INTERNAL MEDICINE REVIEW ABIM PART 1 | EXAM
QUESTIONS AND ANSWERS| COMPLETE STUDY GUIDE
WITH 100% ACCURATE QUESTIONS & ANSWERS!
EXCELLENCE GUARANTEED!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 100.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,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
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
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, 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,
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
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
QUESTIONS AND ANSWERS| COMPLETE STUDY GUIDE
WITH 100% ACCURATE QUESTIONS & ANSWERS!
EXCELLENCE GUARANTEED!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 100.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,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
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
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, 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,
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
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
