INTERNAL MEDICINE PRACTICE EXAM 2026: 100+
HIGH-YIELD QUESTIONS AND 100% VERIFIED
ANSWERS | GRADED A+ | GUARANTEED PASS!!
A woman presents to the clinic complaining of pedal edema. Which of the
following would be most suggestive of congestive heart failure as the likely
etiology?
A. History of bulimia nervosa
B. History of chronic renal insufficiency
C. History of diabetes mellitus
D. History of inflammatory bowel disease
- answer-C. History of diabetes mellitus
An 80-year-old woman with a 36-pack-year history of smoking tobacco presents
with a chief complaint of increasing dyspnea on exertion over the past six months.
Physical exam reveals clubbed digits and bilateral lower lung crackles. Computed
tomography shows honeycombing of the lung parenchyma. What is the most likely
diagnosis?
A. Bronchiectasis
B. Chronic obstructive pulmonary disease
C. Idiopathic pulmonary fibrosis
D. Sarcoidosis
- answer-C. Idiopathic pulmonary fibrosis
An otherwise healthy 20-year-old man suddenly collapses and dies while playing
intramural basketball. The patient's brother died two years ago while playing
soccer. Which of the following is the most likely diagnosis?
A. Dilated cardiomyopathy
B. Hypertrophic cardiomyopathy
C. Restrictive cardiomyopathy
D. Takotsubo cardiomyopathy
- answer-B. Hypertrophic cardiomyopathy
Patient will be a young athlete
,Complaining of dyspnea on exertion (most common presenting symptom)
PE will show harsh crescendo-decrescendo systolic murmur which increases in
intensity with Valsalva maneuver and decreases with squatting
Diagnosis is made by echocardiography
Most commonly caused by an autosomal dominant genetic defect
Treatment is refraining from vigorous physical activity, beta-blockers or calcium
channel blockers
Comments: Most common cause of sudden death in young athletes
An otherwise healthy 24-year-old woman presents with a cough. The cough is
productive of white to yellow sputum and has been present for the last three weeks.
She states that it began with a fever, sinus pressure, and fatigue, but those
symptoms have since resolved. She has never had similar symptoms in the past.
Her vital signs are all within normal limits. Lung auscultation is clear bilaterally,
although deep breaths induce coughing. What is the most likely diagnosis?
A. Acute bronchitis
B. Asthma
C. Chronic bronchitis
D. Community-acquired pneumonia
- answer-A. Acute bronchitis
n the treatment of Alzheimer disease, which of the following pharmacologic
treatment options is found to be neuroprotective?
A. Donepezil
B. Memantine
C. Selegiline
D. Vitamin E
- answer-B. Memantine
Sildenafil is prescribed for an otherwise healthy 54-year-old man who is diagnosed
with erectile dysfunction. Which of the following is a potential adverse effect of
this medication?
A. Constipation
B. Cyanopsia
C. Prostate specific antigen elevation
,D. Urinary retention
- answer-B. Cyanopsia
Cyanopsia, or blue discoloration of vision, is a potential side effect of sildenafil.
The effect may be more likely with higher dosages of medication and is usually
temporary. Sildenafil inhibits phosphodiesterase type five (PDE-5), thereby
increasing nitric oxide levels and cyclic guanosine monophosphate, which results
in smooth muscle relaxation.
The serum creatine kinase-MB peaks after an acute myocardial infarction in which
of the following time frames?
A. 16-24 hours
B. 48-72 hours
C. 4-6 hours
D. 8-12 hours
- answer-A. 16-24 hours
Cardiac Biomarkers
Troponin-Highest sensitivity and specificity
Time detectable from onset: 3-12 hoursPeak: 24-48 hours
Return to baseline: 5-14 days
CK-MB
Time detectable from onset: 3-12 hours
Peak: 24 hours
Return to baseline: 48-72 hrs
Useful for dx of reinfarction
Myoglobin-First to appear, first to peak, first to declineLacks specificity
What is the most common presenting symptom of bladder carcinoma?
A. Nocturia
B. Painless hematuria
C. Unintentional weight loss
D. Urinary frequency
- answer-B. Painless hematuria
The primary modality to diagnose bladder cancer is with cystoscopy, which allows
for direct visualization of tissues and biopsy of any abnormalities.
Smoking is the most important risk factor of bladder cancer.
, What is the treatment of choice for an otherwise healthy patient with a confirmed
diagnosis of acute idiopathic pericarditis?
A. Antiviral therapy
B. Glucocorticoids
C. NSAIDs
D. Pericardiocentesis
- answer-C. NSAIDs
Pericarditis
Patient will be complaining of pleuritic chest pain radiating to the back that is
worse when lying back and improved when leaning forward
PE will show tachycardia and pericardial friction rub
ECG will show PR depression, PR elevation (aVR), diffuse ST-segment elevation
(concave)
A 17-year-old woman with a history of severe menorrhagia was admitted for a
blood transfusion after fainting at school. Her history is positive for fatigue,
exertional dyspnea, and increased cravings for ice over the past several weeks.
Laboratory findings show hemoglobin 6 g/dL, hematocrit 22%, mean corpuscular
volume 72 fL, total serum iron 23 mcg/dL, and total iron binding capacity 92
micromol/L. The patient was found to have conjunctival pallor and koilonychia on
physical examination. What additional physical exam finding would you expect to
find?
A. Facial plethora
B. Jaundice
C. Loss of tongue papillae
D. Petechiae
- answer-C. Loss of tongue papillae
Loss of tongue papillae or atrophic glossitis is seen in patients with iron deficiency
anemia. Iron deficiency anemia is common in women of reproductive age and
children.
