Internal Medicine II Practice Test

These questions are part of the practice quiz. Start practicing

• In suspected acute pancreatitis, which test is typically performed to evaluate gallstone etiology?
• In a pregnant patient with antiphospholipid antibodies, what is the recommended management if persistence is confirmed
• How do you differentiate upper GI bleed from lower GI bleed and what is the initial diagnostic approach?
• What is the recommended window for IV alteplase in acute ischemic stroke, and what is a key exclusion?
• Which combination of manifestations is commonly observed in mixed connective tissue disease?
• Which clinical feature best differentiates thyroid storm from myxedema coma?
• Which clinical feature favors upper gastrointestinal bleeding over lower gastrointestinal bleeding?
• Regarding Methotrexate administration, which statement is incorrect?
• Which statement about antiphospholipid syndrome is true?
• Heberden's nodes are enlargements at which joints?
• Which action reduces adverse drug events in older adults?
• In immunocompromised patients, what is the general vaccination approach?
• First-line therapy for hepatic encephalopathy is:
• Which drug is a classic disease-modifying antirheumatic drug used for RA with potential hepatotoxicity requiring monitoring?
• Which autoantibody is most characteristic of mixed connective tissue disease?
• Which test best assesses humoral immune function by measuring antibody responses to vaccines?
• Using CURB-65, which score thresholds correspond to outpatient management, hospital admission, and ICU-level care?
• Which drug is a COX-2 selective inhibitor?
• Which imaging modality is used to measure bone mineral density in osteoporosis?
• Which of the following is a lupus-specific cutaneous manifestation?
• In rheumatoid arthritis, which joint is commonly affected among the following?
• Which statement about gout is true?
• Which statement about Azathioprine is true?
• In suspected primary adrenal crisis, what is the initial emergency management?
• Which set of investigations is used to evaluate combined T and B cell defects?
• An adult with which finding would raise suspicion for immunodeficiency?
• Which of the following is NOT typical for psoriatic arthritis?
• Which HLA allele is associated with ankylosing spondylitis?
• Generalized osteoporosis is an extra-articular feature of which disease?
• Typical for arthrosis, EXCEPT?
• In Sjögren's syndrome, which finding is NOT associated with an increased risk of lymphoma
• Gout classically presents with acute monoarthritis of which joint?
• Which feature is NOT typically associated with spondyloarthropathies?
• In hypocalcemia presenting with tetany, what is the initial management and evaluation steps?
• Which substance is NOT an approved biological therapy for SLE?
• Methotrexate is typically prescribed how often?
• The induction regimen for lupus nephritis typically combines corticosteroids with which immunosuppressant?
• Which feature is most characteristic of CREST syndrome?
• What are the two most common etiologies of acute pancreatitis, and what is the initial management priority?
• Which feature is NOT characteristic of pathogenic autoantibodies?
• Which joint is most frequently involved in osteoarthritis?
• Which of the following is considered a primary vasculitis?
• In case of suspicion of bacterial arthritis, the most important procedure:
• NSTEMI risk stratification: Which risk scores are used and what threshold indicates high risk?
• Smoking has what effect on Raynaud's symptoms?
• Which biological treatment has the best effect in myositis?
• Which autoantibody is specific for Sjögren's syndrome?
• Which autoantibody is associated with limited cutaneous systemic sclerosis (CREST)?
• Podagra refers to involvement of which joint in gout?
• Features of distal renal tubular acidosis in Sjögren's syndrome, EXCEPT ONE
• Which cell type is considered the principal pathogenic driver in systemic sclerosis?
• Which could be the typical onset scenario for Sjögren's syndrome
• How many cyclooxygenase isoenzymes are known?
• Which disease among the following is not typically associated with RA-like symptoms?
• In cirrhosis with ascites, what is the initial diuretic regimen and the key monitoring parameter?
• Which initial management steps are appropriate for thyroid storm?
• Which drug is the first-line disease-modifying antirheumatic drug for rheumatoid arthritis?
• Characteristic symptoms of Eosinophilic granulomatosis with polyangiitis (Churg-Strauss), except:
• Calcimusc use in allergic diseases is best described by which statement?
• Characteristic features for SNSA, EXCEPT:
• Which drug can cause Raynaud's phenomenon?
• In heart failure with reduced ejection fraction, which disease-modifying therapies have mortality/morbidity benefit?
• Gout is a syndrome caused by deposition of which type of crystals in tissues?
• Skin symptoms in anaphylaxis are characterized by which statement?
• In rheumatoid arthritis, which joint is NOT typically involved?
• Protein-energy malnutrition contributes to secondary immunodeficiency.
• What is the correct preoperative management sequence for pheochromocytoma?
• In a patient with STEMI presenting within two hours of chest pain, what is the preferred reperfusion strategy when a PCI-capable cath lab can perform primary PCI within 90 minutes of first medical contact?
