Internal medicine — in the LEK question base
The largest field in the entire base — cardiology, pulmonology, gastroenterology, nephrology, endocrinology, haematology and rheumatology.
- Questions in base
- 585
- Share of base
- 19.1%
- Roughly on the paper
- ~27
The "on the paper" figure assumes the 140 questions drawn from the base are distributed in proportion to its composition. CEM does not publish per-field quotas, so treat it as an order of magnitude rather than a promise.
Required reading — internal medicine
The list CEM publishes for this field. Questions are written from these titles, so where a lecture and a listed textbook disagree, the textbook decides.
They appear here in Polish, exactly as CEM lists them — these are the specific editions that count, and most have no English translation. That is not an oversight on our part; it is the central practical problem of sitting this exam in English.
- 01 Andrzej Szczeklik, Piotr Gajewski — Interna Szczeklika 2024, Medycyna Praktyczna, 2024
- 02 Interna Szczeklika 2024/25. Mały podręcznik, Medycyna Praktyczna
- 03 S.H. Ralston i in. — Davidson. Choroby wewnętrzne, Edra Urban & Partner, 2020
Source: the CEM reading list . As at August 2026 — check before your session in case CEM has revised it.
Sample questions from the base
Ten items from CEM's public listing for this field, in the official English wording used on the exam paper. The correct answer is highlighted. Detailed explanations live in our Polish application (source of preparation).
A 52-year-old woman receiving orally iron formulations because of mild microcytic anaemia complains of abnormally heavy menorrhagia. The doctor ordered faecal guaiac occult blood test (FOBT) three times and the results were positive. Which strategy should be chosen first?
- A colonoscopy.
- B FOBT should be repeated after discontinuation of iron formulations.
- C coeliac disease should be excluded.
- D diet with elimination of high doses of vitamin C and repeat the test.
- E decision needs to be based on gastrointestinal symptoms. ✓
Which of the following medications should be avoided in the patient with hypertrophic cardiomyopathy, with left ventricular outflow tract peak instantaneous pressure gradient 35 mmHg (measured with Doppler echocardiography), left ventricular ejection fraction 52%, symptoms of heart failure NYHA class II and chest pain: 1) nonsteroidal anti-inflammatory drugs; 2) non-vasodilating beta-blockers; 3) non-dihydropyridine calcium channel blockers; 4) long-acting oral nitrates; 5) digoxin. The correct answer is:
- A 1,3,4.
- B 1,4,5.
- C 2,3,5.
- D 4,5. ✓
- E only 5.
The extra-articular manifestations in rheumatoid arthritis include: 1) lymphadenopathy; 2) rheumatoid nodules; 3) pulmonary fibrosis; 4) keratoconjunctivitis, scleritis, episcleritis; 5) pericarditis. The correct answer is:
- A all the above. ✓
- B only 2.
- C 3,5.
- D 1,2,3,5.
- E 2,3,5.
A 62-year-old patient with arterial hypertension and type 2 diabetes presents at his family doctor office because of a retrosternal stubbing pain that occurs after going upstairs to the first floor. The symptoms started about 6 weeks ago. Medical examination shows no significant abnormalities. The ECG records regular sinus rhythm 70/min without changes within ST segment or T wave. Indicate the correct management of this patient:
- A referring the patient to the cardiology ward in order to exclude myocardial infarction and to perform urgent coronarography.
- B referring the patient to the cardiology outpatient clinic in order to schedule the planned coronarography.
- C referring the patient to the cardiology outpatient clinic in order to perform non-invasive stress echocardiography.
- D referring the patient to the cardiology outpatient clinic in order to perform stress test ECG.
- E patient does not need any further diagnostics. ✓
A 70-year-old patient, treated for arterial hypertension for over 30 years, called his family doctor because of lower limb edemas worsening for a week. Physical examination showed increased blood pressure and edemas around ankles. Indicate the least probable cause of those symptoms:
- A hypertensive nephropathy.
- B drug-induced lymphatic edemas.
- C congestive heart failure.
- D nephrotic syndrome in the course of primary amyloidosis. ✓
- E nephrotic syndrome in the course of glomerulonephritis.
Non-cardiac conditions that predispose towards atrial fibrillation include: 1) hyperthyroidism; 2) hypothyroidism; 3) acute infection; 4) obstructive sleep apnea; 5) pheochromocytoma. The correct answer is:
- A 1,3,5.
- B 1,3,4,5.
- C 1,2,3,5.
- D 2,3,4,5.
- E all the above. ✓
The abnormalities in ECG which are characteristic of hyperkalemia include: 1) ST depression; 2) flattened P wave; 3) shortened QT intervals; 4) tall and narrow T waves; 5) tall and wide U waves. The correct answer is:
- A 1,2,4,5.
- B 1,4,5.
- C 3,4,5.
- D 2,3,4. ✓
- E 2,4.
Cancer-related ileus:
- A is most frequent in patients with ovarian cancer and gastrointestinal tumours.
- B may be caused by a mechanical obstruction or may be related to metabolic disorders.
- C is always an indication for using somatostatin analogues.
- D A and B are true. ✓
- E A, B and C are true.
A decreased serum iron concentration can be found in:
- A megaloblastic anemia.
- B sideroblastic anemia.
- C chronic disease anemia. ✓
- D healthy persons aged 16-20 years.
- E healthy persons aged over 65 years.
In which clinical circumstances a decrease in the diffusing capacity of the lung for carbon monoxide (DLCO) is observed? 1) interstitial pulmonary fibrosis; 2) alveolar hemorrhage; 3) well-controlled asthma; 4) pulmonary emphysema; 5) severe perfusion disturbances (e.g. pulmonary embolism). The correct answer is:
- A 1,2,5.
- B 1,3.
- C 1,4,5. ✓
- D 2,3,5.
- E 1,2,3,4.
Full listing for this field contains 585 questions — these ten are a preview. Detailed rationales, spaced-repetition scheduling and citations are in the Polish app (English coverage is in progress).
How to get through this field
585 questions is a finite, countable set — at twenty a day you are through it in 30 days. The difficulty is not the volume. It is that the CEM listing gives you the questions and nothing else: no answer key, no explanation and no indication which of the books above the answer came from.
In our bank every question in this field carries an explanation and a citation to its source. Instead of memorising a letter you see why the other four options are wrong — and that is the part which transfers to the 60 unpublished questions you cannot prepare for in advance. The English edition is in progress; these pages come first.