American Board of Internal Medicine (ABIM) Certification Practice Exam

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In the case of severe aortic stenosis, characterized by a Vmax of 4 m/s or greater, what follow-up is recommended?

  1. Every month

  2. Clinical eval yearly; echo every 6-12 months

  3. Every 6-12 months for both

  4. Clinical eval every 2-3 years

The correct answer is: Clinical eval yearly; echo every 6-12 months

In cases of severe aortic stenosis, especially when the peak jet velocity (Vmax) reaches 4 m/s or greater, appropriate follow-up is crucial for monitoring disease progression and assessing the need for intervention. The recommended follow-up includes an annual clinical evaluation, which allows for careful assessment of symptoms and overall cardiac function. An echocardiogram is advised every 6 to 12 months to provide detailed information on hemodynamic changes, valve function, and any potential complications that may arise as the stenosis progresses. Maintaining this regular schedule helps identify any deterioration in the patient's condition and allows for timely surgical intervention, such as aortic valve replacement if necessary. The combination of clinical evaluations and echocardiography ensures comprehensive management of the patient's condition and enhances the accuracy of monitoring trends over time, ultimately improving patient outcomes.