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INTERNAL MEDICINE EXAM 2026: 500+ Comprehensive Board-Style Q&A for ABIM & Clinical Rotations

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Dominate Your Internal Medicine Exam with This Comprehensive 500+ Question Test Bank for 2026! Stop scrambling through scattered notes and start mastering the entire internal medicine curriculum with this ultimate exam preparation resource. This document is a comprehensive test bank featuring 500+ board-style clinical vignettes and questions, all with 100% verified answers, covering every major subspecialty you will encounter on your Internal Medicine exam. This isn't just a study guide; it's a complete exam simulator designed to test your diagnostic reasoning, treatment selection, and clinical knowledge across all core internal medicine topics. Inside, you will master the "must-know" topics, including: Gastroenterology (100+ Questions): H. pylori eradication, PUD complications (bleeding, perforation, penetration, pyloric stenosis), GERD (Los Angeles classification, Barrett's esophagus), IBD (UC vs. Crohn's), chronic pancreatitis, cirrhosis, hepatitis (B, C, autoimmune), and celiac disease. Pulmonology (100+ Questions): Community-acquired pneumonia (CAP), COPD (GOLD staging), bronchial asthma (mild/moderate/severe), bronchiectasis, lung abscess, pleurisy, exudative pleuritis, pneumothorax, and lung cancer. Cardiology (100+ Questions): Angina pectoris (stable, unstable, Prinzmetal), acute myocardial infarction (STEMI vs. NSTEMI, localization by ECG), heart failure (NYHA classification), valvular heart disease, hypertensive emergencies, and cardiogenic shock. Endocrinology (80+ Questions): Diabetes mellitus (type 1 vs. type 2, DKA, hypoglycemic coma, hyperosmolar coma), thyroid disorders (Graves' disease, hypothyroidism, thyroiditis, thyroid nodules), Cushing's disease, Addison's disease, pheochromocytoma, and hyperaldosteronism. Hematology (50+ Questions): Iron deficiency anemia, B12 deficiency anemia, hemolytic anemia, acute leukemia, chronic leukemia (CLL, CML), lymphoma (Hodgkin's vs. non-Hodgkin's), ITP, and hemophilia. Nephrology (30+ Questions): Glomerulonephritis, pyelonephritis, nephrotic syndrome, polyuria/oliguria, and diabetic nephropathy. This document is your ultimate review tool for the Internal Medicine Exam 2026. Whether you are a medical student on clinical rotations, a resident preparing for the ITE, or a physician studying for board certification, this comprehensive test bank will sharpen your clinical knowledge and boost your confidence. Everything is 100% verified and guaranteed to help you pass.

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1.Patient K., 29 years old. During the week he underwent outpatient treatment for Hp-
associated gastritis with increased secretory function of the stomach (triple scheme).
Which of the following studies is indicated to monitor the effectiveness of eradication
therapy?

*C13 urease breath test
Detection of antibodies to H.pylori in the blood
Rapid urease test (CLO)
Histological method of detecting H. pylori
Culture method of detecting H. pylori

2.In a 45-year-old patient with megaloblastic anemia, morphological examination
revealed diffuse atrophic areas in the fundal part of the stomach. What is the leading
mechanism of development of this disease?

*Autoimmune (antibodies to parietal cells)
Infection H. pylori
Radiation damage
Chemical damage
Usage of NSAIDs

3.Specify the most informative method for confirmation the diagnosis of nonspecific
ulcerative colitis:

Microbiological stool analysis
Coprogram
* Colonoscopy with biopsy
The fecal occult blood test
Ultrasound of the abdominal cavity

4.The 29-year-old patient complained of cramping abdominal pain, frequent liquid stools
with blood and mucus, and fever up to 37.7 C. At colonoscopy: the mucosa of the
sigmoid colon is swollen, multiple erosions and ulcers up to 2-3 mm in diameter,
contact bleeding. What is the preliminary diagnosis?

*Nonspecific ulcerative colitis
Amoebiasis
Shigellosis
Colon cancer
Celiac disease

5.The patient, 19 years old, complains of diarrhea, weakness, weight loss. The patient's
condition is worsening after eating of pasta, cakes. These signs are observed from early
childhood. What is necessary to determine for diagnosis completion?

. IgM
. IgA
. IgG
. IgE, IgM
*. Anti-gliadin IgA

6.A 44-year-old patient after 3 months of treatment in a hospital due to active

,tuberculosis developed lethargy, jaundice, dull pain in the right hypochondrium. The liver
is enlarged, painful in palpation. Total bilirubin – 122 μm/L (8.5-20.5 μm/L), direct
bilirubin – 82 μm/L (up to 5.1 μm/L), ALT - 3.5 mmol/L*h (0.1-0.68 mmol/L*h), alkaline
phosphatase - 826 IU/L (98-279 IU/L). Markers of HBV and HCV are negative. What
disease is it?

