Cardiology boards ABIM EXAM 2025/2026 ACTUAL COMPLETE
REAL EXAM QUESTIONS AND ACCURATE ANSWERS (EXPERT
VERIFIED SOLUTIONS) |ALREADY PASSED!!
What do all Pts with ACS get - ANSWER-Continuous EKG, ASA, NTG prn for pain or continuous IV gtt if continued ischemia or HTN, oxygen if sats < 90,
morphine is pain not better with NTG, B-blocker, ACE if still with HTN or LV dysfunction
Contraindications for B-blockers - ANSWER-Bradycardia, hypotension, 2nd or 3rd degree AVB, pulmonary edema, asthma. NOT DM
When to use non-dihydropyridne CCBs in ACS - ANSWER- Contraindications to B blockers, continued ischemia, but NO LV dysfunction
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What anticoagulant to use with ACS - ANSWER-Enoxaparin good, but have to stop 12-24 hrs before CABG Fondaparinux is increased risk of bleeding, do not use if going to do PCI - increased risk of catheter thrombosis and coronary complications If using Fondaparanux and decide to do PCI, change to heparin or bivalirudin
What are the platelet P2Y12 receptor blockers - ANSWER- Clopidogrel or plavix, ticlodipine or Ticlid, prasugrel or effident
When to use clopidogrel with ACS - ANSWER-All Pts if proven ACS, hold until after CABG or PCI, or for those intolerant of ASA for conservative treatment
Jones criteria for rheumatic fever - ANSWER-Major criteria,
Major: Carditis,
Polyarthritis, Chorea, Erythema marginatum, Subcutaneous
nodules Minor: Arthralgia, Fever, Elevated Acute Phase
Reactants, Prolonged PR, Previous History of Group A Strep Infeciton or rheumatic Fever.
- Major or 1 major 2 Minor 2 / 4
When to use fibrinolytic therapy - ANSWER-ST elevation in 2+ contiguous lead, new LBBB, under 75 yo, within 12 hrs of symptoms, no capabilty to do PCI
Contraindications to fibrinolytic therapy - ANSWER-absolute - previous hemorhhagic CVA, cerebrovacular event in last yr, intracranial neoplasm, active internal bleeding, suspected aortic dissection Relative - persistent BP > 180/110, remote CVA, INR > 2-3, bleeding disorders, recent (2-3 wks) major trauma, non- compressible venous puncture, previous exposure to streptokinase or antistreplase, pregnancy, active peptic ulcer, chronic HTN
This class of drugs interacts with Clopidogrel and should be carefully watched - ANSWER-PPI's - interfere with Plavix metabolism, increases levels
What vessel for RV infarct and IWMI - ANSWER-RAD; if RV is also infarcted, much worse prognosis
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Triad of RV infarct in setting of IWMI - ANSWER-HoTN, clear lung fields, elevated JVD; also often have Kussmauls sign
R heart cath findings of RV infarct - ANSWER-elevated PA pressure > 10 + > 80% of PCWP
Treatment for RV infarct - ANSWER-Avoid nitrates and preload agents, fluid support, may need inotropic support with dobutamine
AVB and bradycardia are most common with this MI - ANSWER- IWMI. If with AWMI, it means a large part of the intraventricular myocardium is destroyed, is with high mortality, and usually require permanent pacer
Indications for temporary pacing with MI - ANSWER-Asystole, symptomatic bradycardia (sinus brady or AVB with hypotension not responsive to atropine), complete AVB, Mobitz type II
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