Cardiology board review project

Cardiology Board Review Project

▸  The Project

▸  How to Create A Question

▸  Question List

▸  Quality Checklist

▸  ABIM Cardiovascular Disease Certification Exam

▸  Resources

▸  Return to Top

For the USMLE Board Review Project, click here.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

The Project

Overview

The goal of the Cardiology Board Review Project is to create a universally accessible free repository of Cardiology Board Review Questions. All questions must be original and cannot violate WikiDoc's strict policies regarding plagiarism. Liability related to copyright violations regarding cardiology board review questions rests with the person who prepared the question. Please notify WikiDoc in writing if you feel that there has been a copyright violation regarding a board review question. Board review questions are reviewed and discussed by the WikiDoc Scholars. After creating the questions, the editor must quality check his or her own work using the WBR quality checklist. Cardiology board review questions must be approved by the peer-review process prior to uploading them onto WikiDoc.

Statement of Need

Current cardiology board review sites charge exorbitant fees for access to the content which may represent an undue financial burden and barrier to participation.

How Can WikiDoc Meet Those Needs?

• Provide robust resources for cardiology fellows and attending physicians to prepare for the Cardiovascular Disease Certification Exam
• Provide opportunities for cardiology fellows and attending physicians to exchange knowledge, strategies and test-taking skills

How Can You Help WikiDoc Meet Those Needs?

• WikiDoc encourages medical students, interns, residents, fellows, attending physicians, and faculty members to submit cardiology board review questions.
• WikiDoc Cardiology Board Review Project is led by Will Gibson, M.D., Ph.D. from Harvard Medical School. For more details, you can send an email to willjgibson@gmail.com.

How to Create A Question

1. To start creating a question, click here.
2. Enter the name of the new question, for example: Question100.
3. Click the button “Create or edit”.
4. Enter the name of the author.
5. Select “ABIM Cardiology” as the exam type from the drop-down list.
6. Enter the question, explanations, and references.
7. Click the button “Save page”.

Question List

For the list of cardiology board review questions, click here.

Quality Checklist

Standard	Items
1. Correct Classification	Board level Subject/Category System/sub-category High yield topic (frequently tested)
2. Question Stem/Prompt	Logical order in clinical cases: age and gender → chief complaint (time frame) → past medical history → physical exam (vitals) → ECG → image (physical exam, biopsy, CXR, CT) → Lab results Commonly asked question prompt (i.e. What is the most likely)? Main article: How to create a board review question § USMLE Step 1 Question Format Jump question Image in stem (CXR/CT/MRI, biopsy, graph, microscopy) Question length: short (1-2 lines), medium (3-4 lines), long (>4 lines)
3. Answer Choices	Clear distractors Image for each answer choice Use of current guidelines/algorithms Answer choice placement
4. Overall Explanation	Included patient’s presentation (pertinent positives and negatives) Integrated clinical knowledge with tested topic High yield content Educational objective (1 or 2 take-home sentences/phrases) WikiDoc-Mnemonic: own & unique or from common source (FA 2014) Working hyperlinks to relevant info Medical thinking
5. Answer Choices Explanations	Correct answer: summarized relevant info Incorrect choice ___ explanation Incorrect choice ___ explanation Incorrect choice ___ explanation Incorrect choice ___ explanation Appropriate length High yield facts Working hyperlinks to relevant info
6. Promoting WikiDoc Use	Used WikiDoc info Used relevant working hyperlinks Link to more relevant information at the end of the overall explanation, example: Main article: Dyspnea § Differentiating Dyspnea from other Diseases
7. English	Question Format Grammar Case story-telling Punctuation Word choice Correct medical abbreviations from USMLE.org (i.e. for vital signs, labs, images)
8. References	Cited used references Respected Copyright sources and avoided plagiarism Used Copyleft sources
9. Creativity	Visual materials WikiDoc-Mnemonic
10. Include into the WBR Question List	Included question into list of questions WBR Correct classification for board level Working hyperlinks to WBR0____ Correct classification for subject/Category Correct classification for system/sub-category Correct classification for High-Yield Correct classification for keywords Correct classification for author

ABIM Cardiovascular Disease Certification Exam

The Cardiovascular Disease Certification Exam consists of multiple-choice questions and special question formats for the interpretation of electrocardiograms and imaging studies.