. Acute viral hepatitis
. Chronic cholangitis
. Alcoholic liver disease
*Drug-induced hepatitis
. Chronic calculous cholecystitis

7.The patient is 36 years old with chronic viral hepatitis C for 7 years. The condition has
worsened over the past 6 months. He lost 10 kg, complains of skin itch. Objectively:
there are yellow color of the skin, "vascular starlets", ascites, hepatosplenomegaly.
Which syndrome is associated with skin itch in patient?

*Cholestasis
Hypersplenism
Edema-ascitic syndrome
Portal hypertension
Hepatocellular insufficiency

8.What set of biochemical tests indicates the presence of cholestasis?

* Increased activity of alkaline phosphatase, gamma-glutamyltransferase, conjugated
bilirubin
Decreased prothrombin level
Increased ferritin level
Increased level of indirect bilirubin
Increased activity of blood aminotransferases

9.Which virus is the most common cause of chronic hepatitis?

Viral Hepatitis A
*Viral Hepatitis C
Herpes virus
Human immunodeficiency virus
SARS-CoV-2

10.A 36-year-old woman applied to the family doctor with complaints of unpleasant
sensations during rough food, heartburn and acid regurgitation during the year. Upper
endoscopy result: erosive GERD, esophagitis degree B. Which of the listed drugs is the
most expedient to prescribe?

Mebeverine
Domperidone
* Esomeprazole
Azithromycin
Pancreatin

11.Choose the correct combination of drugs for first-line therapy in a patient with

,H.pylori-associated peptic ulcer.

Lansoprazole, metronidazole, ursodeoxycholic acid
Omeprazole, almagel, ranitidine
* Rabeprazole, amoxicillin, clarithromycin
De-nol, pantoprazole, almagel
Clopidogrel, fondaparinux, rosuvastatin

12.In a patient with peptic ulcer, first-line eradication therapy was ineffective. The
second line therapy was prescribed. The classic second-line antihelicobacter therapy
includes the following drugs?

Ranitidine, Levofloxacin, Amoxicillin, Almagel
Bismuth subcitrate, Omeprazole, Biseptol, Clarithromycin
*Omeprazole, Metronidazole, Tetracycline, Bismuth Subcitrate
Famotidine, Norfloxacin, Gentamicin, Almagel
Ranitidine, Bismuth subcitrate, Azithromycin, Meropenem

13.In a patient with cirrhosis of the liver, a general blood test revealed a decrease in the
level of RBC, WBC and platelets. What syndrome it testifies?

Cytolytic
* Hypersplenism
Cholestatic
Hepatic encephalopathy
Intoxication

14.What is the basis for the diagnosis of chronic gastritis?

Complex of clinical data
X-ray examination of the stomach
* Histological examination of a gastric mucosa biopsy
Investigation of the gastric secretory function
Endoscopic examination of the stomach

15.Which research method is crucial for the diagnosis of calculous cholecystitis?

Duodenal sounding
* Ultrasound of the abdominal cavity
Cholecystography
X-ray of the stomach
Retrograde pancreatocholangiography

16.What enzyme activity is increased at cytolytic syndrome?

Nucleopeptidase
Alkaline phosphatase
Amylases
Sour phosphatase
*Alanine aminotransferase

17.What is the best test for evaluation of exocrine function of pancreas?

, Amilase-creatinin coefficient
Coprological test
Activity of trypsin, lipase and amylase in blood serum
Rapid urease test
*Fecal elastase test

18.What is the highly specific enzyme for the pancreas?

Amylase
Lipase
* Elastase
Ribonuclease
Callikrein

19.Epigastric pain, which radiates like a belt indicates the presence in the patient:

Gastritis
Duodenitis
*Pancreatitis
Cholecystitis
Peptic gastric ulcer

20.What is the most common complications of liver cirrhosis?

Mechanical jaundice
*Bleeding from esophageal varices
Chronic heart failure
Chronic renal failure
Spontaneous bacterial peritonitis

21.An early clinical sign of primary biliary cirrhosis is:

Ascites
* Skin itch
Weight lost
Jaundice
Splenomegaly

22.The development of hepatocellular insufficiency indicates:

Increased creatinine in the blood
*Decreased albumin in the blood
Decreased hemoglobin level
Increased level of fibrinogen in the blood
. Increased content of γ-globulin in the blood

23.Functional dyspepsia with postprandial distress syndrome was diagnosed in 24-year-
old woman. From which group of drugs should treatment be started?

Proton pump inhibitors
H2-blockers

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