Free practice quiz
ABIM Cardiovascular Disease Prep Course (Cardiology): free quiz
10 questions from the program. See your score right away, then unlock the explanation of every answer.
- Question 1 of 10
A 62-year-old man with ischemic cardiomyopathy is admitted with worsening dyspnea and cool extremities. Blood pressure is 86/54 mm Hg, jugular venous pressure is elevated, and extremities are poorly perfused. Echocardiography shows an LVEF of 25% without severe valvular disease. Intravenous dobutamine is started for low-output heart failure. Which left ventricular pressure-volume loop change is expected?
Pressure-volume loop response to inotropy
Dobutamine increases contractility, steepening the end-systolic pressure-volume relationship; end-systolic volume falls, so stroke volume and EF rise. A describes increased preload or compliance, not inotropy. A describes increased afterload: higher systolic pressure with impaired emptying and larger ESV. A describes decreased ventricular compliance, as in restrictive physiology or hypertrophy, causing higher diastolic pressure for a given volume.
Diagnose low-output HF by hypoperfusion with reduced EF; order echo/hemodynamic assessment when uncertain; treat temporary cardiogenic hypoperfusion with inotrope support; escalate to advanced HF/critical care if shock persists. - Question 2 of 10
A candidate is asked to interpret an ECG in a patient with suspected conduction disease. The answer choices include several tempting rhythm labels. Before selecting one, which ECG element should remain part of the structured interpretation?
A. This is correct. The selected node is titled ECG Intervals And Axis, and the high-yield bullets explicitly include interval review in a structured ECG approach. Intervals are especially relevant to conduction-focused ECG interpretation.
B. This is incorrect because wedge pressure belongs to hemodynamic assessment, not the ECG interval-and-axis checklist described in the source pack.
C. This is incorrect because angiographic stenosis is an invasive coronary anatomy finding, not an ECG interpretation element within the supplied node.
D. This is incorrect because scar burden by cardiac magnetic resonance is an imaging finding. The node focuses on electrocardiography and electrophysiology skills, including intervals and axis.
- Question 3 of 10
A 67-year-old woman is referred for evaluation of possible ischemia. She has chronic baseline ECG abnormalities that make ST-segment interpretation unreliable, but she can exercise on a treadmill. Which test selection best accounts for this baseline ECG limitation?
A. Exercise ECG without imaging is not the best choice because the source pack explicitly requires applying baseline ECG considerations. If the baseline ECG is not interpretable for ischemic ST changes, a nonimaging exercise ECG loses diagnostic usefulness.
B. Stress imaging with exercise is most appropriate because the patient can exercise, but baseline ECG considerations make imaging preferable. The node specifically includes choosing exercise ECG, stress echo, or nuclear testing appropriately.
C. Canceling stress testing is not supported. The issue is not that functional testing is impossible, but that the modality should account for the uninterpretable baseline ECG.
D. Pharmacologic stress is not required solely because the resting ECG is uninterpretable. The source pack separates baseline ECG considerations from contraindications to exercise or pharmacologic stress; this patient can exercise, so exercise-based imaging remains reasonable.
- Question 4 of 10
A cardiology fellow is reviewing medication options for chronic coronary syndrome. The attending asks which factor should most directly influence the choice among beta blockers, calcium channel blockers, nitrates, and ranolazine for symptom control. Which response is best?
A. Baseline blood pressure, heart rate, and comorbidity profile is correct because this directly restates the source node’s central decision principle for antianginal pharmacology in stable ischemic heart disease.
B. Angina diagnosis alone is incorrect because the supplied bullets explicitly require comparing drug classes and matching therapy to hemodynamics and comorbidities. Antianginal medications are not selected as interchangeable choices.
C. Patient age alone is incorrect because age by itself does not capture the required decision framework. The source pack specifically identifies blood pressure, heart rate, and comorbidity profile as the high-yield matching variables.
D. Avoiding comparison of adverse effects is incorrect because recognizing contraindications and adverse effects is one of the listed high-yield requirements for this node.
- Question 5 of 10
During a STEMI quality review, a fellow is asked which operational action is most central to the selected blueprint topic. The case involves coordinating care among the emergency department, interventional cardiology team, and post-MI monitoring unit. Which answer best reflects the source pack?
A. This is correct because the source pack explicitly lists coordinating rapid reperfusion and post-MI monitoring as a high-yield bullet for STEMI reperfusion and complications.
B. This is incorrect because risk-factor counseling may be relevant to coronary disease broadly, but the supplied STEMI topic prioritizes rapid reperfusion and monitoring.
C. This is incorrect because the node emphasizes choosing primary PCI versus fibrinolysis principles during acute management, not postponing these decisions until discharge.
D. This is incorrect because the selected node is in acute coronary syndromes and addresses STEMI, not exclusively chronic follow-up.
