American Board of Internal Medicine (ABIM) Certification Practice Exam

What procedure should patients with amyloidosis undergo for classification?

1. Amyloid typing of amyloid deposits

2. Genetic testing for familial amyloidosis

3. Bone marrow aspirate

4. CT scan of the abdomen

The correct answer is: Amyloid typing of amyloid deposits

Patients with amyloidosis require amyloid typing of amyloid deposits to classify the specific type of amyloid. This procedure is crucial because amyloidosis consists of a diverse group of diseases characterized by the deposition of amyloid, which are abnormal protein aggregates that can affect various tissues and organs. Identifying the exact type of amyloid is essential for determining the appropriate management and treatment plan. Different types of amyloidosis, such as AL (light chain) amyloidosis or ATTR (transthyretin) amyloidosis, have different underlying causes and implications for therapy. The other options, while they may provide additional information or context regarding the patient's condition, do not directly contribute to the classification of amyloidosis. For example, genetic testing is significant for investigating familial amyloidosis but doesn't aid in classification of the deposited amyloid type in already diagnosed patients. Similarly, a bone marrow aspirate could be useful in certain cases, especially if AL amyloidosis is suspected, but it does not definitively classify the amyloid deposits. A CT scan of the abdomen can help assess organ involvement and complications arising from amyloidosis, but it does not help in identifying the type of amyloid. Thus, amyloid typing remains the definitive