AOBIM Internal Medicine case studies
AOBIM Internal Medicine · Put your knowledge to work in context.
The American Osteopathic Board of Internal Medicine (AOBIM) is one of the AOA's specialty certifying boards, and its Internal Medicine credential is the osteopathic board certification pathway for physicians practicing adult internal medicine. The AOBIM site frames certification as an affirmation of "ongoing evidence-based education resulting in high-quality whole person care," and positions AOA board certification as a quality marker for patients and employers. The AOBIM Internal Medicine case studies are 5 cases and about 2,108 words.
1Anticoagulation in a Patient with Atrial Fibrillation and Recurrent Falls
A 78-year-old woman with permanent atrial fibrillation, hypertension, and stage 3 chronic kidney disease (baseline creatinine 1.6 mg/dL, estimated CrCl 32 mL/min) presents after her third mechanical fall in six months; the most recent fall caused a left wrist fracture but no head trauma. Her CHA2DS2-VASc score is 5 (age, hypertension, female sex, plus prior TIA two years ago) and HAS-BLED is 3 (hypertension, renal function, age 65).
518 words, about 3 min2Chest Pain with a Normal Initial Troponin in a Patient with Diabetes
A 58-year-old man with type 2 diabetes (HbA1c 8.4%), hypertension, and a 30-pack-year smoking history presents to the emergency department 90 minutes after the onset of substernal pressure radiating to the left jaw, associated with diaphoresis and nausea. His initial high-sensitivity troponin at presentation is below the limit of detection, and his ECG shows 1 mm of ST depression in leads V4–V6 without ST elevation.
424 words, about 2 min3Diuretic Titration in Worsening Heart Failure with Worsening Renal Function
A 72-year-old man with heart failure with reduced ejection fraction (EF 30%) is admitted with 4+ lower extremity edema, orthopnea, jugular venous distension to the jaw, and 6 kg weight gain over two weeks. He takes guideline-directed medical therapy including sacubitril/valsartan, carvedilol, spironolactone, and furosemide 40 mg daily.
429 words, about 2 min4New Hyperglycemia in a Hospitalized Patient on Steroids
A 64-year-old woman with no prior diagnosis of diabetes is admitted with a COPD exacerbation and started on prednisone 40 mg daily plus antibiotics and nebulized bronchodilators. On hospital day 2, her point-of-care glucose is 310 mg/dL, and repeat is 285 mg/dL.
388 words, about 2 min5Antibiotic Choice for Community-Acquired Pneumonia with Penicillin Allergy
A 45-year-old woman presents with fever, productive cough, and right lower lobe infiltrate on chest radiograph consistent with community-acquired pneumonia. She reports a 'severe penicillin allergy'-when asked, she describes a childhood rash that occurred after amoxicillin but no anaphylaxis, angioedema, or hospitalization.
349 words, about 2 min