Practice Test GeeksCSC - Cardiac Subspecialty Certification Exam Practice Test
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CSC 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 with dilated cardiomyopathy and LBBB (QRS 158 ms) and EF of 25% is on optimal medical therapy. Which CRT criterion is not met if the patient is NYHA Class I?

    Answer: Symptom threshold for Class I recommendation

    Current guidelines recommend CRT for NYHA Class II–IV patients; Class I is generally not an indication, as mortality benefit requires a minimum symptom burden.

  2. Which pharmacologic stress agent is contraindicated in patients with severe reactive airway disease undergoing pharmacologic stress testing?

    Answer: Adenosine

    Adenosine causes severe bronchospasm via A2B receptor activation and is contraindicated in reactive airway disease; regadenoson (selective A2A agonist) is relatively safer but still used cautiously.

  3. A patient with known aortic stenosis has an aortic valve area of 0.7 cm² but a mean gradient of only 22 mmHg due to low cardiac output. How is this best categorized?

    Answer: Low-flow, low-gradient severe aortic stenosis

    Low-flow, low-gradient severe AS occurs when reduced stroke volume limits gradient despite truly severe valve obstruction; dobutamine stress echo helps distinguish true from pseudosevere AS.

  4. A 55-year-old athlete presents with syncope during exercise. ECG shows epsilon waves and T-wave inversions in V1–V3. Which diagnosis is most likely?

    Answer: Arrhythmogenic right ventricular cardiomyopathy (ARVC)

    ARVC classically presents with epsilon waves, T-wave inversions in right precordial leads, and exercise-induced ventricular arrhythmias due to fibrofatty RV replacement.

  5. Which anticoagulation strategy is recommended for a patient with AF and a CHA₂DS₂-VASc score of 2 who requires bridging therapy before elective surgery?

    Answer: No bridging required for most AF patients on warfarin

    The BRIDGE trial demonstrated that forgoing bridging anticoagulation in AF patients was non-inferior to LMWH bridging, with lower bleeding risk and no increase in thromboembolism.

  6. A patient with inferior MI develops sudden hypotension, clear lung fields, and elevated JVP. Which complication is most likely?

    Answer: Right ventricular infarction

    RV infarction complicates inferior MI (RCA territory) and presents with hypotension, elevated JVP, and clear lungs because the failing RV cannot fill the LV adequately.

  7. Which echocardiographic parameter best estimates LV filling pressures non-invasively in a patient with HFpEF?

    Answer: Mitral annular E/e' ratio

    The E/e' ratio (transmitral E velocity divided by tissue Doppler e' velocity) correlates with PCWP and is the primary non-invasive estimator of LV filling pressures.