Special Purpose Exam (SPEX) Qbank

SPEX Exam Prep Questions

Pricing

Questions

Aligned with the National Board of Medical Examiners SPEX content blueprint. Authored & peer-reviewed by faculty, clinicians, and program directors.

Each question is written to resemble the format and topics on the exam, meaning you won’t see any negatively phrased questions, no “all of the following except,” no “A and B”…you know what we mean. Most importantly, all questions include selective distractors (incorrect answer choices), which will help you think critically.

Must address important content
Must be well structured

Question

A 33-year-old otherwise healthy woman presents to the clinic with symptoms of cough that is productive of one-half teaspoon of green sputum per day, fever up to 99.5°F at home, and slight runny nose for the past 5 days. She is up to date on all her immunizations. Vital signs are normal. Head, eye, ear, nose, and throat exam shows clear tympanic membranes, no nasal congestion, no facial tenderness, and no throat erythema or exudate. Lung examination reveals rhonchi that improve with coughing and no signs of consolidation or wheezing. Which of the following is the most likely diagnosis?

A Pneumonia

B Acute sinusitis

C Allergic rhinitis

D Asthma

E Acute bronchitis

Correct Answer Distractors

Viruses such as rhinovirus, enterovirus, influenza A and B, and others cause the vast majority of cases of acute bronchitis. Cough is the defining symptom of acute bronchitis and may last up to 2 to 3 weeks. Other symptoms include sputum production (purulence does not correlate with bacterial infection), shortness of breath, nasal congestion, headache, and fever (usually < 100°F). Examination may show patients who appear somewhat ill and have rhonchi that improve with coughing. Some patients with bronchitis have wheezing

Other causes of cough such as pertussis, asthma or COPD exacerbation, pneumonia, or heart failure as well as sinusitis or pharyngitis need to be considered in the differential diagnosis. Laboratory testing is usually not required for the diagnosis, unless influenza or pertussis is suspected. The American College of Chest Physicians (ACCP) says chest X-ray is not needed in patients with symptoms of acute bronchitis and normal vital signs and lung findings, unless the patient is > 75 years of age. Patients with pneumonia will typically have tachypnea, tachycardia, or dyspnea and signs of consolidation, egophony, or fremitus on examination.

Supportive care is the key component of management of bronchitis and may include over-the-counter analgesics, zinc, nasal decongestants with or without antihistamines, and inhaled ipratropium. Other treatments such as nasal saline irrigation and acetylcysteine have less certain benefit. Cough medications such as antitussives and expectorants have demonstrated mixed evidence with respect to relieving cough and cold symptoms, although they are commonly prescribed and used for this purpose.

Explanations

Written with a purpose

Understanding why an answer choice is incorrect is just as important as knowing why one is correct. That’s why every Rosh Review question includes detailed explanations for the correct and incorrect answer choices. These comprehensive summaries link the most important components of a topic—from risk factors to diagnostics and treatment—giving you the context to build relationships between them.

Created for optimal learning and recall
Help reinforce your knowledge
Focus on the essential information

Illustrations

Created to enhance learning

Custom illustrations and tables help further clarify the core concepts. When information is presented visually, you can focus on meaning, easily reorganize and group similar ideas, and make better use of your memory.

Powerful Analytics

Track progress, performance, & predictions

Your personal analytics allow you to see your progress at all times, so you can create an efficient and effective learning strategy and stay on pace with your plan.

Focus your learning

Deep insights to determine your strengths and weaknesses so you can spend your time on the subjects that matter.

Compare with your peers

Discover how your answer choices align with those selected by learners across the country.

Find out your probability of passing

Using data generated by previous users, your Qbank gives a prediction of how likely you are to pass your exam.

One Step Further

Taking your learning to the next level

After each explanation is a straightforward question with a simple, memorizable answer that reinforces the corresponding topic.

Strengthens your knowledge
Stands alone from the main explanation so you’re not rereading content

Question

What is the strongest predictor for an antibiotic prescription for an upper respiratory infection?

Reveal Answer

Acute Bronchitis

Most common cause of minor hemoptysis
Most commonly caused by viruses
Sx: productive cough for > 5 days
PE: wheezing and rhonchi
CXR: thickening of the bronchial walls in the lower lobes
Tx: symptomatic management
- Routine Abx therapy not indicated

Rapid Review

Keeping things simple

These bulleted reviews focus on condensed, high-yield concepts about the main topic, from patient presentation to preferred management.

Cover the fundamentals in one list
Allow you to quickly scan the must-know information

FAQs

Get a little more clarification

How do I earn CME with Rosh Review?

If you sign up for an account that is linked to CME, here’s what you need to do:

Complete either all the questions or 1,000 questions in your Qbank (depending on your package)

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Go to the Account Settings tab (only on desktop/laptop)
Select Claim next to the subscription package name (see an example)
Complete the survey
Download your certificate

You’ll earn up to 100 AMA PRA Cat 1 CME credits.

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Who writes the questions and explanations?: The finest people around! Questions writers and content editors are board-certified clinicians who have all performed well on their examinations. Answer explanations are derived from the specialty's authoritative resources with some personal input to simply the material and synthesize it for greatest comprehension and recall.
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Attending Physician

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