INTERNAL MEDICINE EOR TEST PAPER QUESTIONS AND
ANSWERS 2025/2026 ALL RATED A+
✔✔Reidel thyroiditis tx - ✔✔Tamoxifen 20mg po bid x years
✔✔Cushings screen - ✔✔Dexamethasone 1mg at 11pm. Should suppress cortisol. If
cortisol <5mcg then no cushings.
OR Midnight salivary cortisol level
✔✔Addison disease tx - ✔✔Hydrocortisone 15-30mg po 2/3 in AM 1/3 in PM
✔✔Adrenal crisis dx - ✔✔Cosyntropin stim test 0.25mg IM, cortisol 30-60min post
should be 20mcg/dL
✔✔Contrast dye can cause lethal rxn - ✔✔Pheochromocytoma
✔✔Pheochromocytoma tx - ✔✔Phenoxybenzamine, nifedipine or metoprolol; surgery is
definitive
✔✔Diabetes Insipidus sx - ✔✔ADH deficiency = polyuria and polydipsia
✔✔Diabetes Insipidus dx - ✔✔Vasopressin challenge: Measure urine quantity 12 hours
pre & post admin of Desmopressin 0.05-0.1mL
✔✔Diabetes Insipidus tx - ✔✔Desmopressin 0.5mg po bid for central
HCTZ & K+ if nephrogenic
✔✔Acromegaly dx - ✔✔Admin 75g oral glucose, should suppress GH to <1ng/mL
MRI shows pituitary adenoma
✔✔Acromegaly tx - ✔✔Pituitary surgery
If fails - Dopamine agonist 1mg po 2 x week or Octreotide 20-40 sc qmonth
✔✔Hypocalcemia on EKG - ✔✔prolonged QT
✔✔Hypercalcemia on EKG - ✔✔shortened QT
✔✔Hypercalcemia dx - ✔✔Check PTH to see if hyperparathyroidism or malignancy
✔✔Sodium deficit formula - ✔✔TBW x (Desired Na - Actual Na)
TBW= women 50%; men 55%
, ✔✔Paget's disease - ✔✔A fairly common metabolic disease of the bone from unknown
causes. It usually attacks middle-aged and elderly people and is characterized by bone
destruction and deformity.
✔✔Paget's disease tx - ✔✔bisphosphonates cyclically
✔✔BPH tx - ✔✔alpha blocker: Praxosin, Tamsulosin
5-alpha reductase: finasteride
Tx if symptom is >7
✔✔Hydrocele - ✔✔Condition in which parietal fluid accumulates in processus vaginalis
✔✔Hemorrhagic stroke tx - ✔✔Mannitol and Corticosteroids (antiedema)
Surgical clipping
✔✔Subarachnoid aneurysm etiology - ✔✔Berry aneurysm (75%); AVM (10%)
✔✔McDonald's criteria - ✔✔Multiple sclerosis;
At least 2-4 areas
New T2 compared to baseline MRI
✔✔Bell's palsy tx - ✔✔Prednisolone 25mg po bid x 10d
✔✔Gastroparesis tx - ✔✔Metoclopramide
✔✔Diarrhea tx - ✔✔Loperamide (immodium) - binds opiod receptors
✔✔Guillan-Barre tx - ✔✔Plasma exchange within 7 days; IVIG
✔✔Myasthenia gravis tx - ✔✔Pyridostigmine bromide or Neostigmine
✔✔Giant cell arteritis sx - ✔✔HA, tenderness, pale & edematous optic disc
✔✔Cluster HA - ✔✔Periorbital pain; lasts 15-180min; sleep precipitates
Tx: Triptans or verapamil for prophy
✔✔Tension HA - ✔✔bilateral & band like
tx: NSAIDs or if chronic amitriptyline
✔✔Encephalitis - ✔✔viral causes
Tx: Acyclovir or gancilclovir + doxycycline
✔✔Meningitis - ✔✔bacterial - strep pneumo
IV abs and dexamethasone x 14d
ANSWERS 2025/2026 ALL RATED A+
✔✔Reidel thyroiditis tx - ✔✔Tamoxifen 20mg po bid x years
✔✔Cushings screen - ✔✔Dexamethasone 1mg at 11pm. Should suppress cortisol. If
cortisol <5mcg then no cushings.
