ABIM Infectious Disease study guide
ABIM Infectious Disease · Work through your exam, one topic at a time.
The American Board of Internal Medicine (ABIM) Infectious Disease Certification Examination is the assessment physicians must pass to earn board certification in adult infectious diseases, typically after completing an internal medicine residency and an infectious disease fellowship. It is aimed at subspecialists who manage complex infections, immunocompromised hosts, antimicrobial therapy, and infection prevention in hospital and clinic settings. The ABIM Infectious Disease study guide has 10 sections and about 2,023 words.
01Bacterial Infections and Antimicrobial Therapy
Know the mechanism-of-action families cold: beta-lactams (cell wall, bactericidal, time-dependent killing), glycopeptides (cell wall, only gram-positives), aminoglycosides (30S, concentration-dependent, nephro/ototoxic, synergy for enterococcal endocarditis), fluoroquinolones (DNA gyrase/topoisomerase, aortopathy and QT cautions), macrolides (50S, QT), tetracyclines (30S, avoid in pregnancy and children under 8), and oxazolidinones (50S initiation, myelosuppression, serotonin syndrome with MAOIs/SSRIs). Staph aureus (MSSA vs MRSA; vancomycin for MRSA, cefazolin/nafcillin for MSSA), streptococci (penicillin for GAS; ceftriaxone for pneumococcus meningitis at high dose), enterococci (ampicillin + ceftriaxone or gentamicin for endocarditis), gram-negative rods (ESBL = carbapenem; AmpC = cefepime preferred), Pseudomonas (piperacillin-tazobactam, cefepime, or meropenem; avoid ertapenem), anaerobes (metronidazole, clindamycin, or beta-lactam/beta-lactamase inhibitor), and atypical pathogens (doxycycline or azithromycin for Mycoplasma, Chlamydia, Legionella).
256 words, about 1 min02Viral Infections and Antiviral Therapy
Understand the major antiviral classes and their targets: acyclovir/valacyclovir (HSV/VZV thymidine kinase, renal dosing), ganciclovir/valganciclovir (CMV UL97 kinase, myelosuppression), foscarnet (pyrophosphate analog, no kinase required-use for resistant CMV/HSV; nephrotoxic, electrolyte wasting), cidofovir (nephrotoxic, requires probenecid), oseltamivir/baloxavir (influenza; baloxavir is single-dose cap-dependent endonuclease inhibitor), and remdesivir (RNA-dependent RNA polymerase). HSV encephalitis (temporal lobe; start IV acyclovir empirically), VZV (acyclovir; consider VZIG post-exposure in pregnancy/immunocompromised), CMV (retinitis in AIDS, colitis in transplant; valganciclovir), influenza (oseltamivir within 48 hours, but treat severe/hospitalized regardless of timing), RSV (supportive; ribavirin in select immunocompromised), and hepatitis B/C (tenofovir/entecavir; direct-acting antivirals for HCV).
222 words, about 1 min03Fungal Infections and Antifungal Therapy
Classify antifungals: polyenes (amphotericin B binds ergosterol; nephrotoxic, electrolyte wasting), azoles (inhibit 14-alpha-demethylase; fluconazole covers Candida and Cryptococcus, voriconazole covers Aspergillus, posaconazole covers Mucorales), echinocandins (beta-glucan synthase inhibitors; caspofungin, micafungin, anidulafungin-first-line for candidemia), and flucytosine (converted to 5-FU; used with amphotericin for cryptococcal meningitis). Candidemia (echinocandin first-line; remove central line; ophthalmologic exam), invasive aspergillosis (voriconazole or isavuconazole), mucormycosis (liposomal amphotericin B plus surgical debridement; posaconazole step-down), cryptococcal meningitis (amphotericin B + flucytosine induction, then fluconazole), Pneumocystis jirovecii (TMP-SMX; alternatives atovaquone, pentamidine, clindamycin-primaquine), and endemic mycoses (Histoplasma, Blastomyces, Coccidioides-itraconazole or amphotericin for severe disease).
211 words, about 1 min04Mycobacterial Infections including Tuberculosis
Know TB regimens: RIPE (rifampin, isoniazid, pyrazinamide, ethambutol) for 2 months, then rifampin + isoniazid for 4 months for drug-susceptible pulmonary TB. Latent TB: 4R (rifampin 4 months), 3HP (isoniazid + rifapentine weekly x12), or 9H.
206 words, about 1 min05Parasitic and Other Uncommon Infections
Recognize the major parasitic syndromes: malaria (Plasmodium falciparum-artemisinin-based combination therapy; P. vivax/ovale-chloroquine plus primaquine after G6PD testing), babesiosis (azithromycin + atovaquone for mild; clindamycin + quinine for severe), toxoplasmosis (pyrimethamine + sulfadiazine + leucovorin), giardiasis (tinidazole or metronidazole), amebiasis (metronidazole plus paromomycin or iodoquinol for luminal cysts), strongyloidiasis (ivermectin; hyperinfection in HTLV-1 or steroid use), and leishmaniasis (liposomal amphotericin B).
193 words, under 1 min06Infection Prevention, Healthcare Epidemiology, and Antimicrobial Stewardship
Understand transmission-based precautions: contact (MRSA, VRE, C. difficile, scabies), droplet (influenza, pertussis, meningococcus, diphtheria), airborne (TB, measles, varicella, smallpox).
206 words, about 1 min07Immunocompromised Host and Transplant Infectious Diseases
Know the timeline of post-transplant infections: early (first month-surgical, nosocomial, Candida), intermediate (1-6 months-opportunistic: CMV, PJP, Aspergillus, Listeria), and late ( 6 months-community-acquired, late CMV). In neutropenic fever, start empiric anti-pseudomonal beta-lactam (cefepime, piperacillin-tazobactam, or meropenem).
182 words, under 1 min08HIV Medicine and Sexually Transmitted Infections
Know ART: integrase inhibitors (dolutegravir, bictegravir) are preferred first-line; NRTIs (tenofovir, emtricitabine); NNRTIs (efavirenz, rilpivirine); protease inhibitors (darunavir boosted with ritonavir or cobicistat). Start ART in all patients regardless of CD4.
182 words, under 1 min09Travel Medicine, Vaccines, and Pre/Post-exposure Prophylaxis
Know travel vaccines: yellow fever (required for some countries; live-avoid in immunocompromised/pregnancy), typhoid (Vi polysaccharide or Ty21a live), hepatitis A/B, rabies, Japanese encephalitis, and meningococcal (required for Hajj). Malaria prophylaxis: atovaquone-proguanil, doxycycline, or mefloquine (avoid in neuropsychiatric history).
186 words, under 1 min10Diagnostic Microbiology and Laboratory Stewardship
Understand culture vs molecular vs serologic testing. Blood cultures: two sets from separate sites before antibiotics.
179 words, under 1 min