- Question 6 of 10
A 68-year-old man with prior myocardial infarction presents with worsening exertional dyspnea. Echocardiography shows left ventricular ejection fraction of 32%. He is comfortable at rest but becomes dyspneic walking one block. Blood pressure is 118/70 mm Hg; he is alert with warm extremities. Jugular venous pressure is elevated, bibasilar crackles are present, and there is 2+ ankle edema. Which classification best describes his current heart failure status?
HF Classification and Staging
Reduced EF of 32% defines HFrEF; prior/current symptoms make ACC/AHA stage D. Dyspnea with less-than-ordinary activity but comfort at rest is NYHA III. Elevated JVP, crackles, and edema indicate wet congestion; warm extremities and preserved mentation indicate adequate perfusion. A is tempting because prior MI with low EF can be stage B, but symptoms and congestion exclude asymptomatic disease. A has the right stage, class, and profile, but HFmrEF requires EF 41%–49%. C is wrong because stage C/NYHA IV implies refractory symptoms at rest or advanced therapies, and HFpEF requires EF at least 50%. Diagnose HFrEF stage C NYHA III warm/wet; order echo and congestion assessment; treat with GDMT plus diuresis; escalate if hypoperfusion or refractory congestion.
- Question 7 of 10
A patient with HFrEF has persistent exertional dyspnea and is taking only a diuretic. The clinician wants to determine whether the patient is receiving the major guideline-directed classes emphasized for HFrEF. Which medication list best matches the core categories named in the source pack?
A. This list directly matches the core HFrEF guideline therapy categories named in the source pack: ARNI or ACEI, beta blocker, MRA, and SGLT2 inhibitor.
B. This list contains mostly symptom-directed or non-HFrEF medication categories and does not reflect the foundational HFrEF therapies specified in the source pack.
C. These medication categories may be used in unrelated clinical contexts, but they are not the HFrEF guideline therapy categories highlighted in the supplied node.
D. Diuretic therapy alone may improve congestion, but the source pack emphasizes the need to know core HFrEF therapies and to distinguish symptom-relieving drugs from mortality-reducing treatment.
- Question 8 of 10
A 62-year-old patient with long-standing hypertension has increased ventricular wall thickness on echocardiography. The interpreting cardiologist is trying to determine whether the pattern is hypertensive remodeling or hypertrophic cardiomyopathy. Which finding would most strongly support hypertrophic cardiomyopathy?
A. Correct. The supplied HCM recognition node emphasizes asymmetric hypertrophy and dynamic LVOT obstruction as the most important diagnostic clues.
B. Hypertensive remodeling is specifically listed as a condition to distinguish from HCM, so remodeling fully explained by pressure loading would not be the best HCM-supporting feature.
C. The topic asks the learner to relate HCM physiology to murmur and exertional symptoms; wall thickness alone without those physiologic clues is less specific for HCM within the source pack.
D. The node focuses on dynamic LVOT obstruction as a defining recognition point, so a pattern unrelated to outflow dynamics does not best support HCM.
- Question 9 of 10
A 74-year-old man is evaluated after several episodes of lightheadedness. Telemetry shows recurrent symptomatic bradycardia, and the treating team is concerned that the rhythm disturbance is not clearly reversible. Which management decision best reflects the board-level approach to pacing referral?
A. This is correct. The source pack emphasizes knowing major indications for permanent pacing and avoiding pacing only when bradycardia is asymptomatic or reversible; a symptomatic, not clearly reversible bradyarrhythmia warrants pacing referral consideration.
B. This is incorrect. The supplied pacing referral context does not require traumatic syncope before referral; the key issue is clinically significant bradyarrhythmia and whether a permanent pacing indication may be present.
C. This is incorrect. The source pack does not support delaying evaluation until the patient is asymptomatic; symptoms strengthen, rather than weaken, the need to consider pacing referral.
D. This is incorrect. Bradycardia can be part of clinically important sinus node or AV conduction disease, and the node specifically focuses on bradyarrhythmias, syncope, and pacing referral thresholds.
- Question 10 of 10
A 67-year-old man presents with a regular wide complex tachycardia on telemetry. The rhythm is fast and regular, and the immediate clinical team is uncertain whether it represents ventricular tachycardia or supraventricular tachycardia with aberrancy. He is awake and has no signs of hemodynamic collapse. Which diagnostic-management principle is most appropriate?
Option A: This is incorrect because the source pack emphasizes the opposite board-level principle: an undifferentiated regular wide tachycardia should be treated as ventricular tachycardia when the diagnosis is uncertain.
Option B: This is correct because the high-yield bullet explicitly states to treat undifferentiated regular wide tachycardia as VT when uncertain. This approach fits the electrocardiography and electrophysiology focus of wide complex tachycardia principles.
Option C: This is incorrect because morphology clues can help, but the source pack does not support delaying management until every criterion is fully resolved. When uncertainty remains, the rhythm should be handled as VT.
Option D: This is incorrect because AV dissociation is a useful clue, but absence of documented AV dissociation does not make the rhythm noncardiac or remove the need to treat uncertain regular wide tachycardia as VT.
See why each answer is right or wrong
Enter your email to unlock the explanation of every question, free.