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Cardiology Flashcards

7 cards from real ABIM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Cardiology flashcards as text

  1. A 24-year-old athlete has a systolic murmur at the left sternal border that gets louder with Valsalva. Which maneuver would most likely decrease the murmur's intensity?

    Answer: Squatting from a standing position

    Squatting increases venous return and afterload, which enlarges the LV cavity and reduces the dynamic outflow obstruction in hypertrophic cardiomyopathy.

  2. Which finding best favors constrictive pericarditis over restrictive cardiomyopathy?

    Answer: Discordant respiratory changes in RV and LV systolic pressures on catheterization

    Ventricular interdependence produces discordant RV/LV systolic pressure changes with respiration in constriction, whereas restrictive disease shows concordant changes.

  3. A 55-year-old man whose chest pain has resolved has deep symmetric T-wave inversions in V2-V3 and normal troponin. What is the most appropriate next step?

    Answer: Coronary angiography

    Wellens pattern indicates critical proximal LAD stenosis, so stress testing is contraindicated and angiography is indicated.

  4. A 78-year-old man with HFpEF and bilateral carpal tunnel syndrome has grade 3 myocardial uptake on Tc-99m pyrophosphate scintigraphy, with normal serum free light chains and no monoclonal protein on immunofixation. What is the most appropriate therapy?

    Answer: Tafamidis

    Strong PYP uptake without a monoclonal protein confirms ATTR cardiac amyloidosis, and the transthyretin stabilizer tafamidis reduces mortality and hospitalizations.

  5. A patient has a newly implanted On-X-type bileaflet mechanical mitral valve. Which anticoagulation strategy is recommended?

    Answer: Warfarin with a target INR of 3.0

    Mechanical mitral valves need warfarin targeting an INR of 2.5-3.5, and DOACs are contraindicated because of excess thrombosis.

  6. A 35-year-old man with syncope during sleep has spontaneous coved ST elevation in V1-V2 (type 1 Brugada pattern). What is the most appropriate management?

    Answer: Implantable cardioverter-defibrillator

    A spontaneous type 1 Brugada pattern with arrhythmic syncope is a class I indication for ICD placement.

  7. A 68-year-old woman with Takotsubo cardiomyopathy becomes hypotensive, and echo shows a new LV outflow tract obstruction. What is the most appropriate treatment?

    Answer: IV fluids and a beta-blocker

    Dynamic LVOT obstruction gets worse with inotropes and vasodilators, so volume and beta-blockade are used to relieve it.

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