CARDIOLOGY BOARDS ABIM EXAM REVIEW SOLVED QUESTIONS COMPLETE
ANSWERS GRADED A PLUS
Cardiology Boards ABIM TEST BANK 2026/2027
Comprehensive Questions and Answers Verified
Solutions Latest Update
Question:
ANA frequency in dz.
Answer:
Drug induced SLE - 100% SLE - 90% Polymyositis/dermatomyositis - 40-60% RA - 40% MCTD -
95% Limited scleroderma and diffuse scleroderma - 60-90% Sjogrens - 70% Nl population - 30%
(1:40), 5% (1:160) So, need more specific subtype testing if positive
Question:
ANA subtypes.
Answer:
Anti-dsDNA - specific for SLE, can be + if taking TNF inhibs. Marker for dz activity & potential
for renal dz Anti-Sm - specific for SLE, often seen with U1-RNP Anti U1-RNP - sensitive, not
specific for MCTP (neg rules it out) Anti-histone - sens, not spec for drug induced SLE
(procainamide, hydralazine, chlorpromazine, quinidine) Anti-Scl-70 - diffuse scleroderma,
increased chance of interstitial lung dz Anti-centromere - limited scleroderma; increased Pulm HTN
Anti-synthetase (Jo-1) - myositis; increased ILD
Question:
Anti-SSA, SSB tests.
Answer:
SSA (Ro) - SLE, neonatal SLE, Sjogrens, myositis; not in scleroderma; maternal transfer to baby -
neonatal heart block SSB (La) - SLE, Sjogrens; sometimes found with SSA; can see maternal
transfer to baby
Question:
,ANCA testing.
Answer:
Get p & c-ANCA. If positive, check ELISA for subtypes anti-PR3, anti-MPO c-ANCA + anti-PR3 -
Wegeners p-ANCA, MPO positive - Churg-Strauss, PAN, pauci-immune glomerulonephritis,
microscopic polyangiitis, anti-glomerular basement membrane dz p-ANCA, MPO negative -
Crohns, UC, chronic active hepatitis, PBC, PSC, PAN, chronic arthridities
Question:
Compliment tests.
Answer:
low in active SLE, vasculitis Can also be low from genetic deficiency, consumed with activation, or
underproduced (HELLP syndrome) C3 - consumed with any compliment activation C4 - consumed
with only classic pathway activation CH50 - looks at total hemolytic component of classical
pathway
Question:
Rheumatoid factor and anti-CCP (citrullinated cyclic peptide).
Answer:
RF - pos in 80-85% of RA, not specific CCP - appears earlier, greater specificity
Question:
HLA's.
Answer:
HLA-B27 - 7-8% of nl population; 60-80% in Reiters + reactive spondyloarthropathy; 90% with
ank spondy; 60% of sponylitis pts with psoriasis or IBD are positive; 80% in Yersinia, Salmonella,
Shigella arthropathy HLA-DR2, DR3 - Sjogrens, polymyositis HLA-DR4 - severe RA
Question:
Joint fluid evaluation.
, Answer:
Normal - 0-200 WBC Non-inflammatory- 200-2000 WBC - OA, neuropathic joins, hypertrophic
osteoarthropathy, occasionally SLE, scleroderma, rheumatic fever Inflammatory - 2K-50K WBC -
RA, SLE, SS, crystals, ank spon, IBD- assc arthritis Septic - 50K+ - >75% neurophils. Occasionally
see this many WBC with crystals
Question:
Crystals in joint.
Answer:
Gout - yellow, negatively birefringent CPPD - blue crystals, positively birefringent To be sure they
are causing the inflammation, you should see them intracellularly
Question:
Collagen vascular diseases.
Answer:
Marfan syndrome - long limbs, aortic root dilation, ectopia lentis Ehler-Danlos - skin elasticity and
joint hypermobility; types - classic (most severe, easily scarred skin and hypermobile joints),
Hypermobile (mainly joint symptoms), vascular (mainly skin issues and rupture of large vessels)
Osteogenesis imperfecta - procollagen gene defects; osteopenia, brittle bones, blue sclera, teeth
problem, hearing loss Pseudoxanthoma elasticum - autosomal recessive; affects skin, blood vessels,
eyes. Angioid steaks on fundoscopy; recurrent GI bleeding
Question:
Prevalence of RA.
Answer:
1% overall, 40-50 yo, female: male 3:1, 10% with genetics
Question:
Labs for RA.
