Internal Medicine Board Exam Started: Jul 12, 2026 22:46 Page 38 of 40 Attempt #1253 Overall: 0 / 200 questions answered Question 186 / 200 Not answered During a primary-care follow-up visit: a 76-year-old man presents with epigastric pain radiating to back with elevated lipase. Relevant risk context includes chronic multimorbidity. What is the most likely diagnosis? A. Decompensated heart failure B. Complicated community-acquired pneumonia C. Acute kidney injury D. Acute upper GI bleeding E. Acute biliary pancreatitis Show Answer & Explanation Correct Answer: D Explanation: The pattern of epigastric pain radiating to back with elevated lipase with risk factors such as chronic multimorbidity is most consistent with Acute upper GI bleeding. 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 187 / 200 Not answered During ward handover: a 71-year-old man presents with polyuria with high anion gap acidosis. Relevant risk context includes poor diabetes control. What is the most likely diagnosis? A. Acute biliary pancreatitis B. Decompensated heart failure C. Complicated community-acquired pneumonia D. Diabetic ketoacidosis E. Acute upper GI bleeding Show Answer & Explanation Correct Answer: D Explanation: The pattern of polyuria with high anion gap acidosis with risk factors such as poor diabetes control is most consistent with Diabetic ketoacidosis. 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 188 / 200 Not answered During morning rounds: a 68-year-old man has polyuria with high anion gap acidosis with risk profile of ischemic heart disease. After initial stabilization and assessment, what is the most appropriate management step? A. Structured discharge and follow-up planning B. Condition-specific resuscitation protocol C. Early specialist escalation for organ dysfunction D. Evidence-based inpatient antimicrobial strategy when indicated E. VTE prophylaxis and supportive inpatient care Show Answer & Explanation Correct Answer: C 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: 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 189 / 200 Not answered At a preventive-care consultation: a 40-year-old woman 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. Guideline-directed chronic disease optimization B. Early specialist escalation for organ dysfunction C. Condition-specific resuscitation protocol D. Structured discharge and follow-up planning E. Evidence-based inpatient antimicrobial strategy when indicated Show Answer & Explanation Correct Answer: D Explanation: Structured discharge and follow-up planning is preferred because it aligns with guideline-based care priorities, reduces avoidable complications, and supports safe outcomes in 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 190 / 200 Not answered During ward handover: a 31-year-old woman is evaluated for orthopnea with bibasal crackles in the context of gallstone disease. Which is the most appropriate next investigation? A. Comprehensive metabolic panel B. Targeted imaging for source diagnosis C. ABG with lactate D. ECG with cardiac biomarkers when indicated E. CBC and inflammatory markers Show Answer & Explanation Correct Answer: A Explanation: Comprehensive metabolic panel is the most appropriate next test because it directly clarifies the leading diagnosis and guides immediate management 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 Cancel « ← Previous Page 38 of 40 Next → »