ABFM KSA HEART DISEASE EXAM
QUESTIONS WITH CORRECT
ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026/2027 Q&A |
INSTANT DOWNLOAD PDF
Core Domains
1. Coronary Artery Disease & Acute Coronary Syndromes
2. Heart Failure (HFrEF & HFpEF)
3. Arrhythmias & Conduction Disorders
4. Valvular Heart Disease & Endocarditis
5. Hypertension & Cardiovascular Risk Management
6. Pericardial & Myocardial Diseases
7. Preventive Cardiology & Lipid Management
8. Cardiovascular Pharmacology & Therapeutics
9. Clinical Decision-Making & Evidence-Based Practice
10. Special Populations & Comorbidities
Introduction
The ABFM Knowledge Self-Assessment (KSA) Heart Disease Module is a
comprehensive examination designed for family medicine physicians to assess
and enhance their clinical knowledge in cardiovascular medicine. The exam
evaluates competence in diagnosing and managing coronary artery disease,
heart failure, arrhythmias, valvular disorders, hypertension, and preventive
cardiology. Questions emphasize evidence-based guidelines, clinical decision-
making, and real-world patient scenarios. The assessment combines multiple-
choice questions with detailed rationales, ensuring physicians can apply
,current standards of care to diverse patient populations while identifying
knowledge gaps for targeted continuing education.
SECTION ONE: QUESTIONS 1–200
1. A 55-year-old male presents with substernal chest pressure radiating
to his left arm that occurs with exertion and resolves with rest.
Symptoms have been stable for several months. An ECG during an
episode of pain shows ST depression. What is the most likely
diagnosis?
A. Unstable angina
B. Stable angina
C. NSTEMI
D. STEMI
B. Stable angina
RATIONALE: Stable angina is characterized by predictable chest pain
with exertion that is relieved by rest or nitroglycerin, with a stable pattern
over time. ECG may show ST depression during pain. Unstable angina has a
changing pattern or occurs at rest. NSTEMI and STEMI are acute coronary
syndromes with elevated biomarkers.
2. A 62-year-old male with diabetes presents with crushing chest pain at
rest for 30 minutes. ECG shows ST elevation in leads II, III, and aVF.
Troponin I is elevated. What is the priority treatment?
A. Immediate PCI within 90 minutes
B. Thrombolytics within 24 hours
C. Medical management with aspirin and heparin only
,D. Stress testing in 48 hours
A. Immediate PCI within 90 minutes
RATIONALE: STEMI with ST elevation in inferior leads requires
immediate reperfusion therapy. Primary PCI within 90 minutes of first
medical contact is preferred over thrombolytics. Thrombolytics are used if
PCI unavailable within 120 minutes. Medical management alone is
insufficient. Stress testing is contraindicated in acute STEMI.
3. A 58-year-old female with stable angina is started on medical therapy.
Which medication is indicated for symptom relief but does not reduce
mortality?
A. Aspirin
B. High-intensity statin
C. Beta-blocker
D. Sublingual nitroglycerin
D. Sublingual nitroglycerin
RATIONALE: Nitrates provide effective symptom relief for angina by
reducing preload and afterload but have not been shown to reduce mortality.
Aspirin, statins, and beta-blockers all reduce cardiovascular events and
mortality in CAD.
4. A 65-year-old male with NSTEMI is being discharged. Which
combination of medications constitutes optimal secondary
prevention?
A. Aspirin, clopidogrel, atorvastatin 80mg, metoprolol, lisinopril
B. Aspirin alone
, C. Atorvastatin 20mg only
D. Nitroglycerin PRN and diltiazem
A. Aspirin, clopidogrel, atorvastatin 80mg, metoprolol, lisinopril
RATIONALE: Optimal secondary prevention post-ACS includes dual
antiplatelet therapy, high-intensity statin, beta-blocker, and ACE inhibitor.
Single agents or calcium channel blockers are insufficient.
5. A 70-year-old male with 3-vessel CAD and diabetes is being evaluated
for revascularization. Left ventricular function is preserved. Which
approach has shown superior long-term outcomes in this population?
A. PCI with drug-eluting stents
B. CABG (coronary artery bypass grafting)
C. Medical therapy alone
D. PCI with bare metal stents
B. CABG (coronary artery bypass grafting)
RATIONALE: In patients with multi-vessel CAD and diabetes, CABG has
demonstrated superior long-term survival and reduced repeat
revascularization compared to PCI. PCI is appropriate for less complex
disease. Medical therapy alone is insufficient for significant 3-vessel disease.
6. A 45-year-old male with family history of premature CAD has total
cholesterol 240 mg/dL, LDL 160 mg/dL, HDL 35 mg/dL. He smokes.
What is his indication for statin therapy?