The multiple-choice questions are single-best-answer questions which consist of a brief statement, a case history, and an image (in some questions), followed by a question and list of possible options. You must choose the one answer that is better than the others; note that other options may be partially correct. Some multiple-choice questions require the interpretation of still frame and moving images such as radiographs, ECGs, echocardiograms, ventriculograms-aortograms, angiograms, nuclear studies, computed tomography scans, MRIs and histology slides. In addition, some questions may require recognition and interpretation of recorded heart sounds.

Special question formats are used in the ECG and Imaging Studies component of the exam, requiring you to interpret electrocardiograms, echocardiograms and coronary angiograms.

Multiple-Choice Questions

Exam Content

The primary medical content categories are shown below, with the percentage assigned to each for a typical exam:

• Arrhythmias — 15%

• Atrioventricular conduction disease

• Atrioventricular block, 1st degree
• Atrioventricular block, 2nd degree
• Atrioventricular block, complete
• Left bundle branch block
• Right bundle branch block
• Left anterior fascicular block
• Left posterior fascicular block

• Sinus node dysfunction

• Sinus bradycardia
• Sinus pauses
• Bradycardia-tachycardia syndrome

• Supraventricular arrhythmias

• Atrioventricular reentrant nodal tachycardia
• Pre-excitation syndromes (including Wolff-Parkinson-White)
• Atrioventricular reciprocating tachycardia

• Ventricular arrhythmias

• Ventricular tachycardia, monomorphic
• Ventricular tachycardia, polymorphic
• Ventricular fibrillation (including idiopathic and non-idiopathic varieties)
• Premature ventricular complexes

• Atrial arrhythmias

• Paroxysmal atrial fibrillation
• Persistent atrial fibrillation
• Permanent atrial fibrillation
• Typical atrial flutter (Type I)
• Atypical atrial flutter (Type II)
• Atrial tachycardia
• Ectopic atrial rhythms

• Channelopathies

• Long Q-T syndrome
• Brugada syndrome
• Early repolarization syndrome

• Sudden cardiac death
• Syncope
• Pacemaker and ICD function
• Antiarrhythmic drug effects

• Coronary Artery Disease — 21.5%

• Angina pectoris

• Unstable angina
• Vasospastic angina
• Angina equivalent
• Exertional angina
• Angina with microvascular disease

• Chronic ischemic heart disease

• Coronary atherosclerosis
• Remote myocardial infarction
• Aneurysm of the heart
• Coronary artery aneurysm
• Silent myocardial ischemia

• Acute myocardial infarction

• STEMI of the anterior wall
• STEMI of the inferior wall
• Right ventricular involvement
• STEMI of the lateral wall
• STEMI of the posterior wall (including inferoposterior wall)
• Type I Non-STEMI
• Type II myocardial infarction
• Spontaneous coronary artery dissection
• STEMI, other

• Early complications following acute myocardial infarction

• Ventricular septal rupture
• Rupture of the cardiac wall
• Rupture of papillary muscle
• Postinfarction angina
• Postinfarction arrhythmias
• Left ventricular pseudoaneurysm
• Dynamic left ventricular outflow tract obstruction
• Postinfarction systolic heart failure

• Atypical chest pain

• Heart Failure and Cardiomyopathy — 17%

• Heart failure

• Acute decompensated ventricular failure
• Systolic heart failure (heart failure with reduced ejection fraction)
• Diastolic heart failure (heart failure with preserved ejection fraction)
• Heart failure with improved ejection fraction
• Cardiogenic shock

• Cardiomyopathies

• Dilated cardiomyopathies
• Hypertrophic cardiomyopathies
• Restrictive and infiltrative cardiomyopathies
• Chemotherapy-related cardiomyopathy
• Stress-induced cardiomyopathy (Takotsubo syndrome)
• Myocarditis
• Noncompaction cardiomyopathy
• Arrhythmogenic right ventricular dysplasia

