ABIM Cardiology 3

Question 1

A 45-year-old man presents with acute pericarditis. Which finding on ECG is most characteristic?

Accepted Answer

Diffuse ST elevation with PR depression

Answer

Acute pericarditis classically causes diffuse ST elevation (saddle-shaped) in multiple leads with PR segment depression, distinguishing it from focal myocardial infarction.

Question 2

A patient with chronic stable angina is intolerant to beta-blockers and has preserved LV function. Which agent is the best alternative for anti-anginal therapy?

Accepted Answer

Non-dihydropyridine calcium channel blockers

Answer

Non-dihydropyridine calcium channel blockers (diltiazem or verapamil) are acceptable alternatives to beta-blockers for chronic stable angina when beta-blockers are contraindicated or not tolerated.

Question 3

Which of the following is the most common cause of secondary hypertension in adults?

Accepted Answer

Primary aldosteronism

Answer

Primary aldosteronism (Conn syndrome) is the most common cause of secondary hypertension in adults, accounting for approximately 5–10% of all hypertension cases.

Question 4

A 72-year-old woman with a history of MI 6 months ago is found to have a left ventricular apical thrombus on echocardiography. Which treatment is most appropriate?

Accepted Answer

Anticoagulation with warfarin or DOAC for 3–6 months

Answer

LV thrombus after MI requires anticoagulation (warfarin or DOAC) for at least 3–6 months to reduce the risk of systemic embolization and stroke.

Question 5

A patient presents with pulse rate of 180 bpm and ECG showing a narrow complex regular tachycardia that terminates with adenosine. What is the most likely diagnosis?

Accepted Answer

AV nodal reentrant tachycardia (AVNRT)

Answer

AVNRT is the most common form of paroxysmal supraventricular tachycardia, presenting as a regular narrow complex tachycardia that terminates with adenosine.

ABIM - American Board of Internal Medicine Practice Test

ABIM - American Board of Internal Medicine Practice Test

ABIM Cardiology 3