Chest Pain: ABFM practice questions

13 board-style questions on chest pain in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 61-year-old man with hypertension and hyperlipidemia presents with substernal chest pressure that occurs when he walks uphill or climbs two flights of stairs and resolves within 5 minutes of rest. He has no symptoms at rest. An exercise stress test shows 1.5 mm horizontal ST depression at stage 3 of the Bruce protocol. His heart rate and blood pressure response are appropriate, and he has no arrhythmias. Coronary angiography reveals a 55% stenosis in the mid-LAD. What is the most appropriate management?

1. Increase antihypertensive medications and retest in 6 months
2. Aspirin, high-intensity statin, beta-blocker, and sublingual nitroglycerin as needed
3. Percutaneous coronary intervention with drug-eluting stent
4. Coronary artery bypass grafting

Sample question 2

A 32-year-old man presents with sharp substernal chest pain that worsens with inspiration and when lying flat, but improves when sitting up and leaning forward. He had an upper respiratory infection one week ago. ECG shows diffuse ST elevation with PR depression. His troponin is mildly elevated. What is the most appropriate initial treatment?

1. Ibuprofen 400 mg every 8 hours alone without colchicine
2. Prednisone 60 mg daily for 2 weeks
3. Aspirin 650 mg every 8 hours plus colchicine 0.5 mg twice daily
4. Heparin drip and emergent cardiac catheterization

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

PulseMD is an independent educational resource and is not affiliated with, endorsed by, sponsored by, or approved by the American Board of Family Medicine.