Cardiology boards ABIM exam 2023 with 100 correct answers
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Course
NU1426
Institution
NU1426
Cardiology boards ABIM exam 2023 with 100% correct answers
What is a positive stress test
When to stop a stress test
Stress test of choice with a LBBB or ventricular pacing?
Know the algorithm for stress testing
When to not use doutamine for stress
When to not use adenosine for stress
Normal...
Cardiology boards ABIM exam 2023 with 100%
correct answers
1). What is a positive stress test
Ans: Flat or Down sloping St-segment depression >1 mm occurring 80 msec after j
point
2). When to stop a stress test
Ans: St segment depression > 2 mm, ventricular tachycardia, drop in SBP > 15, chest
pain, dyspnea, lightheadedness
3). Stress test of choice with a lbbb or ventricular pacing?
Ans: Myocardial perfusion imaging with adenosine,NOT exercising!
4). Know the algorithm for stress testing
Ans: See page 5-3,figure 5-1
5). When to not use doutamine for stress
Ans: History of VT, severe HTN, Low BP, poor echo images
6). When to not use adenosine for stress
Ans: Bronchospasm, severe valvular dysfunction, severe carotid stenosis, 2nd degree
heart block, theophylline dependent
7). Normals for pa catheter pressures
Ans: RA <7, RV 30/7, PCWP 3-11
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, 8). Pa cath findings in tamponade or restrictive pericarditis
Ans: Diastolic pressures elevated and equalized in all chambers, low BP
9). Pa cath findings with rv ami
Ans: Elevated RA and PA pressures, decreased or nl PCWP, hypotension, and inferior
MI. R side is decompensated, cannot fill L side of the heart
10). Pa cath findings in cardiogenic shock
Ans: Elevated PCWP, RA pressure, and decreased SBP/cardiac output
11). Pa cath findings in mitral stenosis with rv failure
Ans: Elevated RA, PA (very elevated), PCWP, nl SBP
12). Pa cath findings in pulmonary htn
Ans: Elevated PA, RA pressures, nl PCWP, SBP
13). Pulsus paradoxus
Ans: 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
14). What conditions give you pulsus paradoxus?
Ans: Constrictive or restrictive pericarditis, asthma, tension pneumothorax
15). What gives you pulsus bisferiens (two systolic peaks per cycle)
Ans: Aortic regurgitation, HOCM
16). What causes pulsus alternans
Ans: Severe LV dysfunction
17). What causes pulsus tardus
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, Ans: Aortic stenosis
18). How do positional maneuvers affect blood flow and murmurs
Ans: -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
19). What causes a physiologic split s2
Ans: Increased blood volume in the RV prolongs systole and delays pulmonary valve
closure
Ans: 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
27). What gives elevated a and v waves
Ans: Pulmonary HTN, RV infarction
28). Large r side v waves
Ans: Septal rupture
29). Large v waves
Ans: TR (right), MR (left)
30). Rapid x and y descent
Ans: Constrictive pericarditis, restrictive cardiomyopathy, tamponade (x descent only,
loss of y descent)
31). Large a waves
Ans: TS,severe RVH (on right), MS
32). Cannon a waves
Ans: AV disassociation - complete heart block, ventricular pacing
33). Slow y descent
Ans: Delayed atrial emptying - TS
34). Most important prognostic factor with cad
Ans: Degree of LV dysfunction
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