• What is true about methotrexate use in rheumatoid arthritis regarding pregnancy and monitoring?
• In diabetic ketoacidosis management, when should insulin therapy be started?
• Defects of innate immunity are associated with which infections?
• Lyme disease skin lesion hallmark.
• For a stable COPD patient with resting SpO2 of 89%, what is the target oxygen saturation range and when is long-term oxygen therapy indicated?
• When do we not use intravenous immunoglobulin treatment in myositis patients?
• CURB-65 scoring: which thresholds correspond to outpatient management, hospital admission, and ICU-level care?
• What is the diagnostic criterion for spontaneous bacterial peritonitis in ascitic fluid?
• What is the recommended modality and interval for HCC surveillance in cirrhosis?
• Which monitoring parameter is essential to avoid hyperkalemia when initiating spironolactone for cirrhosis-related ascites?
• Which regimen is appropriate for latent tuberculosis infection?
• Which statement best describes the initial management priorities for diabetic ketoacidosis and hyperglycemic hyperosmolar state?
• Which statement correctly distinguishes celiac disease and inflammatory bowel disease?
• How do you interpret a serum-ascites albumin gradient (SAAG) and what does SAAG ≥1.1 g/dL indicate?
• What is a common presenting symptom of Sjögren's syndrome
• IVIG is not indicated in myositis when there is which condition?
• After benzodiazepine failure in status epilepticus, which agent is commonly given?
• Which statement about gout is true?
• Which criterion best describes when to transition from IV insulin to subcutaneous insulin in DKA management?
• Which combination best describes nephrotic syndrome?
• Which method is NOT used for the detection of autoantibodies in serum?
• Secunder or associated Sjögren's syndrome is defined as
• Which is not used in the active phase of mixed connective tissue disease?
• Which statement best describes primary Raynaud's phenomenon?
• In a stable COPD patient with resting SpO2 of 89%, what is the recommended target oxygen saturation range and when is long-term oxygen therapy indicated?
• In systemic sclerosis, which organ systems can be involved?
• Which symptom is not characteristic of anti-Jo-1 syndrome?
• Most specific routine laboratory antibody marker in RA?
• How do you interpret a serum-ascites albumin gradient (SAAG) and what does SAAG ≥1.1 g/dL indicate?
• What is the first-line management for nonalcoholic fatty liver disease (NAFLD) and its primary therapeutic goal?
• “Basic therapy" in osteoporosis
• Initial management steps for status epilepticus in an adult?
• What are the components of the classic triad seen in Reiter's syndrome?
• What is the standard initial therapy for active tuberculosis?
• Which statement about Cyclophosphamide is NOT accurate?
• In diffuse cutaneous systemic sclerosis, which autoantibody is most characteristic?
• Which radiographic finding is typical of osteoarthritis?
• In acute kidney injury, prerenal azotemia due to hypoperfusion is best managed by:
• What class of medication is commonly used to manage hyperlipidemia in nephrotic syndrome?
• Which of the following is a traditional DMARD used in RA but not typically first-line today?
• Which imaging modality is preferred for early diagnosis of synovitis in RA?
• Extraarticular features in RA, EXCEPT:
• What is the mechanism and initial management for hypercalcemia of malignancy?
• Hyponatremia with euvolemia due to SIADH—what is the recommended initial management and the safe rate of correction?
• Which condition is the most common musculoskeletal problem after age 50?
• In STEMI management, what is the correct action when PCI cannot be performed within 120 minutes?
• What is the characteristic first symptom in ankylosing spondylitis?
• Which HLA allele is most strongly associated with ankylosing spondylitis?
• DMARD therapies of rheumatoid arthritis are true except which?
• In rheumatoid arthritis, which cervical spine complication can occur?
• Which is the first-line drug used to treat osteoarthritis-related pain?
• Which joint is most commonly affected by an initial gout attack?
• Which examination is recommended for a patient suspected of systemic sclerosis?
• Given Na 140, Cl 110, HCO3 8, what is the anion gap and the most likely class of metabolic acidosis?
• In microcytic anemia workup, what are the initial tests and how is iron deficiency interpreted?
• Which urinary indices are typical of prerenal AKI?
• The following diseases are secondary vasculitides, except
• What practical strategy helps minimize adverse drug events in elderly patients?
• Which statement best distinguishes latent tuberculosis infection from active tuberculosis?
• For STEMI presenting within 2 hours of chest pain, what is the preferred reperfusion strategy if a PCI-capable cath lab can perform primary PCI within 90 minutes of first medical contact?
• Which is the deforming arthrosis of the distal interphalangeal joints?
• Raynaud's phenomenon can involve which areas?
• Gout is associated with deposition of which crystals?