Answer:
ANSWERS GRADED A PLUS
Cardiology Boards ABIM TEST BANK 2026/2027
Comprehensive Questions and Answers Verified
Solutions Latest Update
Question:
ANA frequency in dz.
Answer:
Drug induced SLE - 100% SLE - 90% Polymyositis/dermatomyositis - 40-60% RA - 40% MCTD -
95% Limited scleroderma and diffuse scleroderma - 60-90% Sjogrens - 70% Nl population - 30%
(1:40), 5% (1:160) So, need more specific subtype testing if positive
Question:
ANA subtypes.
Answer:
Anti-dsDNA - specific for SLE, can be + if taking TNF inhibs. Marker for dz activity & potential
for renal dz Anti-Sm - specific for SLE, often seen with U1-RNP Anti U1-RNP - sensitive, not
specific for MCTP (neg rules it out) Anti-histone - sens, not spec for drug induced SLE
(procainamide, hydralazine, chlorpromazine, quinidine) Anti-Scl-70 - diffuse scleroderma,
increased chance of interstitial lung dz Anti-centromere - limited scleroderma; increased Pulm HTN
Anti-synthetase (Jo-1) - myositis; increased ILD
Question:
Anti-SSA, SSB tests.
Answer:
SSA (Ro) - SLE, neonatal SLE, Sjogrens, myositis; not in scleroderma; maternal transfer to baby -
neonatal heart block SSB (La) - SLE, Sjogrens; sometimes found with SSA; can see maternal
transfer to baby
Question:
,ANCA testing.
Answer:
Get p & c-ANCA. If positive, check ELISA for subtypes anti-PR3, anti-MPO c-ANCA + anti-PR3 -
Wegeners p-ANCA, MPO positive - Churg-Strauss, PAN, pauci-immune glomerulonephritis,
microscopic polyangiitis, anti-glomerular basement membrane dz p-ANCA, MPO negative -
Crohns, UC, chronic active hepatitis, PBC, PSC, PAN, chronic arthridities
Question:
Compliment tests.
Answer:
low in active SLE, vasculitis Can also be low from genetic deficiency, consumed with activation, or
underproduced (HELLP syndrome) C3 - consumed with any compliment activation C4 - consumed
with only classic pathway activation CH50 - looks at total hemolytic component of classical
pathway
Question:
Rheumatoid factor and anti-CCP (citrullinated cyclic peptide).
Answer:
RF - pos in 80-85% of RA, not specific CCP - appears earlier, greater specificity
Question:
HLA's.
Answer:
HLA-B27 - 7-8% of nl population; 60-80% in Reiters + reactive spondyloarthropathy; 90% with
ank spondy; 60% of sponylitis pts with psoriasis or IBD are positive; 80% in Yersinia, Salmonella,
Shigella arthropathy HLA-DR2, DR3 - Sjogrens, polymyositis HLA-DR4 - severe RA
Question:
Joint fluid evaluation.
, Answer:
Normal - 0-200 WBC Non-inflammatory- 200-2000 WBC - OA, neuropathic joins, hypertrophic
osteoarthropathy, occasionally SLE, scleroderma, rheumatic fever Inflammatory - 2K-50K WBC -
RA, SLE, SS, crystals, ank spon, IBD- assc arthritis Septic - 50K+ - >75% neurophils. Occasionally
see this many WBC with crystals
Question:
Crystals in joint.
Answer:
Gout - yellow, negatively birefringent CPPD - blue crystals, positively birefringent To be sure they
are causing the inflammation, you should see them intracellularly
Question:
Collagen vascular diseases.
Answer:
Marfan syndrome - long limbs, aortic root dilation, ectopia lentis Ehler-Danlos - skin elasticity and
joint hypermobility; types - classic (most severe, easily scarred skin and hypermobile joints),
Hypermobile (mainly joint symptoms), vascular (mainly skin issues and rupture of large vessels)
Osteogenesis imperfecta - procollagen gene defects; osteopenia, brittle bones, blue sclera, teeth
problem, hearing loss Pseudoxanthoma elasticum - autosomal recessive; affects skin, blood vessels,
eyes. Angioid steaks on fundoscopy; recurrent GI bleeding
Question:
Prevalence of RA.
Answer:
1% overall, 40-50 yo, female: male 3:1, 10% with genetics
Question:
Labs for RA.
Answer:
