Cardiology boards ABIM LATEST 2023-2024
ACTUAL EXAM 500 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
What is a positive stress test - CORRECT ANSWER Flat or Down sloping
St-segment depression >1 mm occurring 80 msec after j point
When to stop a stress test - CORRECT ANSWER St segment depression
> 2 mm, ventricular tachycardia, drop in SBP > 15, chest pain, dyspnea,
lightheadedness
Stress test of choice with a LBBB or ventricular pacing? - CORRECT
ANSWER Myocardial perfusion imaging with adenosine,NOT
exercising!
Know the algorithm for stress testing - CORRECT ANSWER See page 5-
3,figure 5-1
When to not use doutamine for stress - CORRECT ANSWER History of
VT, severe HTN, Low BP, poor echo images
When to not use adenosine for stress - CORRECT ANSWER
Bronchospasm, severe valvular dysfunction, severe carotid stenosis, 2nd
degree heart block, theophylline dependent
,Normals for PA catheter pressures - CORRECT ANSWER RA <7, RV
30/7, PCWP 3-11
PA cath findings in tamponade or restrictive pericarditis - CORRECT
ANSWER Diastolic pressures elevated and equalized in all chambers,
low BP
PA cath findings with RV AMI - CORRECT ANSWER Elevated RA and PA
pressures, decreased or nl PCWP, hypotension, and inferior MI. R side is
decompensated, cannot fill L side of the heart
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 - CORRECT ANSWER Aortic stenosis
How do positional maneuvers affect blood flow and murmurs -
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 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
KNOW - S3 with LV dysfunction is a poor prognostic factor - CORRECT
ANSWER ...
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 of x descent is TC valve closure
V wave - ventricle contacting against closed TC valve
Y descent - TC valve opens, passive emptying into ventricle
ACTUAL EXAM 500 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
What is a positive stress test - CORRECT ANSWER Flat or Down sloping
St-segment depression >1 mm occurring 80 msec after j point
When to stop a stress test - CORRECT ANSWER St segment depression
> 2 mm, ventricular tachycardia, drop in SBP > 15, chest pain, dyspnea,
lightheadedness
Stress test of choice with a LBBB or ventricular pacing? - CORRECT
ANSWER Myocardial perfusion imaging with adenosine,NOT
exercising!
Know the algorithm for stress testing - CORRECT ANSWER See page 5-
3,figure 5-1
When to not use doutamine for stress - CORRECT ANSWER History of
VT, severe HTN, Low BP, poor echo images
When to not use adenosine for stress - CORRECT ANSWER
Bronchospasm, severe valvular dysfunction, severe carotid stenosis, 2nd
degree heart block, theophylline dependent
,Normals for PA catheter pressures - CORRECT ANSWER RA <7, RV
30/7, PCWP 3-11
PA cath findings in tamponade or restrictive pericarditis - CORRECT
ANSWER Diastolic pressures elevated and equalized in all chambers,
low BP
PA cath findings with RV AMI - CORRECT ANSWER Elevated RA and PA
pressures, decreased or nl PCWP, hypotension, and inferior MI. R side is
decompensated, cannot fill L side of the heart
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 - CORRECT ANSWER Aortic stenosis
How do positional maneuvers affect blood flow and murmurs -
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 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
KNOW - S3 with LV dysfunction is a poor prognostic factor - CORRECT
ANSWER ...
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 of x descent is TC valve closure
V wave - ventricle contacting against closed TC valve
Y descent - TC valve opens, passive emptying into ventricle
