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USMLE Step 2 CK Internal Medicine Practice Questions

Internal medicine carries more Step 2 CK points than any other subject. Generate unlimited timed or study-mode blocks on any IM topic — every question comes with a full rationale, key points and references.

Start an internal medicine block

Why internal medicine first

~1/3+

Of exam content

8

Subspecialty areas

40–80

Questions/day target

IM reasoning also transfers: the same workup logic drives emergency medicine, geriatrics and much of the surgery and OB/GYN medical management on the exam. Time spent here pays twice.

High-yield topics covered

Use these as custom topics — ask for “10 questions on hyponatremia” and get a set built on the spot.

Cardiology

  • ACS: STEMI vs NSTEMI management and timing
  • Heart failure: acute decompensation and GDMT
  • Atrial fibrillation: rate vs rhythm, anticoagulation
  • Valvular disease and murmur-driven workup

Pulmonology

  • COPD and asthma exacerbations
  • Pulmonary embolism: risk scores and imaging choice
  • Community-acquired pneumonia and severity triage
  • Solitary pulmonary nodule follow-up

Gastroenterology & Hepatology

  • Upper and lower GI bleeding
  • Cirrhosis complications: ascites, SBP, encephalopathy
  • Pancreatitis severity and management
  • IBD flares and colorectal cancer screening

Nephrology

  • Acute kidney injury: pre-renal, intrinsic, post-renal
  • Hyponatremia and hyperkalemia algorithms
  • Acid-base disorders with compensation
  • Nephritic vs nephrotic syndromes

Endocrinology

  • DKA and hyperosmolar hyperglycemic state
  • Type 2 diabetes agent selection and targets
  • Thyroid disease and nodule workup
  • Adrenal insufficiency and Cushing syndrome

Hematology & Oncology

  • Microcytic, normocytic and macrocytic anemias
  • Thrombocytopenia: ITP, TTP, HIT
  • Oncologic emergencies
  • Cancer screening guidelines by age

Infectious Disease

  • Sepsis recognition and early management
  • Endocarditis, meningitis, osteomyelitis
  • HIV: opportunistic infections and prophylaxis
  • Antibiotic selection and stewardship

Rheumatology

  • Monoarticular vs polyarticular arthritis
  • SLE, RA and vasculitis presentations
  • Crystal arthropathies
  • Giant cell arteritis and polymyalgia rheumatica

How to practice internal medicine effectively

  • Start in study mode. See the rationale immediately after each question while you are still building the framework for a presentation.
  • Move to timed blocks. Once a topic feels stable, do randomized 20-question blocks so pacing and stamina are trained too.
  • Review as long as you answer. Write one line per missed question explaining why the correct answer beat your choice.
  • Redo your incorrects. Rebuild a set from only the questions you previously missed to confirm the gap actually closed.
  • Anchor to next steps. Most IM items ask for the next best step, not the diagnosis — practice choosing the action.

Fit it into your schedule

Most plans front-load internal medicine across the first two weeks of dedicated study. See the 6-week and 10-week study plans, then check your progress against score and percentile benchmarks.

Frequently asked questions

How much of Step 2 CK is internal medicine?

It is the largest single subject — roughly a third or more of the exam once subspecialty and overlapping emergency and geriatric items are counted.

Which IM topics are highest yield?

ACS and heart failure, COPD/asthma and PE, GI bleeding and liver disease, AKI and electrolytes, diabetes and thyroid, anemias, sepsis, and initial rheumatology workups.

How many questions per day?

40–80 per day during dedicated study, 20–40 per day on a longer timeline, always with equal review time.

Are these practice questions free?

Yes — unlimited internal medicine questions with full rationales are free during the current beta.

Practice internal medicine now

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