Here's an example of an EKG showing inverted cerebral T waves as a consequences of an intracrantial hemorrhage (bleeding stroke). Cerebral T waves are known to be symmetric and deeply inverted. This patient had a cardiac echo confirming normal wall motion.
I have no idea what the physiological basis is for getting inverted T waves on an ECG from a stroke. However, the ABIM thought it was important enough to throw onto boards a few years ago. An ECG showing cerebral T waves as a consequence of an intracranial hemorrhage was, apparently, an internal medicine ABIM board question years ago. I know this because I was told by some of my attending physicians taking their boards years ago. They missed the question. I don't think a single resident from my program will miss that question ever again.
It's the phrase heard over and over again as a resident. "This is a boards question". Learn it.
Now that I've divulged an ABIM boards question, I wonder if the academicians four times removed from community based clinical medicine are going to hire blog police to catch cheaters finding knowledge on The Happy Hospitalist. What do you think? Am I a cheater for repeating what my residency director told us?
By the way, I still can't figure out why I'm paying over $1000 to take a test and annoy my life with unnecessary busy work to prove value if the federal and state rules and regulations are doing the same. I have yet to find someone show me evidence that taking recertification boards makes me a better doctor or provide better care. And since we're all about evidence, I think it's time someone proved it one way or another.
Otherwise, what's the point of taking boards other than to provide four vacations a year for academic doctors to travel to sunny places and make up boards questions on a beach front terrace for one hour a day while surfing the rest of the day for an all expenses paid work vacation.