• Transplanted heart
• Mechanical circulatory support

• Valvular Disease — 15%

• Mitral valve disorders

• Mitral valve regurgitation, native
• Mitral valve stenosis, native
• Mitral valve prolapse, native
• Prosthetic mitral valve

• Aortic valve disorders

• Aortic valve regurgitation, native
• Aortic valve stenosis, native
• Prosthetic aortic valve

• Tricuspid valve disorders

• Tricuspid valve regurgitation, native
• Tricuspid valve stenosis, native
• Prosthetic tricuspid valve

• Pulmonary valve disorders

• Pulmonary valve regurgitation, native
• Pulmonary valve stenosis, native
• Prosthetic pulmonary valve

• Endocarditis
• Cardiac murmurs and other cardiac sounds

• Pericardial Disease — 4%

• Acute pericarditis
• Chronic pericarditis (including relapsing)
• Pericardial constriction and effusion

• Pericardial effusion
• Cardiac tamponade
• Constrictive pericarditis
• Effusive-constrictive pericarditis

• Abnormalities of the pericardium

• Congenital Heart Disease — 5%

• Congenital malformations of cardiac chambers and connections

• Complete transposition of the great vessels
• Corrected transposition of the great vessels
• Tricuspid atresia
• Anomalous origin of coronary artery
• Tetralogy of Fallot

• Congenital malformations of cardiac septa

• Ventricular septal defect Atrial septal defect
• Patent foramen ovale
• Atrioventricular septal defect

• Congenital malformations of pulmonary and tricuspid valves

• Congenital pulmonary valve stenosis
• Ebstein anomaly

• Congenital malformations of aortic and mitral valves
• Other congenital malformations of the heart

• Dextrocardia
• Congenital heart block

• Congenital malformations of the great arteries

• Patent ductus arteriosus
• Coarctation of the aorta
• Aneurysm of the sinus of Valsalva
• Congenital malformation of the aortic arch
• Pulmonary artery malformation

• Congenital malformations of the great veins

• Persistent left superior vena cava
• Anomalous pulmonary venous connections

• Congenital disorders with cardiovascular implications
• Eisenmenger syndrome

• Vascular Diseases — 6%

• Cerebrovascular diseases

• Cerebral infarction
• Extracranial cervical (carotid and vertebral)
• Subclavian steal syndrome with vertebral artery steal
• Carotid artery dissection

• Diseases of the arteries, arterioles, and capillaries

• Peripheral atherosclerosis
• Aortic aneurysm and dissection
• Raynaud's phenomenon
• Thromboangiitis obliterans (Buerger's disease)
• Claudication
• Acute limb ischemia
• Critical limb ischemia
• Atheroembolism
• Septic arterial embolism
• Polyarteritis nodosa
• Mucocutaneous lymph node syndrome (Kawasaki disease)
• Takayasu arteritis
• Giant cell arteritis with polymyalgia rheumatica
• Mesenteric arterial insufficiency
• Subclavian steal syndrome with internal mammary artery steal
• Fibromuscular dysplasia

• Diseases of the veins, lymphatic vessels, and lymph nodes

• Deep vein thrombosis
• Portal vein thrombosis
• Iliac vein compression syndrome (May-Thurner syndrome)
• Varicose veins of the lower extremities
• Chronic venous insufficiency
• Chronic idiopathic venous hypertension
• Lymphedema

• Systemic Hypertension and Hypotension — 7.5%

• Hypertensive diseases

• Essential (primary) hypertension
• Hypertensive heart disease
• Hypertensive chronic kidney disease
• Severe or resistant hypertension
• Malignant hypertension
• Secondary hypertension
• Hypertension in pregnancy

• Hypotensive diseases

• Hypotensive syndrome
• Drug-induced hypotension

• Pulmonary Circulation Disorders — 3%

• Pulmonary embolism

• Pulmonary embolism with acute cor pulmonale
• Pulmonary embolism without acute cor pulmonale
• Chronic pulmonary embolism

