Practice Test GeeksCSC - Cardiac Subspecialty Certification Exam Practice Test
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Cardiac Subspecialty Flashcards

7 cards from real CSC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 72-year-old with chronic AF is on warfarin (INR 2.4) and undergoes elective percutaneous coronary intervention with drug-eluting stent placement. He has no prior bleeding history. What antithrombotic regimen is recommended at discharge?

    Answer: Dual therapy with warfarin + P2Y12 inhibitor for 1-6 months, then warfarin monotherapy

    Current guidelines recommend dual antithrombotic therapy (OAC + P2Y12) for most AF patients after PCI to balance thrombotic and bleeding risk.

  2. On echocardiography, a patient has E velocity of 120 cm/s, E/A ratio of 2.4, deceleration time of 140 ms, and E/e' of 18. What grade of diastolic dysfunction does this represent?

    Answer: Grade III (restrictive filling)

    Grade III diastolic dysfunction (restrictive filling) is characterized by E/A >2, shortened deceleration time (14), reflecting markedly elevated filling pressures.

  3. A patient with acute decompensated heart failure is started on intravenous dobutamine. What is the PRIMARY mechanism by which dobutamine improves cardiac output?

    Answer: Beta-1 adrenergic receptor stimulation increasing myocardial contractility

    Dobutamine primarily acts on beta-1 adrenergic receptors to increase inotropy and heart rate, thereby augmenting cardiac output.

  4. Which ECG pattern is pathognomonic for acute pericarditis?

    Answer: Diffuse ST elevation with reciprocal changes in aVR and PR depression

    Acute pericarditis classically shows diffuse saddle-shaped ST elevation with PR depression in most leads and reciprocal PR elevation in aVR.

  5. A 45-year-old with familial hypercholesterolemia (LDL 210 mg/dL on maximum-dose statin + ezetimibe) has an ASCVD risk >20%. What is the most appropriate next escalation of lipid-lowering therapy?

    Answer: Add a PCSK9 inhibitor (evolocumab or alirocumab)

    PCSK9 inhibitors reduce LDL by 50-60% and are indicated for patients with ASCVD or FH who remain above target on maximally tolerated statin + ezetimibe.

  6. During electrophysiology study, the His-Purkinje conduction time (HV interval) is measured at 85 ms. What is the clinical significance?

    Answer: Suggests infra-Hisian conduction disease with risk of complete heart block

    An HV interval >70 ms (normal 35-55 ms) indicates prolonged infra-Hisian conduction, which at ≥100 ms carries risk of progression to complete AV block.

  7. Cardiac amyloidosis is increasingly recognized as a cause of heart failure with preserved ejection fraction. Which finding on bone scintigraphy (pyrophosphate scan) is most specific for transthyretin amyloidosis (ATTR)?

    Answer: Grade 2 or 3 cardiac uptake with H/CL ratio >1.5 in the absence of monoclonal protein

    Grade 2-3 cardiac uptake on pyrophosphate scintigraphy (H/CL >1.5) without monoclonal protein has >99% specificity for ATTR amyloidosis, obviating biopsy.