ABIM Cheat Sheet 2026

The 30 highest-yield ABIM facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which feature of psoriatic arthritis most distinctly differentiates it from rheumatoid arthritis? → Dactylitis (sausage digits)
2. A patient with CKD stage 4 has a serum potassium of 6.2 mEq/L with peaked T waves on ECG. What is the immediate treatment? → IV calcium gluconate
3. Which acid-base disorder is most commonly associated with diarrhea? → Non-anion gap metabolic acidosis
4. A 35-year-old woman develops hypercalcemia with a PTH of 120 pg/mL (normal 10–65). She is asymptomatic. Which statement is correct about management? → Surgery is indicated if age 1 mg/dL above upper limit
5. A patient with community-acquired pneumonia (CAP) is admitted to the hospital (non-ICU). Blood cultures are negative. What is the preferred antibiotic regimen? → Beta-lactam plus macrolide, or respiratory fluoroquinolone
6. A patient with a history of recurrent kidney stones has 24-hour urine showing hypercalciuria with normal serum calcium. What is the most likely diagnosis? → Idiopathic hypercalciuria
7. A 28-year-old woman presents with heat intolerance, tremor, weight loss, and a diffuse goiter with a bruit. TSH is undetectable. What is the most likely cause? → Graves disease
8. What is the primary mechanism of action of colchicine in the treatment of acute gout? → Inhibition of neutrophil microtubule polymerization
9. Which antibody is most specific for rheumatoid arthritis? → Anti-cyclic citrullinated peptide (anti-CCP)
10. A patient with heart failure has an ejection fraction of 35%. Which medication class has been shown to reduce mortality in this population? → Beta-blockers
11. A 25-year-old man presents with recurrent painful oral ulcers, genital ulcers, and uveitis. What is the most likely diagnosis? → Behçet's disease
12. During an asthma attack, confusion, bradycardia, and paradoxical breathing signify: → Imminent respiratory arrest
13. A patient with chronic stable angina is intolerant to beta-blockers and has preserved LV function. Which agent is the best alternative for anti-anginal therapy? → Non-dihydropyridine calcium channel blockers
14. A patient with hypertrophic obstructive cardiomyopathy (HOCM) experiences syncope during exercise. Which medication is contraindicated? → Nitroglycerin
15. A 45-year-old woman with primary biliary cholangitis has an alkaline phosphatase of 4x normal and pruritus. Which medication is first-line? → Ursodeoxycholic acid (UDCA)
16. Which antibody is most specific for systemic lupus erythematosus (SLE)? → Anti-Smith (anti-Sm)
17. A patient with type 2 diabetes has a foot ulcer that probes to bone. X-ray shows periosteal reaction and bone erosion. What is the most appropriate next step? → MRI of the foot
18. A patient with alcohol-related cirrhosis has hepatic encephalopathy. Ammonia is elevated. Which treatment reduces recurrence of hepatic encephalopathy? → Rifaximin plus lactulose
19. The COPD symptom that frequently develops several years before the onset of airflow restriction is: → Dyspnea
20. A patient with Graves disease is planning pregnancy. Which treatment is preferred in the first trimester? → Propylthiouracil (PTU)
21. A 40-year-old woman with nephrotic syndrome due to minimal change disease (MCD) fails to respond to two courses of prednisone. What is the next treatment? → Cyclosporine
22. A 55-year-old woman with Cushing disease undergoes transsphenoidal surgery but has persistent hypercortisolism. What is the next treatment option? → Repeat transsphenoidal surgery or radiotherapy
23. Pulmonary function tests show: FEV1/FVC 0.82, FVC 58% predicted, TLC 65% predicted. DLCO is 50% of predicted. What pattern is present? → Restrictive pattern
24. Anemia due to a lack of iron Typically, transferrin saturation is lower. → 15%
25. A 45-year-old man presents with acute pericarditis. Which finding on ECG is most characteristic? → Diffuse ST elevation with PR depression
26. A 55-year-old man with gout and recurrent uric acid kidney stones has a 24-hour urine uric acid of 900 mg. What is the most appropriate preventive treatment? → Allopurinol
27. A 60-year-old diabetic patient has proteinuria of 3.5 g/day, hypoalbuminemia, and peripheral edema. Serum creatinine is normal. What is the diagnosis? → Nephrotic syndrome
28. Which antibody is characteristically associated with drug-induced lupus? → Anti-histone
29. Near the medial plantar heel surface, there is pain and discomfort. Pain often strikes right after waking up and after a lengthy period of relaxation. → Plantar fasciitis
30. A 30-year-old man develops arthritis, urethritis, and conjunctivitis 2-4 weeks after a Salmonella gastroenteritis. What is the most likely diagnosis? → Reactive arthritis