A. No indication for statin
B. Primary prevention with moderate-intensity statin
QUESTIONS WITH CORRECT
ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026/2027 Q&A |
INSTANT DOWNLOAD PDF
Core Domains
1. Coronary Artery Disease & Acute Coronary Syndromes
2. Heart Failure (HFrEF & HFpEF)
3. Arrhythmias & Conduction Disorders
4. Valvular Heart Disease & Endocarditis
5. Hypertension & Cardiovascular Risk Management
6. Pericardial & Myocardial Diseases
7. Preventive Cardiology & Lipid Management
8. Cardiovascular Pharmacology & Therapeutics
9. Clinical Decision-Making & Evidence-Based Practice
10. Special Populations & Comorbidities
Introduction
The ABFM Knowledge Self-Assessment (KSA) Heart Disease Module is a
comprehensive examination designed for family medicine physicians to assess
and enhance their clinical knowledge in cardiovascular medicine. The exam
evaluates competence in diagnosing and managing coronary artery disease,
heart failure, arrhythmias, valvular disorders, hypertension, and preventive
cardiology. Questions emphasize evidence-based guidelines, clinical decision-
making, and real-world patient scenarios. The assessment combines multiple-
choice questions with detailed rationales, ensuring physicians can apply
,current standards of care to diverse patient populations while identifying
knowledge gaps for targeted continuing education.
SECTION ONE: QUESTIONS 1–200
1. A 55-year-old male presents with substernal chest pressure radiating
to his left arm that occurs with exertion and resolves with rest.
Symptoms have been stable for several months. An ECG during an
episode of pain shows ST depression. What is the most likely
diagnosis?
A. Unstable angina
B. Stable angina
C. NSTEMI
D. STEMI
B. Stable angina
RATIONALE: Stable angina is characterized by predictable chest pain
with exertion that is relieved by rest or nitroglycerin, with a stable pattern
over time. ECG may show ST depression during pain. Unstable angina has a
changing pattern or occurs at rest. NSTEMI and STEMI are acute coronary
syndromes with elevated biomarkers.
2. A 62-year-old male with diabetes presents with crushing chest pain at
rest for 30 minutes. ECG shows ST elevation in leads II, III, and aVF.
Troponin I is elevated. What is the priority treatment?
A. Immediate PCI within 90 minutes
B. Thrombolytics within 24 hours
C. Medical management with aspirin and heparin only
,D. Stress testing in 48 hours
A. Immediate PCI within 90 minutes
RATIONALE: STEMI with ST elevation in inferior leads requires
immediate reperfusion therapy. Primary PCI within 90 minutes of first
medical contact is preferred over thrombolytics. Thrombolytics are used if
PCI unavailable within 120 minutes. Medical management alone is
insufficient. Stress testing is contraindicated in acute STEMI.
3. A 58-year-old female with stable angina is started on medical therapy.
Which medication is indicated for symptom relief but does not reduce
mortality?
A. Aspirin
B. High-intensity statin
C. Beta-blocker
D. Sublingual nitroglycerin
D. Sublingual nitroglycerin
RATIONALE: Nitrates provide effective symptom relief for angina by
reducing preload and afterload but have not been shown to reduce mortality.
Aspirin, statins, and beta-blockers all reduce cardiovascular events and
mortality in CAD.
4. A 65-year-old male with NSTEMI is being discharged. Which
combination of medications constitutes optimal secondary
prevention?
A. Aspirin, clopidogrel, atorvastatin 80mg, metoprolol, lisinopril
B. Aspirin alone
, C. Atorvastatin 20mg only
D. Nitroglycerin PRN and diltiazem
A. Aspirin, clopidogrel, atorvastatin 80mg, metoprolol, lisinopril
RATIONALE: Optimal secondary prevention post-ACS includes dual
antiplatelet therapy, high-intensity statin, beta-blocker, and ACE inhibitor.
Single agents or calcium channel blockers are insufficient.
5. A 70-year-old male with 3-vessel CAD and diabetes is being evaluated
for revascularization. Left ventricular function is preserved. Which
approach has shown superior long-term outcomes in this population?
A. PCI with drug-eluting stents
B. CABG (coronary artery bypass grafting)
C. Medical therapy alone
D. PCI with bare metal stents
B. CABG (coronary artery bypass grafting)
RATIONALE: In patients with multi-vessel CAD and diabetes, CABG has
demonstrated superior long-term survival and reduced repeat
revascularization compared to PCI. PCI is appropriate for less complex
disease. Medical therapy alone is insufficient for significant 3-vessel disease.
6. A 45-year-old male with family history of premature CAD has total
cholesterol 240 mg/dL, LDL 160 mg/dL, HDL 35 mg/dL. He smokes.
What is his indication for statin therapy?
A. No indication for statin
B. Primary prevention with moderate-intensity statin
