rationale: NSAIDs like ibuprofen and naproxen are first-line for primary dysmenorrhea. If symptoms
persist or side effects occur, combined oral contraceptives are next-line therapy.
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3. A 72-year-old man with a history of falls asks about fall prevention. He is cognitively intact and lives
independently. Which intervention is most effective?
A) Vitamin D supplementation only
B) Individualized exercise program
C) Hip protectors
D) Home hazard assessment
Answer: B
Rationale: Individualized exercise programs (balance, gait, and strength training) are effective in
preventing falls in cognitively intact, community-dwelling older adults.
4. A 55-year-old woman with a 35-pack-year smoking history presents for routine care. She quit
smoking 5 years ago. What screening is recommended?
A) Annual low-dose CT chest
B) Screening mammography
C) Colonoscopy every 10 years
D) No lung cancer screening
Answer: A
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Rationale: Annual low-dose CT is recommended for adults aged 55-80 with ≥30 pack-year smoking
history, including those who quit within the past 15 years.
5. A 68-year-old man with a 45-pack-year smoking history presents with a new cough and weight loss.
Biopsy shows NSCLC with EGFR exon 19 deletion. What is the preferred first-line therapy?
A) Erlotinib
B) Carboplatin and paclitaxel
C) Pembrolizumab
D) Radiation therapy
Answer: A
Rationale: EGFR tyrosine kinase inhibitors (erlotinib, afatinib, osimertinib) are first-line for NSCLC with
EGFR mutations. Osimertinib is now preferred.
6. A 28-year-old woman with BMI 42 kg/m² and hypertension is being evaluated for bariatric surgery.
She has no other comorbidities. What is the minimum BMI requirement?
A) 30 kg/m²
B) 35 kg/m²
ABIM Internal Medicine Boards & ITE QUESTIONS AND
VERIFIED ANSWERS WITH RATIONALES JUST RELEASED
ABIM Internal Medicine Boards & ITE – Comprehensive Practice Questions
10 Most Tested Coverage Areas
1. Cardiovascular Medicine - Hypertension, hyperlipidemia, acute coronary syndrome, heart
failure, atrial fibrillation, valvular disease, syncope evaluation
2. Pulmonary Medicine - COPD, asthma, pneumonia, pulmonary embolism, ILD, lung cancer
screening
3. Endocrine and Metabolic Disorders - Diabetes, thyroid disorders, adrenal insufficiency,
osteoporosis, lipid disorders, obesity management
4. Gastroenterology and Hepatology - PUD, GERD, hepatitis, cirrhosis, IBD, pancreatitis, liver
disease coagulopathy
5. Infectious Diseases - CAP, meningitis, HIV/AIDS, tuberculosis, endocarditis, UTIs, tick-borne
illnesses, C. diff
6. Rheumatology and Immunology - RA, SLE, vasculitis, gout, OA, spondyloarthropathies, ANCA-
associated vasculitis, complement deficiencies
7. Nephrology and Acid-Base - AKI, CKD, glomerulonephritis, electrolyte disorders, acid-base
interpretation, RRT, stone disease
8. Hematology and Oncology - Anemia, leukemias, lymphomas, multiple myeloma,
breast/lung/colorectal cancer, thrombocytopenia, coagulopathies
9. Neurology - Stroke, seizures, headache, dementia, Parkinson's, MS, neuropathy, syncope,
vestibular disorders
10. Preventive Medicine and Screening - Cancer screening (breast, cervical, colon, lung),
immunizations, osteoporosis screening, AAA screening, smoking cessation, fall prevention
1. A 67-year-old woman with hypertension and diabetes is evaluated for fatigue. She has no chest
pain or shortness of breath. BMI is 32 kg/m². Blood pressure is 138/82 mm Hg. LDL cholesterol is 118
mg/dL. 10-year ASCVD risk is 18%. Which medication should be added to reduce cardiovascular risk?
A) Aspirin 81 mg daily
B) Atorvastatin 40 mg daily
, Page 2 of 172
C) Metformin 500 mg twice daily
D) Ezetimibe 10 mg daily
Answer: B
Rationale: High-intensity statin therapy is indicated for patients with diabetes and ASCVD risk ≥7.5%.
Atorvastatin 40-80 mg or rosuvastatin 20-40 mg is recommended.
2. A 45-year-old woman with primary dysmenorrhea has not responded to ibuprofen. What is the
next best treatment option?
A) Acetaminophen
B) Combined oral contraceptive pill
C) Naproxen
D) Transcutaneous electrical nerve stimulation
Answer: B
Rationale: NSAIDs like ibuprofen and naproxen are first-line for primary dysmenorrhea. If symptoms
persist or side effects occur, combined oral contraceptives are next-line therapy.
, Page 3 of 172
3. A 72-year-old man with a history of falls asks about fall prevention. He is cognitively intact and lives
independently. Which intervention is most effective?
A) Vitamin D supplementation only
B) Individualized exercise program
C) Hip protectors
D) Home hazard assessment
Answer: B
Rationale: Individualized exercise programs (balance, gait, and strength training) are effective in
preventing falls in cognitively intact, community-dwelling older adults.
4. A 55-year-old woman with a 35-pack-year smoking history presents for routine care. She quit
smoking 5 years ago. What screening is recommended?
A) Annual low-dose CT chest
B) Screening mammography
C) Colonoscopy every 10 years
D) No lung cancer screening
Answer: A
, Page 4 of 172
Rationale: Annual low-dose CT is recommended for adults aged 55-80 with ≥30 pack-year smoking
history, including those who quit within the past 15 years.
5. A 68-year-old man with a 45-pack-year smoking history presents with a new cough and weight loss.
Biopsy shows NSCLC with EGFR exon 19 deletion. What is the preferred first-line therapy?
A) Erlotinib
B) Carboplatin and paclitaxel
C) Pembrolizumab
D) Radiation therapy
Answer: A
Rationale: EGFR tyrosine kinase inhibitors (erlotinib, afatinib, osimertinib) are first-line for NSCLC with
EGFR mutations. Osimertinib is now preferred.
6. A 28-year-old woman with BMI 42 kg/m² and hypertension is being evaluated for bariatric surgery.
She has no other comorbidities. What is the minimum BMI requirement?
A) 30 kg/m²
B) 35 kg/m²
