Internal Medicine Board Exam Started: Jul 13, 2026 04:19 Page 32 of 40 Attempt #1951 Overall: 0 / 200 questions answered Question 156 / 200 Not answered At a multidisciplinary case conference: a 65-year-old man presents with epigastric pain radiating to back with elevated lipase. Relevant risk context includes ischemic heart disease. What is the most likely diagnosis? A. Decompensated heart failure B. Acute kidney injury C. Diabetic ketoacidosis D. Complicated community-acquired pneumonia E. Acute biliary pancreatitis Show Answer & Explanation Correct Answer: E Explanation: The pattern of epigastric pain radiating to back with elevated lipase with risk factors such as ischemic heart disease is most consistent with Acute biliary pancreatitis. This answer best matches the expected diagnostic framework for Internal Medicine. Reference: ACG and ADA contemporary guidance 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 157 / 200 Not answered During ward handover: a 68-year-old man is evaluated for oliguria with rising creatinine in the context of ischemic heart disease. Which is the most appropriate next investigation? A. Comprehensive metabolic panel B. CBC and inflammatory markers C. ABG with lactate D. ECG with cardiac biomarkers when indicated E. Targeted imaging for source diagnosis Show Answer & Explanation Correct Answer: D Explanation: ECG with cardiac biomarkers when indicated is the most appropriate next test because it directly clarifies the leading diagnosis and guides immediate management in Internal Medicine. Reference: ACP and Society of Hospital Medicine guidance 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 158 / 200 Not answered During morning rounds: a 42-year-old woman presents with oliguria with rising creatinine. Relevant risk context includes gallstone disease. What is the most likely diagnosis? A. Acute kidney injury B. Acute biliary pancreatitis C. Diabetic ketoacidosis D. Complicated community-acquired pneumonia E. Acute upper GI bleeding Show Answer & Explanation Correct Answer: C Explanation: The pattern of oliguria with rising creatinine with risk factors such as gallstone disease is most consistent with Diabetic ketoacidosis. This answer best matches the expected diagnostic framework for Internal Medicine. Reference: ACP and Society of Hospital Medicine guidance 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 159 / 200 Not answered During a primary-care follow-up visit: a 67-year-old man has fever with hypoxemia and focal infiltrate with risk profile of chronic multimorbidity. After initial stabilization and assessment, what is the most appropriate management step? A. VTE prophylaxis and supportive inpatient care B. Guideline-directed chronic disease optimization C. Evidence-based inpatient antimicrobial strategy when indicated D. Condition-specific resuscitation protocol E. Structured discharge and follow-up planning Show Answer & Explanation Correct Answer: D Explanation: Condition-specific resuscitation protocol is preferred because it aligns with guideline-based care priorities, reduces avoidable complications, and supports safe outcomes in Internal Medicine. Reference: ACG and ADA contemporary guidance 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 160 / 200 Not answered At a preventive-care consultation: a 48-year-old woman presents with orthopnea with bibasal crackles. Relevant risk context includes chronic multimorbidity. What is the most likely diagnosis? A. Decompensated heart failure B. Acute kidney injury C. Acute biliary pancreatitis D. Acute upper GI bleeding E. Complicated community-acquired pneumonia Show Answer & Explanation Correct Answer: B Explanation: The pattern of orthopnea with bibasal crackles with risk factors such as chronic multimorbidity is most consistent with Acute kidney injury. This answer best matches the expected diagnostic framework for Internal Medicine. Reference: ACG and ADA contemporary guidance 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 32 of 40 Next → »