• In DKA management, why must potassium be ≥3.3 mEq/L before initiating IV insulin therapy?
• Signs and symptoms of antiphospholipid syndrome are
• Which factor worsens hyperuricemia?
• For NSTEMI, which risk stratification tool guides an early invasive strategy, and what thresholds indicate high risk?
• Among osteoporotic fractures, which site is most commonly fractured?
• Which of the following is not among the most frequent manifestations of mixed connective tissue disease?
• Which finding is not typical of arthrosis?
• Heberden nodes are associated with osteoarthritis of which joints?
• In polyarteritis nodosa, the following organs could be affected, except:
• Which are the three most frequent sites for osteoporotic fractures?
• Anti-SSA and anti-SSB antibodies are most characteristic of which condition?
• NOT a typical feature of mixed connective tissue disease?
• Which antibody is a classic antiphospholipid antibody associated with thrombosis?
• Which statement best describes the characteristics of primary immunodeficiency diseases (PID)?
• Which of the following is NOT a clinical feature of osteoporosis?
• Which statement best describes Crohn's disease?
• Which method is commonly used for detection of autoantibodies in serum?
• Which statement best describes Crohn's disease versus ulcerative colitis in terms of location and pathology?
• The following statement about Polymyalgia Rheumatica is false?
• Which statement describes a side effect NOT associated with steroids?
• In spontaneous bacterial peritonitis, IV albumin is used to prevent renal dysfunction in selected patients. Which option represents this adjunct therapy?
• What best describes pharmacotherapy for NAFLD?
• Which statement about arthrosis is NOT true?
• The most characteristic skin symptom in Lyme-disease
• In cirrhosis with acute variceal bleeding, which management strategy improves survival?
• Defects of B cells are most commonly associated with which infection pattern?
• RA typically begins in which age range?
• Which cell types may participate in the pathogenesis of systemic lupus erythematosus (SLE)?
• What are the key elements of the Surviving Sepsis Campaign bundle and the recommended time to administer antibiotics?
• Anti-SSA and anti-SSB positivity is NOT typical in which disease?
• In Sjögren's syndrome, increased risk of lymphoma is associated with which finding
• What are the key differences between Crohn's disease and ulcerative colitis in terms of location, pathology, and typical treatments?
• In SLE, which antibody level tends to reflect disease activity?
• Which statement about Azathioprine is NOT accurate?
• Which radiographic finding is typical of rheumatoid arthritis in the hands?
• Which technique is used to examine nutritive capillary arteries in the nail bed?
• Which HLA type is a prognostic factor in rheumatoid arthritis?
• Which statement best differentiates latent TB infection from active TB and their initial testing and treatment strategies?
• Which enzyme is inhibited by allopurinol in the treatment of gout?
• Which electrolyte abnormalities are commonly seen in primary adrenal insufficiency?
• Which statement is true regarding physiologic immunology changes during pregnancy
• Anti-SSA (Ro) antibodies are most associated with which condition?
• Which feature is commonly seen with defects in B cells?
• Which immune cell plays an important role in the pathogenesis of rheumatoid arthritis synovitis?
• Which of the following is NOT a cause of secondary osteoporosis?
• What is considered the most serious organ involvement in SLE?
• Arthropathia can occur in.... EXCEPT:
• Which HLA allele is associated with prognosis in rheumatoid arthritis?
• Which investigation best assesses humoral defects by measuring antibody responses to vaccines?
• Venom immunotherapy is indicated when which condition is proven?
• Which internal organ changes are included in the 2013 classification criteria for systemic sclerosis?
• What is the first-line disease-modifying antirheumatic drug (DMARD) for rheumatoid arthritis and what monitoring is required?
• In a conscious patient with type 1 diabetes experiencing hypoglycemia, the recommended initial treatment is:
• In heart failure with reduced ejection fraction, which statement about ARNI use is correct?
• What is the most common cause of secondary immunodeficiency?
• Which radiologic abnormality is not typically seen in rheumatoid arthritis?
• Suspected adrenal crisis in a patient with known adrenal insufficiency—what is the immediate treatment?
• Which antibody is not a myositis-specific antibody?
• The following diseases are primary vasculitides, except:
• What is the diagnostic criterion for spontaneous bacterial peritonitis and the recommended initial management?
• Which patterns differentiate intravascular vs extravascular hemolysis on laboratory findings?
• In osteoarthritis, the initial analgesic of choice is what?
• What regimens are used for latent TB infection?
• Which of the following is NOT a treatment for arthrosis?
• In HIV infection with a CD4 count less than 200 cells/µL, what is the standard prophylaxis against Pneumocystis jirovecii, and what vaccination considerations apply?
• In cirrhosis with ascites, what is the initial diuretic regimen and the monitoring parameter?
• What is the recommended antithyroid drug strategy in pregnancy?
