Practice Test GeeksCSC - Cardiac Subspecialty Certification Exam Practice Test
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Cardiac Subspecialty Certification 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 patient presents with acute inferior STEMI. Which lead pattern is MOST specific for right ventricular involvement?

    Answer: ST elevation in V4R

    ST elevation in lead V4R (right-sided lead) is the most sensitive and specific marker for right ventricular MI.

  2. In the management of acute decompensated heart failure with cardiogenic shock, which hemodynamic profile (Forrester classification) defines 'cold and wet'?

    Answer: Low CI, high PCWP

    The 'cold and wet' profile (Forrester Class IV) is defined by low cardiac index (18 mmHg), reflecting reduced perfusion and congestion.

  3. Which finding on cardiac catheterization is diagnostic of constrictive pericarditis versus restrictive cardiomyopathy?

    Answer: Discordant ventricular pressure changes with respiration

    Discordant interventricular pressure changes during respiration (RV pressure rises while LV pressure falls with inspiration) is the hemodynamic hallmark of constrictive pericarditis.

  4. A patient with dilated cardiomyopathy (LVEF 28%) and LBBB (QRS 155 ms) is on maximally tolerated medical therapy. Which device therapy has the STRONGEST evidence for mortality reduction?

    Answer: Cardiac resynchronization therapy with defibrillator (CRT-D)

    CRT-D is indicated for LVEF ≤35%, LBBB with QRS ≥150 ms on GDMT, providing both resynchronization benefit and sudden death protection.

  5. Which medication is CONTRAINDICATED in a patient with severe aortic stenosis presenting with acute pulmonary edema?

    Answer: IV nitroglycerin

    Nitroglycerin causes preload and afterload reduction; in severe AS, reducing preload can precipitate severe hypotension as fixed obstruction limits compensatory cardiac output increase.

  6. A patient has a 12-lead ECG showing delta waves, short PR interval, and wide QRS. He develops rapid atrial fibrillation. Which drug is CONTRAINDICATED?

    Answer: IV adenosine

    Adenosine (and AV-nodal blocking agents like digoxin, verapamil, diltiazem, and beta-blockers) are contraindicated in WPW with AF as they can accelerate conduction down the accessory pathway, precipitating ventricular fibrillation.

  7. Which echocardiographic parameter BEST differentiates Grade I diastolic dysfunction from a normal diastolic function pattern in a patient with a preserved LVEF?

    Answer: Mitral E/A ratio <0.8 with average E/e' ≤14

    Grade I diastolic dysfunction is characterized by impaired relaxation with E/A <0.8 and average E/e' ≤14, reflecting decreased LV relaxation without elevated filling pressures.