American Board of Internal Medicine (ABIM) Certification Practice Exam

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In treating pulmonary arterial hypertension, what condition must be assessed before starting medication?

  1. Exercise tolerance

  2. Blood pressure levels

  3. Right ventricular function

  4. Functional impairment

The correct answer is: Functional impairment

In managing pulmonary arterial hypertension (PAH), assessing functional impairment is crucial before initiating treatment. This evaluation typically involves determining the patient's functional capacity using the World Health Organization (WHO) functional classification. Understanding the degree of functional impairment helps to categorize the patient's condition and guides therapeutic decisions. By assessing functional status, healthcare providers can better understand how the disease impacts the patient’s daily activities. This information is vital for selecting appropriate treatment options, as it can inform the severity of the PAH and the potential need for more aggressive therapy. While factors such as exercise tolerance or right ventricular function are important in the overall assessment and ongoing monitoring of PAH, the classification of functional impairment directly correlates with the need for intervention and can influence outcomes significantly. Additionally, blood pressure levels, while important in a broader cardiovascular context, do not specifically address the unique concerns of pulmonary arterial hypertension in the same way that functional impairment does.