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Clinical shelf · Study guide

Internal Medicine

Start with a clinical decision, read a focused lesson, then practice questions and revisit your misses. Organ-system problem → competing diagnosis → next management decision.

Practice this shelf →Explore free practiceShelf exam bank

Start with a clinical decision

These existing lessons are suggested starting points, not a ranked prediction of exam frequency. Check the full lesson directory below for more systems and cases.

Clinical lesson

Adrenal Insufficiency

Distinguish primary from central failure and connect cortisol testing to crisis prevention.

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Clinical lesson

Heart Failure

Connect filling pressure and perfusion to symptoms, EF phenotype, and acute versus chronic care.

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Clinical lesson

Infective Endocarditis

Read the teaching and identify the decision that changes management.

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Choose your pace

2 weeks

Focused review

Days 1–4: map and lessons. Days 5–10: targeted questions and an error log. Days 11–14: mixed retrieval.

4 weeks

Steady blocks

Week 1: map and lessons. Weeks 2–3: topic blocks and spaced retrieval. Week 4: mixed review.

6 weeks

Build and consolidate

Weeks 1–2: lessons. Weeks 3–4: shelf blocks. Week 5: mixed application. Week 6: weak-area retest.

Retrieve, then resume

After each question, name one wrong-answer discriminator and the finding that would change management. Return after 48 hours and on day 7 to explain the decision without looking. Scale question blocks to available eligible questions; no fixed count is promised.

Open study plan · Resume your pathway · Browse all subjects

Free practice is subject to reviewed question availability and guest access. It is not an official exam simulation.

New Module Prevention & Screening USPSTF cancer screening, adult immunizations, and health maintenance by age: the prevention questions that actually show up.

140 related teaching pages across subjects. These are the original lessons, collected here for clinical study.

Osteopathic material is separately marked. Continue in your study plan or browse the full directory below.

01

Cardiovascular & Circulatory

Heart murmurs. Timing, pressure and bedside decisions
Cardio · Valvular
Mitral RegurgitationPro
Cardio · Valvular
Diastolic RumblePro
Cardio · Valvular
Wide S2 SplitPro
Cardio · Heart sounds
Paradoxical S2 SplitPro
Cardio · Heart sounds
Cardiomyopathies. Shape, tissue and clinical decisions
Cardio · Myocardial
Frank-Starling
Cardio · Mechanism
HemodynamicsPro
Cardio · Mechanism
Inferior MI, right ventricular failure, and AV blockPro
Cardio · ACS
Post-MI complications through rhythm, flow, and tissue failurePro
Cardio · ACS
MI ED Meds: MONA-BAHPro
Cardio · ACS management
Antiarrhythmics
Cardio · Arrhythmia mgmt
EKG Lead I: Vector from RA to LAPro
Cardio · Dx tech
Beta blockers: predict the tissue responsePro
Pharm · HTN / IHD mgmt
Digoxin: stronger contraction, slower conduction, narrow margin
Pharm · Rate / CHF mgmt
Renal artery stenosis and RAAS
Renal · Secondary HTN
Cholesterol Synthesis & RegulationPro
Biochem · Hyperlipidemia
Hypertension: Staging, First-Line Drugs, and the Crisis RulePro
Cardio · HTN management
Heart failure through pressure, perfusion and treatment
Cardio · HFrEF / GDMT
Atrial Fibrillation: Rate, Rhythm, and Stroke PreventionPro
Cardio · Arrhythmia
Infective Endocarditis: Vegetations, Duke Criteria & the Peripheral SignsPro
Cardio · Valve infection
EKG Interpretation
Cardio · Dx tech
Congenital heart defects through blood flow
Cardio · Congenital
Chronic Venous InsufficiencyPro
Cardio · Vascular
02

Respiratory

Asthma and COPD
Resp · Obstructive
Centriacinar vs Panacinar Emphysema
Resp · Obstructive
Pneumonias: from airspace findings to targeted care
Resp · Infection
Lung abscess: follow the route, locate the collection
Resp · Infection
PE and DVT from probability to treatment
Resp · Vascular
ARDS and the lung that needs protection
Resp · Critical care
Acid-base disorders
Resp · Dx tech
Pulmonary Physiology: Air, Blood and Pressure
Resp · Mechanism
Sarcoidosis: diagnosis, organ risk, and treatment
Resp · Interstitial
Lung cancers: tissue, physiology, and treatment decisions
Resp · Oncology
03