OR Midnight salivary cortisol level
✔✔Addison disease tx - ✔✔Hydrocortisone 15-30mg po 2/3 in AM 1/3 in PM
✔✔Adrenal crisis dx - ✔✔Cosyntropin stim test 0.25mg IM, cortisol 30-60min post
should be 20mcg/dL
✔✔Contrast dye can cause lethal rxn - ✔✔Pheochromocytoma
✔✔Pheochromocytoma tx - ✔✔Phenoxybenzamine, nifedipine or metoprolol; surgery is
definitive
✔✔Diabetes Insipidus sx - ✔✔ADH deficiency = polyuria and polydipsia
✔✔Diabetes Insipidus dx - ✔✔Vasopressin challenge: Measure urine quantity 12 hours
pre & post admin of Desmopressin 0.05-0.1mL
✔✔Diabetes Insipidus tx - ✔✔Desmopressin 0.5mg po bid for central
HCTZ & K+ if nephrogenic
✔✔Acromegaly dx - ✔✔Admin 75g oral glucose, should suppress GH to <1ng/mL
MRI shows pituitary adenoma
✔✔Acromegaly tx - ✔✔Pituitary surgery
If fails - Dopamine agonist 1mg po 2 x week or Octreotide 20-40 sc qmonth
✔✔Hypocalcemia on EKG - ✔✔prolonged QT
✔✔Hypercalcemia on EKG - ✔✔shortened QT
✔✔Hypercalcemia dx - ✔✔Check PTH to see if hyperparathyroidism or malignancy
✔✔Sodium deficit formula - ✔✔TBW x (Desired Na - Actual Na)
TBW= women 50%; men 55%
, ✔✔Paget's disease - ✔✔A fairly common metabolic disease of the bone from unknown
causes. It usually attacks middle-aged and elderly people and is characterized by bone
destruction and deformity.
✔✔Paget's disease tx - ✔✔bisphosphonates cyclically
✔✔BPH tx - ✔✔alpha blocker: Praxosin, Tamsulosin
5-alpha reductase: finasteride
Tx if symptom is >7
✔✔Hydrocele - ✔✔Condition in which parietal fluid accumulates in processus vaginalis
✔✔Hemorrhagic stroke tx - ✔✔Mannitol and Corticosteroids (antiedema)
Surgical clipping
✔✔Subarachnoid aneurysm etiology - ✔✔Berry aneurysm (75%); AVM (10%)
✔✔McDonald's criteria - ✔✔Multiple sclerosis;
At least 2-4 areas
New T2 compared to baseline MRI
✔✔Bell's palsy tx - ✔✔Prednisolone 25mg po bid x 10d
✔✔Gastroparesis tx - ✔✔Metoclopramide
✔✔Diarrhea tx - ✔✔Loperamide (immodium) - binds opiod receptors
✔✔Guillan-Barre tx - ✔✔Plasma exchange within 7 days; IVIG
✔✔Myasthenia gravis tx - ✔✔Pyridostigmine bromide or Neostigmine
✔✔Giant cell arteritis sx - ✔✔HA, tenderness, pale & edematous optic disc
✔✔Cluster HA - ✔✔Periorbital pain; lasts 15-180min; sleep precipitates
Tx: Triptans or verapamil for prophy
✔✔Tension HA - ✔✔bilateral & band like
tx: NSAIDs or if chronic amitriptyline
✔✔Encephalitis - ✔✔viral causes
Tx: Acyclovir or gancilclovir + doxycycline
✔✔Meningitis - ✔✔bacterial - strep pneumo
IV abs and dexamethasone x 14d
