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Internal Medicine Review ABIM part 1 Exam Questions With 100% Verified Answers.

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  • Internal Medicine Board ABIM

Internal Medicine Review ABIM part 1 Exam Questions With 100% Verified Answers. What is a positive stress test - answerFlat or Down sloping St-segment depression >1 mm occurring 80 msec after j point When to stop a stress test - answerSt segment depression > 2 mm, ventricular tachycard...

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  • September 30, 2024
  • 130
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • Internal Medicine Board ABIM
  • Internal Medicine Board ABIM
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Internal Medicine Review ABIM part 1
Exam Questions With 100% Verified
Answers.


What is a positive stress test - answer✔Flat or Down sloping
St-segment depression >1 mm
occurring 80 msec after j point

When to stop a stress test - 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? - answer✔Myocardial perfusion
imaging with adenosine,
NOT exercising!

When to not use doutamine for stress - answer✔History of VT,
severe HTN,
Low BP,
poor echo images

When to not use adenosine for stress - answer✔Bronchospasm,
severe valvular dysfunction,
severe carotid stenosis,
2nd degree heart block, t

, ©BRAINBARTER 2024/2025


heophylline dependent

Normals for PA catheter pressures - answer✔RA <8
RV 30/8
PCWP 3-12
PAP 12--12
Diastolic pressures
elevated & equalized
in all chambers,

low BP - answer✔tamponade
or restrictive pericarditis
Elevated RA and PA pressures,
decreased or nl PCWP,

hypotension - answer✔RV MI
Elevated PCWP, RA pressure

decreased SBP/cardiac output - answer✔cardiogenic shock
high RA,
PA very elevated
high PCWP

nl SBP - answer✔mitral stenosis with RV failure
Elevated PAP, RAP

nl PCWP, SBP - answer✔pulmonary HTN
decr in SBP>10mmHg with nl inspiration;
palpated as weakened pulse with inspiration &

more heart contractions to pulse beats - answer✔pulsus paradoxus:
Constrictive or restrictive pericarditis,
asthma,

, ©BRAINBARTER 2024/2025


tension pneumothorax
What gives you pulsus bisferiens

(two systolic peaks per cycle) - answer✔Aortic regurgitation,
HOCM

What causes pulsus alternans - answer✔Severe LV dysfunction

What causes pulsus tardus - answer✔Aortic stenosis

How do positional maneuvers affect blood flow and murmurs - 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 - answer✔Increased blood volume in the RV
prolongs systole and
delays pulmonary valve closure

What causes a fixed split S2 - answer✔Pulmonary stenosis,
PE,
LV pacer,
RBBB,

, ©BRAINBARTER 2024/2025


MR (early AV closure),
ASD,
RV failue

What causes a paradoxic split S2 - answer✔LBBB,
RV pacing,
HOCM

What causes an S3? - answer✔Rapid LV filling:
acute ventricular decompensation,
severe AR or MR

What are the parts of the venous waveform? - 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

What gives elevated a and v waves - answer✔Pulmonary HTN,
RV infarction

Large r side v waves - answer✔Septal rupture

Large v waves - answer✔TR (right),
MR (left)

Rapid x and y descent - answer✔Constrictive pericarditis,
restrictive cardiomyopathy,
tamponade

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