General Internal Medicine Part 2 (ABIM)
What is Hypomagnesemia? - correct answer ✔✔muscle cramps, tremor, weakness; cause- PPI, diuretic,
GI (diarrhea, malabsorption), alcohol; (tx-oral magnesium + stop PPI)
Psychology: Medically unexplained symptom - correct answer ✔✔symptoms can't be attributed to
specific medical cause after eval; fatigue, HA, abdominal pain; dx-H&P, obtain medical records; (tx-CBT,
PT/OT, stress management)
Psychology: Somatic symptom disorder - correct answer ✔✔one or more somatic symptoms >6 mo,
significant distress/interference w. life+ excessive feelings related to symptoms; dx-no identifiable
organic source; (tx-CBT)
Guidelines: Prostate Cancer screening - correct answer ✔✔55-69yo w/ discussion about PSA;
Guidelines: Elevated PSA Screening - correct answer ✔✔routine (DRE, PSA <3), repeat PSA (DRE, PSA 3-
7), urology referral (abnormal DRE or PSA >7); TRUS prostate biopsy (prostate nodule, rising PSA level)
Guidelines: Blood pressure - correct answer ✔✔annually (>40yo), every 3-5yrs (18-39yo, BP <130/85)
Guidelines: Low-dose aspirin - correct answer ✔✔50-59 years +10-year ASCVD risk > 10%, no ↑risk for
bleeding, life expectancy >10yrs, willing to take low-dose aspirin daily for 10yrs; primary prevention of
atherosclerotic cardiovascular disease (ASCVD), colorectal cancer
Guidelines: Weight-loss medications indications - correct answer ✔✔trial of comprehensive lifestyle
modification (↓dietary intake, exercise, behavioral therapy) fails to achieve a 5% to 10% ↓ weight after
3-6 mo; liraglutide (victoza)
Guidelines: Lipids - correct answer ✔✔lipid panel every 5yrs, 40-75yo; men <35 and women <44 w.
family hx of CHD, tobacco use, DM, obesity, HTN
, Guidelines: Statin Categories - correct answer ✔✔primary prevention (DM, LDL > 190; 40-75yo 10yr
ASCVD risk > 7.5% + one more ASCVD risk factors-dyslipidemia, diabetes, hypertension, or smoking);
secondary prevention (ASCVD); check alanine aminotransferase level (ALT)
Guidelines: Aspirin - correct answer ✔✔50-59, 10-year ASCVD risk > 10%, >10 life expectance, take it for
10yrs
What are Established ASCVD? - correct answer ✔✔acute coronary syndrome, stable angina, coronary or
other arterial revascularization, stroke, transient ischemic attack, PAD
What is High-Intensity Statin Indication? - correct answer ✔✔ASCVD patients, DM (ASCVD risk > 7.5%),
LDL > 190; (tx-atorvastatin 40/80, rousavastatin 20/40); check alanine aminotransferase level (ALT)
Guidelines: Cervical Cancer Starts - correct answer ✔✔21-65yo: 21-29, cervical cytology, Q3yrs; 30-65yo:
cervical cytology+ HPV, Q5yrs
Guidelines: Cervical Cancer Ends - correct answer ✔✔hysterectomy for benign disease; >65yo, if 3
consecutive negative Paps within last 10yrs, with most recent test <5yrs; or 2 consecutive negative HPV
tests within last 10yrs, with most recent test <5yrs
Guidelines: Cervical Cancer Post-Treatment Surveillance - correct answer ✔✔history + examination, Q3-
6mo for first 2 years, then every 6 to 12 months for years 2- 5
Guidelines: Beast Cancer Screening - correct answer ✔✔50-74, every 2 years; mammography
Guidelines: Breast Cancer BRCA1, BRCA2 mutations - correct answer ✔✔breast, ovarian cancer;
prophylaxis- bilateral mastectomy + bilateral salpingo-oophorectomy after child bearing 35-40yo; screen-
genetic counselor, breast MRI at age 25yo, mammography at 30yo
Guidelines: Breast Cancer BRCA1, BRCA2 mutations - correct answer ✔✔epithelial ovarian cancer,
regardless of age of onset/family hx/ancestry
