Cardiology boards ABIM LATEST 2023-2024
ACTUAL EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+
Normals for PA catheter pressures - CORRECT ANSWER RA <7, RV 30/7, PCWP 3-
11
PA cath findings in tamponade or constrictive pericarditis - CORRECT ANSWER
Diastolic pressures elevated and equalized in all chambers, low BP, tachycardia,
interventricular dependence (septal bounce)
PA cath findings in cardiogenic shock - CORRECT ANSWER Elevated PCWP, RA
pressure, and decreased SBP/cardiac output
PA cath findings in mitral stenosis with RV failure - CORRECT ANSWER Elevated
RA, PA (very elevated), PCWP, nl SBP
PA cath findings in pulmonary HTN - CORRECT ANSWER Elevated PA, RA
pressures, nl PCWP, SBP
Pulsus paradoxus - CORRECT ANSWER decrease in systolic BP of more than
10mmHg with normal inspiration; palpated as weakened pulse with inspiration
along with more heart contractions to pulse beats
,What conditions give you pulsus paradoxus? - CORRECT ANSWER Constrictive or
restrictive pericarditis, asthma, tension pneumothorax
What gives you pulsus bisferiens (two systolic peaks per cycle) - CORRECT
ANSWER Aortic regurgitation, HOCM
What causes pulsus alternans? - CORRECT ANSWER Severe LV dysfunction
What causes pulsus tardus et parvus? - CORRECT ANSWER Late and weak; Aortic
stenosis
How do positional maneuvers affect blood flow and murmurs?
a) Standing/Valsalva
b) Squatting/Lying down
c) Sustained handgrip - CORRECT ANSWER -standing/valsalva - decreased cardiac
filling, decreases most murmurs except MVP and HOCM
-squatting/ lying down - increase cardiac volume, increased murmurs except MVP,
HOCM
-sustained handgrip - increases systemic resistance, decreases murmur in HOCM,
AS
What are the stages of the Valsalva maneuver? - CORRECT ANSWER -Phase one is
the onset of straining with increased intrathoracic pressure. The heart rate does
not change but blood pressure rises.
-Phase two is marked by the decreased venous return and consequent reduction
of stroke volume and pulse pressure as straining continues. The heart rate
increases and blood pressure drops.
, -Phase three is the release of straining with decreased intrathoracic pressure and
normalization of pulmonary blood flow.
-Phase four marks the blood pressure overshoot (in the normal heart) with return
of the heart rate to baseline.
What causes a physiologic split S2? - CORRECT ANSWER Increased blood volume
in the RV prolongs systole and delays pulmonary valve closure
What causes a fixed split S2? - CORRECT ANSWER Pulmonary stenosis, PE, LV
pacer, RBBB, MR (early AV closure), ASD, RV failue
What causes a paradoxic split S2 - CORRECT ANSWER LBBB, RV pacing, HOCM
What causes an S3? - CORRECT ANSWER Rapid LV filling - acute ventricular
decompensation, severe AR or MR
What causes a S4? - CORRECT ANSWER Decreased ventricular compliance during
atrial contraction - ischemic heart dz, AS, MR, HOCM, hypertrophic or diabetic
cardiomyopathy, HTN heart dz, concentric LVH
Can you have a S4 with atrial fibrillation? - CORRECT ANSWER No - no atrial
contraction
What are the parts of the venous waveform? - CORRECT ANSWER A wave - atrial
contraction
X descent - atria relax, RV fills rapidly; Bottom/middle of x descent is TC valve
closure (c wave)
ACTUAL EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+
Normals for PA catheter pressures - CORRECT ANSWER RA <7, RV 30/7, PCWP 3-
11
PA cath findings in tamponade or constrictive pericarditis - CORRECT ANSWER
Diastolic pressures elevated and equalized in all chambers, low BP, tachycardia,
interventricular dependence (septal bounce)
PA cath findings in cardiogenic shock - CORRECT ANSWER Elevated PCWP, RA
pressure, and decreased SBP/cardiac output
PA cath findings in mitral stenosis with RV failure - CORRECT ANSWER Elevated
RA, PA (very elevated), PCWP, nl SBP
PA cath findings in pulmonary HTN - CORRECT ANSWER Elevated PA, RA
pressures, nl PCWP, SBP
Pulsus paradoxus - CORRECT ANSWER decrease in systolic BP of more than
10mmHg with normal inspiration; palpated as weakened pulse with inspiration
along with more heart contractions to pulse beats
,What conditions give you pulsus paradoxus? - CORRECT ANSWER Constrictive or
restrictive pericarditis, asthma, tension pneumothorax
What gives you pulsus bisferiens (two systolic peaks per cycle) - CORRECT
ANSWER Aortic regurgitation, HOCM
What causes pulsus alternans? - CORRECT ANSWER Severe LV dysfunction
What causes pulsus tardus et parvus? - CORRECT ANSWER Late and weak; Aortic
stenosis
How do positional maneuvers affect blood flow and murmurs?
a) Standing/Valsalva
b) Squatting/Lying down
c) Sustained handgrip - CORRECT ANSWER -standing/valsalva - decreased cardiac
filling, decreases most murmurs except MVP and HOCM
-squatting/ lying down - increase cardiac volume, increased murmurs except MVP,
HOCM
-sustained handgrip - increases systemic resistance, decreases murmur in HOCM,
AS
What are the stages of the Valsalva maneuver? - CORRECT ANSWER -Phase one is
the onset of straining with increased intrathoracic pressure. The heart rate does
not change but blood pressure rises.
-Phase two is marked by the decreased venous return and consequent reduction
of stroke volume and pulse pressure as straining continues. The heart rate
increases and blood pressure drops.
, -Phase three is the release of straining with decreased intrathoracic pressure and
normalization of pulmonary blood flow.
-Phase four marks the blood pressure overshoot (in the normal heart) with return
of the heart rate to baseline.
What causes a physiologic split S2? - CORRECT ANSWER Increased blood volume
in the RV prolongs systole and delays pulmonary valve closure
What causes a fixed split S2? - CORRECT ANSWER Pulmonary stenosis, PE, LV
pacer, RBBB, MR (early AV closure), ASD, RV failue
What causes a paradoxic split S2 - CORRECT ANSWER LBBB, RV pacing, HOCM
What causes an S3? - CORRECT ANSWER Rapid LV filling - acute ventricular
decompensation, severe AR or MR
What causes a S4? - CORRECT ANSWER Decreased ventricular compliance during
atrial contraction - ischemic heart dz, AS, MR, HOCM, hypertrophic or diabetic
cardiomyopathy, HTN heart dz, concentric LVH
Can you have a S4 with atrial fibrillation? - CORRECT ANSWER No - no atrial
contraction
What are the parts of the venous waveform? - CORRECT ANSWER A wave - atrial
contraction
X descent - atria relax, RV fills rapidly; Bottom/middle of x descent is TC valve
closure (c wave)
