ABIM Internal Medicine study guide
ABIM Internal Medicine · Work through your exam, one topic at a time.
The ABIM Internal Medicine Certification Examination is the secure, computer-based assessment that the American Board of Internal Medicine uses to grant and maintain certification in internal medicine. It is built for physicians who have completed an accredited residency in internal medicine and want to demonstrate, to hospitals, credentialing bodies, insurers, and patients, that they meet a national standard of knowledge across the full breadth of adult medicine. The ABIM Internal Medicine study guide has 12 sections and about 3,365 words.
01Allergy and Immunology
Anaphylaxis is a clinical diagnosis : acute onset with skin/mucosal involvement plus respiratory compromise or hypotension, or hypotension after a known allergen. Epinephrine is first-line - IM 0.3–0.5 mg of 1:1000 into the lateral thigh, repeated every 5–15 minutes.
316 words, about 2 min02Cardiovascular Disease
Obtain a 12-lead ECG within 10 minutes. STEMI mandates immediate reperfusion (PCI preferred); NSTEMI and unstable angina are managed with risk stratification using troponin trend, ECG changes, and a validated score.
281 words, about 1 min03Endocrinology, Diabetes, and Metabolism
Screen with TSH; free T4 and total T3 follow. Remember sick euthyroid physiology - abnormal thyroid tests in hospitalized patients often resolve.
288 words, about 1 min04Gastroenterology and Hepatology
Upper GI bleeding with cirrhosis requires vasoactive therapy (octreotide) plus prophylactic ceftriaxone and pre-endoscopic PPI. Use restrictive transfusion thresholds (about 7 g/dL; 8 g/dL with cardiovascular disease).
263 words, about 1 min05General Internal Medicine (Geriatrics, Dermatology, Psychiatry, Women's Health, Preventive Care)
Any acute change in cognition or function in an older adult is delirium until proven otherwise. Search for drugs, pain, urinary retention, constipation, dehydration, infection, and sensory deprivation; use non-pharmacologic measures first and reserve antipsychotics for danger to self or others.
273 words, about 1 min06Hematology
Classify by MCV, then use the reticulocyte count to separate underproduction from destruction or loss. Iron deficiency gives low ferritin, low transferrin saturation, and high TIBC - but ferritin is an acute-phase reactant and may be normal in inflammation.
269 words, about 1 min07Infectious Disease
Recognize sepsis early and give broad-spectrum antibiotics within one hour for shock, after cultures when it does not delay treatment. De-escalate based on culture data; treating colonization (asymptomatic bacteriuria, sputum grown from a colonized airway) is a classic trap.
289 words, about 1 min08Nephrology
Divide into prerenal, intrinsic, and postrenal causes; obtain a bladder scan to exclude obstruction. Prerenal states show a fractional excretion of sodium below 1% and bland urine sediment (hepatorenal and contrast-associated injury are exceptions).
277 words, about 1 min09Neurology
Check glucose immediately - hypoglycemia mimics stroke. Get a noncontrast head CT to exclude hemorrhage; an early normal CT does not exclude ischemia.
287 words, about 1 min10Oncology
Febrile neutropenia (absolute neutrophil count under 500 with fever) requires cultures and empiric antipseudomonal antibiotics within 60 minutes. Suspected spinal cord compression demands dexamethasone and urgent MRI of the entire spine before neurologic deficits become fixed.
258 words, about 1 min11Pulmonary Disease
Spirometry after bronchodilator is essential: an FEV1/FVC ratio below 0.70 defines obstruction, and a significant FEV1 improvement indicates reversible airflow limitation. In COPD, smoking cessation is the only intervention that slows decline; add long-acting bronchodilators, and reserve inhaled corticosteroids for frequent exacerbations or elevated eosinophils.
269 words, about 1 min12Rheumatology and Orthopedics
Aspirate before giving antibiotics. Gout shows negatively birefringent needle-shaped crystals; pseudogout shows positively birefringent rhomboid crystals with chondrocalcinosis.
295 words, about 1 min