1
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Internal Medicine Review ABIM part 1
Questions and Answers (100% Correct
Answers) Already Graded A+
What is a positive stress test [ ANS: ] Flat or Down sloping
St-segment depression >1 mm
occurring 80 msec after j point
When to stop a stress test [ ANS: ] St segment depression > 2 mm,
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ventricular tachycardia,
drop in SBP > 15,
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CP,
dyspnea,
lightheadedness
Stress test of choice with a LBBB or ventricular pacing? [ ANS: ]
Myocardial perfusion imaging with adenosine,
NOT exercising!
When to not use doutamine for stress [ ANS: ] History of VT,
severe HTN,
Low BP,
poor echo images
When to not use adenosine for stress [ ANS: ] Bronchospasm,
severe valvular dysfunction,
severe carotid stenosis,
, 2
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2nd degree heart block, t
heophylline dependent
Normals for PA catheter pressures [ ANS: ] RA <8
RV 30/8
PCWP 3-12
PAP 12--12
Diastolic pressures
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elevated & equalized
in all chambers,
low BP [ ANS: ] tamponade
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or restrictive pericarditis
Elevated RA and PA pressures,
decreased or nl PCWP,
hypotension [ ANS: ] RV MI
Elevated PCWP, RA pressure
decreased SBP/cardiac output [ ANS: ] cardiogenic shock
high RA,
PA very elevated
high PCWP
nl SBP [ ANS: ] mitral stenosis with RV failure
Elevated PAP, RAP
nl PCWP, SBP [ ANS: ] pulmonary HTN
, 3
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decr in SBP>10mmHg with nl inspiration;
palpated as weakened pulse with inspiration &
more heart contractions to pulse beats [ ANS: ] pulsus paradoxus:
Constrictive or restrictive pericarditis,
asthma,
tension pneumothorax
What gives you pulsus bisferiens
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(two systolic peaks per cycle) [ ANS: ] Aortic regurgitation,
HOCM
What causes pulsus alternans [ ANS: ] Severe LV dysfunction
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What causes pulsus tardus [ ANS: ] Aortic stenosis
How do positional maneuvers affect blood flow and murmurs [
ANS: ] -standing/valsalva:
decreased cardiac filling,
decreases most murmurs
except MVP and HOCM
-squatting/ lying down:
increase cardiac volume,
increased murmurs
except MVP, HOCM
, 4
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-sustained handgrip:
increases systemic resistance
decreases murmur in HOCM, AS
What causes a physiologic split S2 [ ANS: ] Increased blood
volume in the RV
prolongs systole and
delays pulmonary valve closure
What causes a fixed split S2 [ ANS: ] Pulmonary stenosis,
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PE,
LV pacer,
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RBBB,
MR (early AV closure),
ASD,
RV failue
What causes a paradoxic split S2 [ ANS: ] LBBB,
RV pacing,
HOCM
What causes an S3? [ ANS: ] Rapid LV filling:
acute ventricular decompensation,
severe AR or MR
What are the parts of the venous waveform? [ ANS: ] A wave -
atrial contraction
For Expert help and assignment solutions, +254707240657
Internal Medicine Review ABIM part 1
Questions and Answers (100% Correct
Answers) Already Graded A+
What is a positive stress test [ ANS: ] Flat or Down sloping
St-segment depression >1 mm
occurring 80 msec after j point
When to stop a stress test [ ANS: ] St segment depression > 2 mm,
© 2025 Assignment Expert
ventricular tachycardia,
drop in SBP > 15,
Guru01 - Stuvia
CP,
dyspnea,
lightheadedness
Stress test of choice with a LBBB or ventricular pacing? [ ANS: ]
Myocardial perfusion imaging with adenosine,
NOT exercising!
When to not use doutamine for stress [ ANS: ] History of VT,
severe HTN,
Low BP,
poor echo images
When to not use adenosine for stress [ ANS: ] Bronchospasm,
severe valvular dysfunction,
severe carotid stenosis,
, 2
For Expert help and assignment solutions, +254707240657
2nd degree heart block, t
heophylline dependent
Normals for PA catheter pressures [ ANS: ] RA <8
RV 30/8
PCWP 3-12
PAP 12--12
Diastolic pressures
© 2025 Assignment Expert
elevated & equalized
in all chambers,
low BP [ ANS: ] tamponade
Guru01 - Stuvia
or restrictive pericarditis
Elevated RA and PA pressures,
decreased or nl PCWP,
hypotension [ ANS: ] RV MI
Elevated PCWP, RA pressure
decreased SBP/cardiac output [ ANS: ] cardiogenic shock
high RA,
PA very elevated
high PCWP
nl SBP [ ANS: ] mitral stenosis with RV failure
Elevated PAP, RAP
nl PCWP, SBP [ ANS: ] pulmonary HTN
, 3
For Expert help and assignment solutions, +254707240657
decr in SBP>10mmHg with nl inspiration;
palpated as weakened pulse with inspiration &
more heart contractions to pulse beats [ ANS: ] pulsus paradoxus:
Constrictive or restrictive pericarditis,
asthma,
tension pneumothorax
What gives you pulsus bisferiens
© 2025 Assignment Expert
(two systolic peaks per cycle) [ ANS: ] Aortic regurgitation,
HOCM
What causes pulsus alternans [ ANS: ] Severe LV dysfunction
Guru01 - Stuvia
What causes pulsus tardus [ ANS: ] Aortic stenosis
How do positional maneuvers affect blood flow and murmurs [
ANS: ] -standing/valsalva:
decreased cardiac filling,
decreases most murmurs
except MVP and HOCM
-squatting/ lying down:
increase cardiac volume,
increased murmurs
except MVP, HOCM
, 4
For Expert help and assignment solutions, +254707240657
-sustained handgrip:
increases systemic resistance
decreases murmur in HOCM, AS
What causes a physiologic split S2 [ ANS: ] Increased blood
volume in the RV
prolongs systole and
delays pulmonary valve closure
What causes a fixed split S2 [ ANS: ] Pulmonary stenosis,
© 2025 Assignment Expert
PE,
LV pacer,
Guru01 - Stuvia
RBBB,
MR (early AV closure),
ASD,
RV failue
What causes a paradoxic split S2 [ ANS: ] LBBB,
RV pacing,
HOCM
What causes an S3? [ ANS: ] Rapid LV filling:
acute ventricular decompensation,
severe AR or MR
What are the parts of the venous waveform? [ ANS: ] A wave -
atrial contraction