HIGH-YIELD QUESTIONS AND 100% VERIFIED
ANSWERS | GRADED A+ | GUARANTEED PASS!!
A woman presents to the clinic complaining of pedal edema. Which of the
following would be most suggestive of congestive heart failure as the likely
etiology?
A. History of bulimia nervosa
B. History of chronic renal insufficiency
C. History of diabetes mellitus
D. History of inflammatory bowel disease
- answer-C. History of diabetes mellitus
An 80-year-old woman with a 36-pack-year history of smoking tobacco presents
with a chief complaint of increasing dyspnea on exertion over the past six months.
Physical exam reveals clubbed digits and bilateral lower lung crackles. Computed
tomography shows honeycombing of the lung parenchyma. What is the most likely
diagnosis?
A. Bronchiectasis
B. Chronic obstructive pulmonary disease
C. Idiopathic pulmonary fibrosis
D. Sarcoidosis
- answer-C. Idiopathic pulmonary fibrosis
An otherwise healthy 20-year-old man suddenly collapses and dies while playing
intramural basketball. The patient's brother died two years ago while playing
soccer. Which of the following is the most likely diagnosis?
A. Dilated cardiomyopathy
B. Hypertrophic cardiomyopathy
C. Restrictive cardiomyopathy
D. Takotsubo cardiomyopathy
- answer-B. Hypertrophic cardiomyopathy
Patient will be a young athlete
,Complaining of dyspnea on exertion (most common presenting symptom)
PE will show harsh crescendo-decrescendo systolic murmur which increases in
intensity with Valsalva maneuver and decreases with squatting
Diagnosis is made by echocardiography
Most commonly caused by an autosomal dominant genetic defect
Treatment is refraining from vigorous physical activity, beta-blockers or calcium
channel blockers
Comments: Most common cause of sudden death in young athletes
An otherwise healthy 24-year-old woman presents with a cough. The cough is
productive of white to yellow sputum and has been present for the last three weeks.
She states that it began with a fever, sinus pressure, and fatigue, but those
symptoms have since resolved. She has never had similar symptoms in the past.
Her vital signs are all within normal limits. Lung auscultation is clear bilaterally,
although deep breaths induce coughing. What is the most likely diagnosis?
A. Acute bronchitis
B. Asthma
C. Chronic bronchitis
D. Community-acquired pneumonia
- answer-A. Acute bronchitis
n the treatment of Alzheimer disease, which of the following pharmacologic
treatment options is found to be neuroprotective?
A. Donepezil
B. Memantine
C. Selegiline
D. Vitamin E
- answer-B. Memantine
Sildenafil is prescribed for an otherwise healthy 54-year-old man who is diagnosed
with erectile dysfunction. Which of the following is a potential adverse effect of
this medication?
A. Constipation
B. Cyanopsia
C. Prostate specific antigen elevation
,D. Urinary retention
- answer-B. Cyanopsia
Cyanopsia, or blue discoloration of vision, is a potential side effect of sildenafil.
The effect may be more likely with higher dosages of medication and is usually
temporary. Sildenafil inhibits phosphodiesterase type five (PDE-5), thereby
increasing nitric oxide levels and cyclic guanosine monophosphate, which results
in smooth muscle relaxation.
The serum creatine kinase-MB peaks after an acute myocardial infarction in which
of the following time frames?
A. 16-24 hours
B. 48-72 hours
C. 4-6 hours
D. 8-12 hours
- answer-A. 16-24 hours
Cardiac Biomarkers
Troponin-Highest sensitivity and specificity
Time detectable from onset: 3-12 hoursPeak: 24-48 hours
Return to baseline: 5-14 days
CK-MB
Time detectable from onset: 3-12 hours
Peak: 24 hours
Return to baseline: 48-72 hrs
Useful for dx of reinfarction
Myoglobin-First to appear, first to peak, first to declineLacks specificity
What is the most common presenting symptom of bladder carcinoma?
A. Nocturia
B. Painless hematuria
C. Unintentional weight loss
D. Urinary frequency
- answer-B. Painless hematuria
The primary modality to diagnose bladder cancer is with cystoscopy, which allows
for direct visualization of tissues and biopsy of any abnormalities.
Smoking is the most important risk factor of bladder cancer.
, What is the treatment of choice for an otherwise healthy patient with a confirmed
diagnosis of acute idiopathic pericarditis?
A. Antiviral therapy
B. Glucocorticoids
C. NSAIDs
D. Pericardiocentesis
- answer-C. NSAIDs
Pericarditis
Patient will be complaining of pleuritic chest pain radiating to the back that is
worse when lying back and improved when leaning forward
PE will show tachycardia and pericardial friction rub
ECG will show PR depression, PR elevation (aVR), diffuse ST-segment elevation
(concave)
A 17-year-old woman with a history of severe menorrhagia was admitted for a
blood transfusion after fainting at school. Her history is positive for fatigue,
exertional dyspnea, and increased cravings for ice over the past several weeks.
Laboratory findings show hemoglobin 6 g/dL, hematocrit 22%, mean corpuscular
volume 72 fL, total serum iron 23 mcg/dL, and total iron binding capacity 92
micromol/L. The patient was found to have conjunctival pallor and koilonychia on
physical examination. What additional physical exam finding would you expect to
find?
A. Facial plethora
B. Jaundice
C. Loss of tongue papillae
D. Petechiae
- answer-C. Loss of tongue papillae
Loss of tongue papillae or atrophic glossitis is seen in patients with iron deficiency
anemia. Iron deficiency anemia is common in women of reproductive age and
children.
