AQUIFER INTERNAL MEDICINE EXAM STUDY GUIDE CASE REVIEW PRACTICE QUESTIONS AND CLINICAL DECISION MAKING

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AQUIFER INTERNAL MEDICINE EXAM STUDY GUIDE CASE REVIEW PRACTICE QUESTIONS AND CLINICAL DECISION MAKING

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Prepare for the Aquifer Internal Medicine Exam and related clerkship assessments with a focused review of high-yield clinical presentations, diagnostic reasoning, and patient management. This resource reinforces the evidence-based, patient-centered approach emphasized across Aquifer Internal Medicine’s 36 interactive virtual patient cases. It reviews data gathering, problem definition, differential diagnosis, test selection, and management decisions commonly assessed through clinical vignettes. The organized format is useful for third-year medical students completing an internal medicine clerkship, as well as other healthcare learners strengthening their clinical reasoning skills. Use it as an independent revision aid alongside your institution’s assigned Aquifer cases, current clinical guidelines, and official course materials.

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AQUIFER INTERNAL MEDICINE EXAM

STUDY GUIDE 2026 2027 CASE REVIEW

PRACTICE QUESTIONS AND CLINICAL

DECISION MAKING

What tests to get on initial evaluation of HTN? In addition to

EKG, electrolytes (4) - CORRECT ANSWERS -diabetes

screening, fasting lipid panel, hematocrit, TSH, urinalysis

When to follow up on BP that is 125/76? - CORRECT

ANSWERS -six months

,What are potential side effects of lisinopril? (6) - CORRECT

ANSWERS -angioedema, cough, fatigue, hyperkalemia,

hypotension, worsening renal insufficiency

What is the goal BP for hypertensive urgency? - CORRECT

ANSWERS -180/90

What is on the differential of hypotension, polyuria, nausea,

vomiting, diarrhea? (5) - CORRECT ANSWERS -acute

hyperglycemia, adrenal insufficiency, gastroenteritis, pregnancy,

urosepsis

What is a classic sign of hyperglycemia in DKA? - CORRECT

ANSWERS -Kussumal breathing

,What is the first step in management of HHS? - CORRECT

ANSWERS -normal saline

In a patient with DKA, when is it safe to start the insulin drip? -

CORRECT ANSWERS -After the patient has had a dose of

long-acting insulin; has had two successive panels showing an

anion gap; when the patient can take food PO

What tests should be checked in a patient with newly diagnosed

T2DM? - CORRECT ANSWERS -fasting lipid panel, A1C,

urine albumin/creatinine ratio

T/F in critically ill medical patients, tight blood sugar control is

associated with lower mortality - CORRECT ANSWERS -

False!

, Which diabetes med is most likely to reduce risk of heart failure or

future cardiovascular event? - CORRECT ANSWERS -SGLT2

inhibitor

Can patients accurately detect hypoglycemia by symptoms alone?

- CORRECT ANSWERS -No

What are the neuropathies a diabetic patient might develop? (5) -

CORRECT ANSWERS -distal symmetric polyneuropathy, ED,

gastroparesis, postural hypotension, resting tachycardia

What is the optimal BP goal for diabetics? - CORRECT

ANSWERS -less than 140/90

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Uploaded on: August 19, 2026
Number of pages: 52
Written in: 2026/2027
Type: Exam (elaborations)
Contains: Questions & answers

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