ARIZONA INTERNAL MEDICINE BOARD EXAM
QUESTIONS WITH CORRECT ANSWERS AND
RATIONALES LATEST 2026 UPDATE
� CARDIOLOGY (1–10)
1. A 65-year-old man presents with crushing chest pain radiating to
the left arm. ECG shows ST elevation in leads II, III, aVF. What is
the most likely culprit artery?
Answer: Right coronary artery
Rationale: Inferior MI (II, III, aVF) most commonly involves RCA.
2. First-line long-term therapy for HFrEF (EF 30%)?
Answer: ACE inhibitor + beta blocker + mineralocorticoid
antagonist
Rationale: Guideline-directed medical therapy improves mortality.
3. Most common cause of atrial fibrillation in the US?
Answer: Hypertension
Rationale: Structural atrial remodeling from chronic HTN is leading
cause.
4. Wide-complex tachycardia in unstable patient → next step?
, Answer: Immediate synchronized cardioversion
Rationale: Hemodynamic instability requires urgent cardioversion.
5. Most specific biomarker for MI?
Answer: Troponin I/T
Rationale: High specificity for myocardial injury.
6. Treatment of torsades de pointes?
Answer: IV magnesium sulfate
Rationale: Even if Mg level is normal.
7. Murmur of hypertrophic cardiomyopathy increases with Valsalva
due to?
Answer: Decreased preload
Rationale: Smaller LV cavity worsens obstruction.
8. First-line therapy for stable angina?
Answer: Beta blockers
Rationale: Reduce myocardial oxygen demand.
9. Endocarditis most common organism in IV drug users?
Answer: Staphylococcus aureus
Rationale: Right-sided tricuspid infection typical.
QUESTIONS WITH CORRECT ANSWERS AND
RATIONALES LATEST 2026 UPDATE
� CARDIOLOGY (1–10)
1. A 65-year-old man presents with crushing chest pain radiating to
the left arm. ECG shows ST elevation in leads II, III, aVF. What is
the most likely culprit artery?
Answer: Right coronary artery
Rationale: Inferior MI (II, III, aVF) most commonly involves RCA.
2. First-line long-term therapy for HFrEF (EF 30%)?
Answer: ACE inhibitor + beta blocker + mineralocorticoid
antagonist
Rationale: Guideline-directed medical therapy improves mortality.
3. Most common cause of atrial fibrillation in the US?
Answer: Hypertension
Rationale: Structural atrial remodeling from chronic HTN is leading
cause.
4. Wide-complex tachycardia in unstable patient → next step?
, Answer: Immediate synchronized cardioversion
Rationale: Hemodynamic instability requires urgent cardioversion.
5. Most specific biomarker for MI?
Answer: Troponin I/T
Rationale: High specificity for myocardial injury.
6. Treatment of torsades de pointes?
Answer: IV magnesium sulfate
Rationale: Even if Mg level is normal.
7. Murmur of hypertrophic cardiomyopathy increases with Valsalva
due to?
Answer: Decreased preload
Rationale: Smaller LV cavity worsens obstruction.
8. First-line therapy for stable angina?
Answer: Beta blockers
Rationale: Reduce myocardial oxygen demand.
9. Endocarditis most common organism in IV drug users?
Answer: Staphylococcus aureus
Rationale: Right-sided tricuspid infection typical.
