Risk Assessment & Management 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.
Read the first 7 Risk Assessment & Management flashcards as text
A patient on dual antiplatelet therapy (DAPT) after drug-eluting stent placement requires urgent non-cardiac surgery at 2 months post-stent. What is the recommended management?
Answer: Continue aspirin alone and hold the P2Y12 inhibitor perioperatively
When surgery cannot be deferred beyond 30 days post-DES, continuing aspirin while holding the P2Y12 inhibitor minimizes both bleeding and stent thrombosis risk.
Which non-invasive stress test has the highest sensitivity for detecting significant coronary artery disease in patients with known left bundle branch block (LBBB)?
Answer: Adenosine stress myocardial perfusion imaging (MPI)
Vasodilator pharmacologic stress (adenosine or regadenoson) MPI is preferred in LBBB because exercise and dobutamine can cause false-positive septal defects.
The EuroSCORE II is primarily designed to predict which outcome in cardiac surgical patients?
Answer: In-hospital or 30-day operative mortality
EuroSCORE II predicts in-hospital or 30-day operative mortality risk in patients undergoing cardiac surgery.
In a patient with stable ischemic heart disease, which finding on coronary CT angiography (CCTA) most increases the risk of future MACE beyond luminal stenosis assessment?
Answer: Positive remodeling with low-attenuation plaque (vulnerable plaque features)
Positive arterial remodeling combined with low-attenuation (lipid-rich) plaque on CCTA identifies high-risk 'vulnerable' plaques associated with future acute coronary events.
Which variable is NOT included in the MAGGIC risk calculator for heart failure prognosis?
Answer: 6-minute walk distance
The MAGGIC score incorporates clinical and laboratory variables including age, EF, BMI, creatinine, NYHA class, and serum sodium, but not 6-minute walk distance.
A 58-year-old diabetic woman presents with atypical chest pain. Her pretest probability of obstructive CAD is intermediate. Which initial diagnostic strategy is most appropriate?
Answer: Stress imaging (nuclear MPI or stress echo)
In patients with intermediate pretest probability and interpretable ECG but suboptimal exercise capacity, or atypical symptoms, stress imaging provides higher sensitivity and specificity than exercise ECG alone.
Which scoring system stratifies risk of contrast-induced nephropathy following PCI based on pre-procedure clinical variables?
Answer: Mehran risk score
The Mehran risk score uses variables such as age, contrast volume, eGFR, hemodynamic status, and diabetes to stratify the risk of contrast-induced nephropathy after PCI.