Internal Medicine ABIM part 1
Internal Medicine Review ABIM
part 1 Exam Study Guide –
Practice Questions with Verified
Answers. GRADED A+. Latest
2026/2027 Update
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
,Internal Medicine ABIM part 1
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
or restrictive pericarditis
,Internal Medicine ABIM part 1
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,
, Internal Medicine ABIM part 1
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
Internal Medicine Review ABIM
part 1 Exam Study Guide –
Practice Questions with Verified
Answers. GRADED A+. Latest
2026/2027 Update
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
,Internal Medicine ABIM part 1
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
or restrictive pericarditis
,Internal Medicine ABIM part 1
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,
, Internal Medicine ABIM part 1
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