• Immediate treatment for suspected adrenal crisis in known adrenal insufficiency?
• Which statement about arthrosis is NOT true?
• In osteoporosis with a T-score of -2.5 or lower, what is the first-line pharmacologic therapy?
• For a hemodynamically stable patient with suspected DVT or PE, what is the initial diagnostic approach and treatment plan?
• Anti-dsDNA antibodies are characteristic of which disease?
• What is the typical age range for onset of Sjögren's syndrome
• Differentiate thyroid storm from myxedema coma and identify initial management steps for each.
• What is the general principle for initiating antiretroviral therapy in patients newly diagnosed with HIV?
• Which investigations are used in combined T and B cell defects?
• Vaccination considerations in immunocompromised patients and which vaccines are generally contraindicated?
• Which HBV serologic pattern distinguishes acute HBV infection from chronic infection?
• Which antithyroid drug is used in thyroid storm as part of the treatment?
• Bechterew disease true statement?
• What is the most important advantage of selective COX-2 inhibitors?
• Hyponatremia with euvolemia due to SIADH—what is the recommended initial management and the safe rate of correction?
• Which statement is NOT a characteristic feature of Felty syndrome?
• What is the standard long-term pharmacologic treatment for chronic hepatitis B?
• Which statement describes the initial approach to a suspected upper gastrointestinal bleed?
• Eczemas may be characterized by which of the following?
• The absolute indication of venom immunotherapy is which statement?
• Which joint is most frequently involved in gout?
• The laboratory values Na 140, Cl 110, HCO3 8 yield what anion gap, and what is the most likely class of metabolic acidosis?
• Which therapy is central to treating myxedema coma?
• Which statement about Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) is true?
• Which of the following is not part of the classic triad of Reiter's disease?
• Which statement is true of primary Raynaud's phenomenon?
• Bouchard arthrosis involves which joints?
• Nephrotic range proteinuria is defined as protein excretion greater than:
• Measurement of chest expansion is important in ..... disease?
• Which therapy is considered hyperosmolar for intracranial pressure management?
• Routine diagnostic method for calcipenia
• Which management steps are appropriate for increased intracranial pressure following head injury?
• List the common etiologies of acute pancreatitis and the initial management priorities.
• In cirrhosis with acute variceal bleeding, what management strategy improves survival?
• Distinguish diabetic ketoacidosis from hyperosmolar hyperglycemic state and outline initial management priorities.
• Which is a commonly used empiric antibiotic for suspected spontaneous bacterial peritonitis?
• Active tuberculosis is characterized by which combination?
• Heberden's nodes are most commonly located at which joints?
• Which constellation is considered a red flag in suspected systemic sclerosis?
• Which drug is definitely teratogenic
• Which agents are used for maintenance therapy in lupus nephritis?
• Which biological therapy is approved for SLE?
• Raynaud's syndrome description includes which of the following?
• Which feature is NOT typical of adult-onset Still's disease?
• A 34-year-old woman with two prior abortions and antiphospholipid antibodies detected; she is pregnant again. What is the recommended thinking according to the material?
• Which circumstances are optimal to minimize fetal complications when a patient with lupus is pregnant
• Which radiologic finding is commonly seen in rheumatoid arthritis of the hands?
• For Reiter disease, which treatment is NOT typically used?
• What is the standard initial treatment for active tuberculosis?
• What is a commonly used empiric antibiotic for spontaneous bacterial peritonitis?
• Which statement about ACE inhibitors and ARBs in CKD with albuminuria is correct?
• Atopic dermatitis may be characterized by which statement?
• Which statement describes the Duke criteria for native valve endocarditis and a common initial empiric regimen?
• Which drug is not a DMARD used for rheumatoid arthritis?
• Which is the biomarker of osteoclast activity (bone resorption)?
• In heart failure with reduced ejection fraction, which drug classes have proven mortality/morbidity benefit, and what is the role of ARNI?
• In hypercalcemia of malignancy, what is the typical pathophysiology and initial management steps?
• Which is the most frequent primary immunodeficiency in adults?
• Not a characteristic autoantibody for mixed connective tissue disease?
• RA onset age again: which range is most characteristic?
• Gout arthritis is characterized by which of the following features? EXCEPT DIP pain.
• Use of Calcimusc in allergic diseases is best described by which statement?
• Which symptom profile best differentiates thyroid storm from myxedema coma?
• If spironolactone alone is insufficient to control cirrhosis-related ascites, which diuretic should be added?
• Which HLA type is most strongly associated with reactive arthritis?
• Alpha-adrenergic blockade in pheochromocytoma is used before beta-blockade because:
• In lupus nephritis, what is the standard induction therapy and maintenance therapy?
• Which finding would generally exclude using IV thrombolysis in suspected ischemic stroke?
• What is first-line therapy for hepatic encephalopathy?