American Board of Internal Medicine (ABIM) Certification Practice Exam

What test should be performed before initiating treatment for PAH to establish baseline functional impairment?

1. ABG analysis

2. Chest X-ray

3. 6-minute walk test

4. Echocardiogram

The correct answer is: 6-minute walk test

The 6-minute walk test is a crucial assessment tool used to evaluate a patient's functional capacity before initiating treatment for pulmonary arterial hypertension (PAH). This test measures the distance a patient can walk in six minutes and provides valuable insights into their exercise tolerance and overall functional status. Establishing a baseline using this test is important as it helps to gauge the severity of pulmonary hypertension and monitor response to treatment over time. In the context of PAH management, knowing the patient's functional capacity can guide treatment decisions, track progression, and inform clinicians about potential improvements or deterioration in the patient's condition. The 6-minute walk test is practical, reproducible, and can be done in an outpatient setting, making it an ideal choice for establishing baseline functional impairment prior to therapy initiation. While other tests like ABG analysis, chest X-ray, and echocardiogram have their roles in diagnosis and assessment of PAH, they do not specifically focus on functional exercise capacity in the same way that the 6-minute walk test does. Thus, this test is uniquely positioned to provide a baseline for evaluating treatment outcomes in patients with PAH.