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General Internal Medicine Flashcards

7 cards from real ITE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 58-year-old man with type 2 diabetes presents with a foot ulcer that probes to bone. The most appropriate next diagnostic step is:

    Answer: MRI of the foot

    MRI is the gold standard for diagnosing osteomyelitis as it has the highest sensitivity and specificity for bone marrow involvement.

  2. A 45-year-old woman presents with fatigue, weight gain, cold intolerance, and constipation. TSH is 12 mIU/L and free T4 is low. Which treatment is most appropriate?

    Answer: Levothyroxine

    Levothyroxine (synthetic T4) is the standard treatment for hypothyroidism due to its stable half-life and consistent dosing.

  3. A 72-year-old woman is found to have an estimated GFR of 28 mL/min/1.73m². Which medication should be dose-adjusted or avoided?

    Answer: Metformin

    Metformin is contraindicated when eGFR <30 due to risk of lactic acidosis from drug accumulation.

  4. A 35-year-old man presents with acute gout flare in the right first metatarsophalangeal joint. He has no renal disease or peptic ulcer disease. What is the first-line treatment?

    Answer: NSAIDs (e.g., indomethacin)

    NSAIDs are first-line for acute gout flares in patients without contraindications, providing rapid anti-inflammatory relief.

  5. A patient with community-acquired pneumonia has a CURB-65 score of 3. What is the most appropriate disposition?

    Answer: Hospital admission, consider ICU

    A CURB-65 score of 3 indicates severe pneumonia with significant 30-day mortality risk, warranting hospital admission and possible ICU-level care.

  6. A 60-year-old woman with hypertension and chronic kidney disease (proteinuria 1.5 g/day) presents for medication management. The most appropriate antihypertensive is:

    Answer: ACE inhibitor (lisinopril)

    ACE inhibitors are preferred in CKD with proteinuria because they reduce intraglomerular pressure and slow progression of kidney disease.

  7. A 50-year-old male smoker presents with a 30-pack-year history. Screening for lung cancer with low-dose CT is recommended for which age range and smoking history per USPSTF guidelines?

    Answer: Ages 50-80 with ≥20 pack-year history, currently smoking or quit within 15 years

    The 2021 USPSTF guidelines recommend annual low-dose CT screening for adults ages 50-80 with ≥20 pack-year history who currently smoke or quit within 15 years.