• Pulmonary hypertension

• Pulmonary arterial hypertension (WHO Group 1)
• Pulmonary hypertension associated with other diseases (WHO Groups 2–5)

• Systemic Disorders Affecting the Circulatory System — 4%

• Musculoskeletal and connective tissue

• Systemic lupus erythematosus
• Systemic sclerosis

• Endocrine, nutritional, metabolic, and hematologic disorders

• Dyslipidemias
• Diabetes
• Obesity
• Electrolyte and endocrine abnormalities
• Hematologic disorders

• Renal disorders
• Injury and poisoning

• Toxic effects of alcohol
• Toxic effects of tobacco and nicotine
• Toxic effects of drugs other than alcohol and tobacco
• Anaphylactic shock
• Angioedema

• Cardio-Oncology

• Cardiovascular effects of pharmacological cancer therapy
• Cardiovascular effects of radiation therapy
• Neoplasms

• Malignant neoplasm of the heart and pericardium
• Benign neoplasms (including myxoma, fibroma, and fibroelastoma)

• Normal Cardiovascular Anatomy and Physiology — 2%

Exam questions in the content areas above may also address clinical topics in:

• Preventive and rehabilitative cardiology
• Cardiovascular disease in women
• Geriatric cardiovascular disease
• Preoperative assessment for noncardiac surgery
• Postoperative cardiac care
• Critical care medicine, cardiovascular surgery, and general internal medicine as encountered in the practice of cardiology (including some general pediatrics with an emphasis on adolescent medicine)

Exam Format

The exam is composed of multiple-choice questions with a single best answer, predominantly describing patient scenarios. Questions ask about the work done (that is, tasks performed) by physicians in the course of practice:

• Making a diagnosis
• Ordering and interpreting results of tests
• Recommending treatment or other patient care
• Assessing risk, determining prognosis, and applying principles from epidemiologic studies
• Understanding the underlying pathophysiology of disease and basic science knowledge applicable to patient care

Some questions require interpretation of pictorial material including electrocardiograms, intracardiac electrograms, hemodynamic recordings, chest radiographs, photomicrographs, and imaging studies such as coronary angiograms, echocardiograms, ventriculograms, myocardial perfusion studies, computed tomograms, magnetic resonance images, and intravascular ultrasound images. Some questions may also require recognition and interpretation of recorded heart sounds.

ECG and Imaging Studies

Exam Content

The content categories are shown below, with the percentage assigned to each for a typical exam:

• Electrocardiograms — 48%

• General features
• P wave abnormalities
• Rhythms

• Atrial rhythms
• Atrioventricular junctional rhythms
• Ventricular rhythms

• Atrioventricular conduction
• Abnormal QRS voltage or axis
• Ventricular hypertrophy
• Intraventricular conduction
• Myocardial infarction
• S-T, T, and U wave abnormalities
• Clinical disorders
• Pacemaker function

• Echocardiograms — 37%

• Left ventricular size, function, and structure
• Right ventricular size, function, and structure
• Diseases of the atria
• Valvular heart disease
• Cardiomyopathy
• Systemic disease
• Pulmonary disease
• Diseases of the aorta
• Pericardial and pleural diseases
• Congenital heart disease

• Coronary Angiograms — 15%

• Normal
• Stenoses

• Insignificant stenosis
• Moderate stenosis
• Severe stenosis
• Total occlusion

• Filled by collateral vessels
• Spasm
• Thrombus
• Myocardial bridge
• Anomalous origin
• Fistula
• Aneurysm
• Bypass graft
• Dissection
• Stents

• Patent stent
• Occluded stent

Exam Format

Special question formats are used, requiring diagnostic interpretation of electrocardiograms, echocardiograms, and coronary angiograms. The format comprises a brief patient description and one (or multiple) images.

Resources

• American Board of Internal Medicine, Cardiovascular Disease Certification Exam