What is Hypomagnesemia? - correct answer ✔✔muscle cramps, tremor, weakness; cause- PPI, diuretic,
GI (diarrhea, malabsorption), alcohol; (tx-oral magnesium + stop PPI)
Psychology: Medically unexplained symptom - correct answer ✔✔symptoms can't be attributed to
specific medical cause after eval; fatigue, HA, abdominal pain; dx-H&P, obtain medical records; (tx-CBT,
PT/OT, stress management)
Psychology: Somatic symptom disorder - correct answer ✔✔one or more somatic symptoms >6 mo,
significant distress/interference w. life+ excessive feelings related to symptoms; dx-no identifiable
organic source; (tx-CBT)
Guidelines: Prostate Cancer screening - correct answer ✔✔55-69yo w/ discussion about PSA;
Guidelines: Elevated PSA Screening - correct answer ✔✔routine (DRE, PSA <3), repeat PSA (DRE, PSA 3-
7), urology referral (abnormal DRE or PSA >7); TRUS prostate biopsy (prostate nodule, rising PSA level)
Guidelines: Blood pressure - correct answer ✔✔annually (>40yo), every 3-5yrs (18-39yo, BP <130/85)
Guidelines: Low-dose aspirin - correct answer ✔✔50-59 years +10-year ASCVD risk > 10%, no ↑risk for
bleeding, life expectancy >10yrs, willing to take low-dose aspirin daily for 10yrs; primary prevention of
atherosclerotic cardiovascular disease (ASCVD), colorectal cancer
Guidelines: Weight-loss medications indications - correct answer ✔✔trial of comprehensive lifestyle
modification (↓dietary intake, exercise, behavioral therapy) fails to achieve a 5% to 10% ↓ weight after
3-6 mo; liraglutide (victoza)
Guidelines: Lipids - correct answer ✔✔lipid panel every 5yrs, 40-75yo; men <35 and women <44 w.
family hx of CHD, tobacco use, DM, obesity, HTN
, Guidelines: Statin Categories - correct answer ✔✔primary prevention (DM, LDL > 190; 40-75yo 10yr
ASCVD risk > 7.5% + one more ASCVD risk factors-dyslipidemia, diabetes, hypertension, or smoking);
secondary prevention (ASCVD); check alanine aminotransferase level (ALT)
Guidelines: Aspirin - correct answer ✔✔50-59, 10-year ASCVD risk > 10%, >10 life expectance, take it for
10yrs
What are Established ASCVD? - correct answer ✔✔acute coronary syndrome, stable angina, coronary or
other arterial revascularization, stroke, transient ischemic attack, PAD
What is High-Intensity Statin Indication? - correct answer ✔✔ASCVD patients, DM (ASCVD risk > 7.5%),
LDL > 190; (tx-atorvastatin 40/80, rousavastatin 20/40); check alanine aminotransferase level (ALT)
Guidelines: Cervical Cancer Starts - correct answer ✔✔21-65yo: 21-29, cervical cytology, Q3yrs; 30-65yo:
cervical cytology+ HPV, Q5yrs
Guidelines: Cervical Cancer Ends - correct answer ✔✔hysterectomy for benign disease; >65yo, if 3
consecutive negative Paps within last 10yrs, with most recent test <5yrs; or 2 consecutive negative HPV
tests within last 10yrs, with most recent test <5yrs
Guidelines: Cervical Cancer Post-Treatment Surveillance - correct answer ✔✔history + examination, Q3-
6mo for first 2 years, then every 6 to 12 months for years 2- 5
Guidelines: Beast Cancer Screening - correct answer ✔✔50-74, every 2 years; mammography
Guidelines: Breast Cancer BRCA1, BRCA2 mutations - correct answer ✔✔breast, ovarian cancer;
prophylaxis- bilateral mastectomy + bilateral salpingo-oophorectomy after child bearing 35-40yo; screen-
genetic counselor, breast MRI at age 25yo, mammography at 30yo
Guidelines: Breast Cancer BRCA1, BRCA2 mutations - correct answer ✔✔epithelial ovarian cancer,
regardless of age of onset/family hx/ancestry
