ABIM Internal Medicine Review part 1
Questions and Answers (Latest Update
2025)
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,
CP,
dyspnea,
lightheadedness
Stress test of choice with a LBBB or ventricular pacing? -
Correct Answer ✅Myocardial perfusion imaging with
adenosine,
NOT exercising!
When to not use doutamine for stress - Correct Answer
✅History of VT,
severe HTN,
Low BP,
poor echo images
,ABIM Internal Medicine Review part 1
Questions and Answers (Latest Update
2025)
When to not use adenosine for stress - Correct Answer
✅Bronchospasm,
severe valvular dysfunction,
severe carotid stenosis,
2nd degree heart block, t
heophylline dependent
Normals for PA catheter pressures - Correct Answer ✅RA
<8
RV 30/8
PCWP 3-12
PAP 12--12
Diastolic pressures
elevated & equalized
in all chambers,
low BP - Correct Answer ✅tamponade
or restrictive pericarditis
Elevated RA and PA pressures,
decreased or nl PCWP,
,ABIM Internal Medicine Review part 1
Questions and Answers (Latest Update
2025)
hypotension - Correct Answer ✅RV MI
Elevated PCWP, RA pressure
decreased SBP/cardiac output - Correct Answer
✅cardiogenic shock
high RA,
PA very elevated
high PCWP
nl SBP - Correct Answer ✅mitral stenosis with RV failure
Elevated PAP, RAP
nl PCWP, SBP - Correct Answer ✅pulmonary HTN
decr in SBP>10mmHg with nl inspiration;
palpated as weakened pulse with inspiration &
more heart contractions to pulse beats - Correct Answer
✅pulsus paradoxus:
Constrictive or restrictive pericarditis,
asthma,
tension pneumothorax
, ABIM Internal Medicine Review part 1
Questions and Answers (Latest Update
2025)
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:
Questions and Answers (Latest Update
2025)
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,
CP,
dyspnea,
lightheadedness
Stress test of choice with a LBBB or ventricular pacing? -
Correct Answer ✅Myocardial perfusion imaging with
adenosine,
NOT exercising!
When to not use doutamine for stress - Correct Answer
✅History of VT,
severe HTN,
Low BP,
poor echo images
,ABIM Internal Medicine Review part 1
Questions and Answers (Latest Update
2025)
When to not use adenosine for stress - Correct Answer
✅Bronchospasm,
severe valvular dysfunction,
severe carotid stenosis,
2nd degree heart block, t
heophylline dependent
Normals for PA catheter pressures - Correct Answer ✅RA
<8
RV 30/8
PCWP 3-12
PAP 12--12
Diastolic pressures
elevated & equalized
in all chambers,
low BP - Correct Answer ✅tamponade
or restrictive pericarditis
Elevated RA and PA pressures,
decreased or nl PCWP,
,ABIM Internal Medicine Review part 1
Questions and Answers (Latest Update
2025)
hypotension - Correct Answer ✅RV MI
Elevated PCWP, RA pressure
decreased SBP/cardiac output - Correct Answer
✅cardiogenic shock
high RA,
PA very elevated
high PCWP
nl SBP - Correct Answer ✅mitral stenosis with RV failure
Elevated PAP, RAP
nl PCWP, SBP - Correct Answer ✅pulmonary HTN
decr in SBP>10mmHg with nl inspiration;
palpated as weakened pulse with inspiration &
more heart contractions to pulse beats - Correct Answer
✅pulsus paradoxus:
Constrictive or restrictive pericarditis,
asthma,
tension pneumothorax
, ABIM Internal Medicine Review part 1
Questions and Answers (Latest Update
2025)
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:
