Internal Medicine Board Exam Started: Jul 12, 2026 22:56 Page 36 of 40 Attempt #1287 Overall: 0 / 200 questions answered Question 176 / 200 Not answered During morning rounds: a 42-year-old man presents with epigastric pain radiating to back with elevated lipase. Relevant risk context includes NSAID exposure. What is the most likely diagnosis? A. Acute kidney injury B. Complicated community-acquired pneumonia C. Decompensated heart failure D. Diabetic ketoacidosis E. Acute upper GI bleeding Show Answer & Explanation Correct Answer: C Explanation: The pattern of epigastric pain radiating to back with elevated lipase with risk factors such as NSAID exposure is most consistent with Decompensated heart failure. This answer best matches the expected diagnostic framework for Internal Medicine. Reference: IDSA and ATS infectious disease guidelines Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 177 / 200 Not answered During a primary-care follow-up visit: a 78-year-old man is evaluated for orthopnea with bibasal crackles in the context of gallstone disease. Which is the most appropriate next investigation? A. ECG with cardiac biomarkers when indicated B. CBC and inflammatory markers C. Targeted imaging for source diagnosis D. ABG with lactate E. Blood and site cultures when infection suspected Show Answer & Explanation Correct Answer: C Explanation: Targeted imaging for source diagnosis is the most appropriate next test because it directly clarifies the leading diagnosis and guides immediate management in Internal Medicine. Reference: AHA/ACC and ESC disease guidelines Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 178 / 200 Not answered At a preventive-care consultation: a 51-year-old woman has fever with hypoxemia and focal infiltrate with risk profile of gallstone disease. After initial stabilization and assessment, what is the most appropriate management step? A. Early specialist escalation for organ dysfunction B. Evidence-based inpatient antimicrobial strategy when indicated C. Guideline-directed chronic disease optimization D. Structured discharge and follow-up planning E. VTE prophylaxis and supportive inpatient care Show Answer & Explanation Correct Answer: A Explanation: Early specialist escalation for organ dysfunction is preferred because it aligns with guideline-based care priorities, reduces avoidable complications, and supports safe outcomes in Internal Medicine. Reference: AHA/ACC and ESC disease guidelines Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 179 / 200 Not answered At a preventive-care consultation: a 50-year-old woman has melena with hemodynamic instability with risk profile of gallstone disease. After initial stabilization and assessment, what is the most appropriate management step? A. Guideline-directed chronic disease optimization B. Early specialist escalation for organ dysfunction C. Structured discharge and follow-up planning D. Evidence-based inpatient antimicrobial strategy when indicated E. Condition-specific resuscitation protocol Show Answer & Explanation Correct Answer: A Explanation: Guideline-directed chronic disease optimization is preferred because it aligns with guideline-based care priorities, reduces avoidable complications, and supports safe outcomes in Internal Medicine. Reference: AHA/ACC and ESC disease guidelines Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 180 / 200 Not answered In an emergency department assessment: a 60-year-old woman has epigastric pain radiating to back with elevated lipase with risk profile of advanced age. After initial stabilization and assessment, what is the most appropriate management step? A. Evidence-based inpatient antimicrobial strategy when indicated B. Condition-specific resuscitation protocol C. Guideline-directed chronic disease optimization D. Early specialist escalation for organ dysfunction E. VTE prophylaxis and supportive inpatient care Show Answer & Explanation Correct Answer: E Explanation: VTE prophylaxis and supportive inpatient care is preferred because it aligns with guideline-based care priorities, reduces avoidable complications, and supports safe outcomes in Internal Medicine. Reference: AHA/ACC and ESC disease guidelines Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Cancel « ← Previous Page 36 of 40 Next → »