Heme / Onc / Immunology

Anemias: explain cell size and marrow response
Heme · Hub
Microcytic Anemias
Heme · Anemia
Macrocytic, Normocytic Anemias & PNH
Heme · Anemia
Iron Deficiency Anemia Workup
Heme · Dx tech
Lead Poisoning
Heme · Toxic
Coagulation: connect assays to bleeding and thrombosis
Heme · Coagulation
Clotting cascade: localize the defect, then explain the phenotype
Heme · Mechanism
Hemophilia & the Coag CascadePro
Heme · Coagulation
Platelet disorders: number, function and clinical patternPro
Heme · Coagulation
Drugs of the Clotting CascadePro
Heme · Management
Multiple Myeloma & MGUS
Heme · Malignancy
Cancer Translocations: t(9;22), t(8;14) & More
Heme · Malignancy
Hypersensitivity Reactions (Types I-IV)
Immuno · Allergy
Autoantibodies: Disease Associations & Drug-Induced Lupus
Immuno · Dx tech
Primary Immunodeficiency DisordersPro
Immuno · Immunodeficiency
Vasculitis: read the vessel before naming the diseasePro
Immuno · Vasculitis
Opportunistic infections: connect immune risk to the affected organ
Micro · HIV / AIDS
HIV Diagnosis and Antiretroviral ManagementPro
ID · HIV
Sepsis and Septic Shock · Hour-1 Bundle and Shock PhysiologyPro
ID · Critical care
Meningitis: urgent decisions, CSF patterns and pathogen-specific care
ID · CNS infection
Antimetabolites & Drug Interactions
Pharm · Chemo
Cancer Pathology: Lineage, Spread, and Driver Logic
Path · Neoplasm
Cancer Metastasis Patterns
Path · Metastasis
Oncogenes and tumor suppressors: added drive versus lost restraint
Path · Mechanism
Psammoma Bodies: The 5 Classic Tumors
Path · Solid tumor
Ionizing radiation: from energy deposition to cancer
Path · Radiation
04

GI & Nutrition

Crohn Disease vs Ulcerative Colitis
GI · IBD
Hepatitis serologies: what the result can actually tell you
GI · Liver / Dx tech
Hepatocellular carcinoma: the tumor and the liver
GI · Liver
Liver Metastases and Secondary Tumors
GI · Liver
Primary Sclerosing Cholangitis versus Primary Biliary Cholangitis
GI · Biliary
Acute Pancreatitis
GI · Pancreas
PPI-associated hypergastrinemia: read the hormone beside the acidPro
GI · Upper GI
Zinc DeficiencyPro
GI · Nutrition
Wernicke Encephalopathy and Korsakoff SyndromePro
Neuro · Thiamine deficiency
GERD, Erosive Esophagitis, and Peptic Ulcer DiseasePro
GI · Upper GI
Cirrhosis and Portal HypertensionPro
GI · Liver
05

Nervous System & Mental Health

Stroke Syndromes
Neuro · Stroke
Cortical Stroke Syndromes: Localize the DysfunctionPro
Neuro · Stroke
Brainstem Stroke Syndromes: Trace the Pathway, Test the PatternPro
Neuro · Stroke
Lenticulostriate StrokesPro
Neuro · Stroke
Intracranial HemorrhagesPro
Neuro · Stroke
Dementias: Timing, Networks, and Treatable Contributors
Neuro · Neurodegenerative
Parkinson DiseasePro
Neuro · Neurodegenerative
Movement Disorders: Parkinson, Huntington, TremorsPro
Neuro · Movement
Demyelinating diseases: localization, timing and treatment
Neuro · Demyelinating
Neuromuscular Junction Disorders: MG, LEMS and Botulism
Neuro · Neuromuscular
Spinal Stenosis: When the Canal Squeezes the CordPro
Neuro · Spinal cord
Seizures and epilepsyPro
Neuro · Cerebral
Idiopathic Intracranial HypertensionPro
Neuro · Cerebral
Cranial nerves and clinical localization
Neuro · Peripheral
Schizophrenia and mood disorders
Psych · Mental health
Antidepressants
Psych · Management
Antipsychotics, Mood Stabilizers, and Anxiolytics
Psych · Management
Personality disorders
Psych · Mental health
The Agitated Patient
Psych · Management
06

Genitourinary / Renal

AKI and CKD. Read the timeline, perfusion, and urine together
Renal · AKI / CKD
Nephrotic and nephritic syndromes. Find the injured compartment
Renal · Glomerular
Renal tubular acidosis
Renal · Tubular
Electrolytes in clinical context
Renal · Fluid / lytes
Renal artery stenosis and RAAS
Renal · Vascular
Diuretics and the nephronPro
Renal · Management
Prostate Cancer Drugs
Pharm · GU oncology
07

