American Board of Internal Medicine Certification (ABIM Board Certification) General Internal Medicine, Neurology & Geriatrics Syllabus

General Internal Medicine, Neurology & Geriatrics syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for General Internal Medicine, Neurology & Geriatrics in American Board of Internal Medicine Certification (ABIM Board Certification), not a summary of it.

1. 1

   Preventive Medicine & Health Maintenance

   4 topics

   • Cancer and disease screening across age groups
   • Adult immunization schedules
   • Smoking cessation and substance use counseling
   • Obesity management and nutrition
2. 2

   Ambulatory & Perioperative Medicine

   4 topics

   • Preoperative cardiac and pulmonary risk assessment
   • Perioperative medication management
   • Common outpatient complaints
     • Fatigue, dizziness, syncope, undifferentiated symptoms
   • Dermatologic conditions in primary care
3. 3

   Neurology for the Internist

   5 topics

   • Stroke and TIA management
   • Headache disorders and migraine
   • Seizures and epilepsy
   • Neurodegenerative disorders
     • Dementia, Parkinson disease
   • Peripheral neuropathy and neuromuscular disorders
4. 4

   Geriatrics & Palliative Care

   4 topics

   • Geriatric syndromes
     • Falls, frailty, delirium, polypharmacy
   • Cognitive impairment assessment
   • Pain and symptom management at end of life
   • Goals of care and advance care planning
5. 5

   Psychiatry, Ethics & Patient Safety

   5 topics

   • Depression, anxiety, and somatic symptom disorders
   • Medical ethics
     • Informed consent, capacity, confidentiality
   • Patient safety and quality improvement
   • Biostatistics and evidence-based medicine interpretation
   • Women's health and men's health across the lifespan

General Internal Medicine, Neurology & Geriatrics flashcards for American Board of Internal Medicine Certification (ABIM Board Certification)

21 of 51 cards from the General Internal Medicine, Neurology & Geriatrics deck — real questions with worked answers.

1. At what age does the USPSTF recommend starting average-risk colorectal cancer screening, and until what age is routine screening recommended?

   Start at age 45; routine screening through age 75. Ages 76-85 should be individualized; screening is generally not recommended after 85.

2. What is the USPSTF lung cancer screening recommendation (modality, age, and smoking criteria)?

   Annual low-dose CT for adults aged 50-80 with a 20 pack-year history who currently smoke or quit within the past 15 years. Stop once a person hasn't smoked for 15 years or develops a life-limiting condition.

3. What is the USPSTF recommendation for cervical cancer screening in women aged 30-65?

   Cytology alone every 3 years, OR high-risk HPV testing alone every 5 years, OR co-testing (cytology + HPV) every 5 years.

4. What is the USPSTF one-time screening recommendation for abdominal aortic aneurysm?

   One-time ultrasound screening in men aged 65-75 who have ever smoked.

5. Which adults should receive the pneumococcal vaccine, and what is the current schedule for adults 65+?

   All adults ≥65. Give PCV20 alone, OR PCV15 followed by PPSV23 ≥1 year later. Adults 19-64 with certain risk conditions also qualify.

6. What is the recommended zoster (shingles) vaccine and schedule for immunocompetent adults?

   Recombinant zoster vaccine (Shingrix), 2 doses 2-6 months apart, for all adults ≥50 (and immunocompromised adults ≥19).

7. How often should adults receive Td/Tdap boosters, and when is Tdap specifically required?

   A Td or Tdap booster every 10 years. Substitute Tdap once if never received, and give Tdap during each pregnancy (ideally 27-36 weeks).

8. What are the 5 A's framework for smoking cessation counseling?

   Ask (about tobacco use), Advise (to quit), Assess (willingness to quit), Assist (with a quit plan/pharmacotherapy), and Arrange (follow-up).

9. Which two first-line pharmacotherapies for smoking cessation are most effective, and which is associated with the highest quit rates as monotherapy?

   Varenicline and nicotine replacement therapy (and bupropion). Varenicline has the highest quit rates as monotherapy; combining varenicline or NRT increases efficacy.

10. What single screening question is validated for detecting unhealthy alcohol use, and what defines at-risk drinking?

    "How many times in the past year have you had X or more drinks in a day?" (X=5 for men, 4 for women). At-risk: >14 drinks/week or >4/day (men); >7/week or >3/day (women, and all >65).

11. What BMI thresholds define overweight, obesity class I, II, and III?

    Overweight 25-29.9; Class I 30-34.9; Class II 35-39.9; Class III (severe) ≥40 kg/m².

12. What are the BMI thresholds for offering pharmacotherapy and bariatric surgery for obesity?

    Pharmacotherapy: BMI ≥30, or ≥27 with a weight-related comorbidity. Bariatric surgery: BMI ≥40, or ≥35 with a comorbidity (some guidelines now ≥30-34.9 with type 2 diabetes).

13. What is the Revised Cardiac Risk Index (RCRI), and name its six predictors?

    A tool estimating perioperative major cardiac risk. Predictors: high-risk surgery, ischemic heart disease, history of heart failure, history of cerebrovascular disease, insulin-dependent diabetes, and creatinine >2.0 mg/dL.

14. What functional capacity threshold (in METs) suggests a patient can proceed to surgery without further cardiac testing?

    ≥4 METs (e.g., climbing a flight of stairs, walking up a hill) without symptoms indicates adequate functional capacity, generally allowing surgery without further cardiac stress testing.

15. In perioperative management, how should beta-blockers and statins be handled?

    Continue chronic beta-blockers and statins through surgery (do NOT start beta-blockers acutely on the day of surgery). Statins are beneficial perioperatively, especially in vascular surgery.

16. How long before surgery should warfarin and direct oral anticoagulants typically be held?

    Warfarin: stop ~5 days before (INR normalizes). DOACs: hold ~2-3 days (longer for dabigatran with renal impairment). Bridging with heparin only for high thromboembolic risk.

17. What are the indications for thrombolysis (tPA/alteplase) in acute ischemic stroke and the time window?

    IV alteplase within 4.5 hours of symptom onset (3 hours for some), after excluding hemorrhage on CT and no contraindications (e.g., recent surgery, active bleeding, BP >185/110).

18. What is the time window for mechanical thrombectomy in large-vessel occlusion stroke, and how is the extended window selected?

    Up to 24 hours from last known well for selected anterior-circulation large-vessel occlusions, guided by perfusion imaging (DAWN/DEFUSE-3 criteria showing salvageable penumbra).

19. What does the ABCD2 score predict, and what are its components?

    Predicts short-term stroke risk after TIA. Components: Age ≥60, BP ≥140/90, Clinical features (unilateral weakness=2, speech impairment without weakness=1), Duration (≥60 min=2, 10-59 min=1), Diabetes.

20. What are the diagnostic features distinguishing migraine without aura (POUND or ICHD criteria)?

    ≥5 attacks lasting 4-72 hours with ≥2 of: unilateral, pulsating, moderate/severe intensity, aggravated by activity; PLUS nausea/vomiting or photophobia and phonophobia.

21. What are first-line acute and preventive treatments for migraine?

    Acute: triptans (or NSAIDs, gepants). Preventive (≥4 headache days/month): beta-blockers (propranolol), topiramate, amitriptyline, candesartan, or CGRP monoclonal antibodies.

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