Endocrine & Metabolism

DKA and HHS: Ketones, Acidosis, and Hyperosmolality
Endo · Diabetes
Insulinoma and the hypoglycemia critical sample
Endo · Diabetes
Antidiabetic drugs. Match the mechanism to the personPro
Pharm · Management
Thyroid disorders from hormone source to treatment
Endo · Thyroid
The Calcium, PTH, and Vitamin D Axis
Endo · Parathyroid
Adrenal InsufficiencyPro
Endo · Adrenal
Adrenal masses: hormones, feedback, and the incidentaloma fork
Endo · Adrenal
Congenital adrenal hyperplasia: read the blocked steroid pathway
Endo · Adrenal
Pituitary tumors and the logic of water balance
Endo · Pituitary
Gigantism (GH Excess)
Endo · Pituitary
MEN Syndromes: MEN1 vs MEN2A vs MEN2B
Endo · Tumor syndrome
Pancreatic Neuroendocrine Tumors: VIPoma & Friends
Endo · Islet tumors
Glucagonoma Syndrome: NME, Catabolism, and Pancreatic NET Reasoning
Endo · Islet tumors
Hypothalamic and Pituitary Drugs: Timing, Targets and Water
Pharm · Management
08

MSK & Rheumatology

The Big 5 Autoimmune Diseases
MSK · Inflammatory
Seronegative Spondyloarthropathies: The 4 ComparedPro
MSK · Seronegative
Autoantibodies: Disease Associations & Drug-Induced Lupus
Immuno · Rheum serology
Vasculitis: read the vessel before naming the diseasePro
Immuno · Vasculitis
Viscerosomatic reflexes: pathways, patterns and limits
OMM · Viscerosomatic
Low Back Pain: Clinical Patterns and Osteopathic Reasoning
OMM · Somatic dysfunction
09

Integumentary

Classic Derm Findings
Derm · Lesions
Skin cancers through tissue, invasion and risk
Derm · Oncology
Actinic keratosis and the epidermal boundary
Derm · Precancer
Hypersensitivity Reactions (Types I-IV)
Immuno · Atopic mechanism
10

Community Health & Prevention

Adult Prevention & Screening: Who Gets What & When
IM · New module
Screening Tests, Predictive Values, and Study Results
Biostats · Screening principles
Medical Interpreter Rules and Meaningful Communication
Biostats · Communication
Medication Adherence: Exposure, Barriers and Safe Treatment
Endo · Behavioral
🔎

Read the Test

Diagnostic Technologies is the single heaviest physician task on the shelf. These pages cut across every system: the EKG, the ABG, the LFTs, the CBC, and the serology that the vignette hands you.

Acid-base disorders
Read the ABG
Iron Deficiency Anemia Workup
Read the CBC / iron studies
Hepatitis serologies: what the result can actually tell you
Read the serology panel
Autoantibodies: Disease Associations & Drug-Induced Lupus
Read the rheum panel
EKG Lead I: Vector from RA to LAPro
Read the tracing
Screening Tests, Predictive Values, and Study Results
Interpret the test
Dyslipidemia and Lipid ManagementPro
IM · Statin intensity by risk
Urinary Tract InfectionsPro
IM · Cystitis vs pyelonephritis
Osteoporosis: read the fracture, DXA, risk, and treatment sequencePro
IM · DEXA, FRAX, bisphosphonates
+

More Internal Medicine Deep-Dives

ALS, Upper + Lower Motor Neuron SignsPro
Neuro · Motor neuron disease
Huntington Disease, CAG Repeats & ChoreaPro
Neuro · Neurodegenerative
Normal pressure hydrocephalus: from gait to a treatment decision
Neuro · Reversible dementia
Brain TumorsPro
Neuro · Neuro-oncology
Spinal Cord Tracts and SyndromesPro
Neuro · Cord localization
Conus Medullaris + Cauda Equina + LP LandmarksPro
Neuro · Cord emergency
Restless Leg SyndromePro
Neuro · Movement / sleep
AIDS Dementia Complex, HIV EncephalopathyPro
Neuro · HIV encephalopathy
Aphasias: Test the Pattern, Localize the Network, Plan the Care
Neuro · Stroke localization
Neurodegeneration Decoder: Anatomy, Circuits and Tempo
Neuro · Synthesis
Eating disorders
Psych · Mental health
Trauma and PTSD Disorders: Criteria, Context and Care
Psych · Mental health
Toxidromes and antidotes: recognize the failing physiology
Pharm · Poisoning / AMS
Tyramine Crisis: MAOI Hypertensive ReactionPro
Pharm · MAOI reaction
Botulism: Recognize the Pattern, Protect Breathing
ID · Neuromuscular toxin
Wilson DiseasePro
GI · Metabolic liver disease
E. coli and Shigella: mechanism, tissue and treatment
ID · Infectious diarrhea
Platelets & HemostasisPro
Heme · Mechanism
Chapman Points
OMM · Viscerosomatic chart
Autonomic Spinal Levels
OMM · Sympathetic / parasympathetic
Bone Wizardry is an independent educational resource for visual learning in the medical sciences. It is not affiliated with, endorsed by, or sponsored by any licensing or examination board, contains no real or recalled examination questions, and does not guarantee any educational or examination outcome.

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