CCI Cardiac Pharmacology and Hemodynamic Monitoring 3

Question 1

Which drug class is contraindicated in patients with severe aortic stenosis when treating systemic hypertension due to risk of hemodynamic collapse?

Accepted Answer

Potent vasodilators such as hydralazine or nitroprusside

Answer

Potent arterial vasodilators are relatively contraindicated in severe aortic stenosis because the fixed outflow obstruction prevents compensatory increase in cardiac output, causing sudden hypotension.

Question 2

During right heart catheterization, the oxygen saturation step-up from the right atrium to the right ventricle suggests which condition?

Accepted Answer

Ventricular septal defect (VSD) with left-to-right shunt

Answer

An oxygen saturation step-up at the RV level indicates oxygenated blood shunting from the left ventricle to the right ventricle through a ventricular septal defect.

Question 3

What is the mechanism by which beta-blockers reduce mortality in systolic heart failure (HFrEF)?

Accepted Answer

Blocking chronic sympathetic activation that causes adverse cardiac remodeling

Answer

In HFrEF, chronic sympathetic overactivation causes adverse cardiac remodeling; beta-blockers block these effects, reducing neurohormonal toxicity, improving EF, and reducing sudden cardiac death.

Question 4

Which vasoactive agent is used in the cardiac catheterization lab to provoke coronary vasospasm in patients with suspected Prinzmetal (variant) angina?

Accepted Answer

Ergonovine (ergometrine) or acetylcholine

Answer

Ergonovine or intracoronary acetylcholine provokes vasospasm in susceptible patients by stimulating smooth muscle contraction, confirming the diagnosis of vasospastic angina.

Question 5

What is the primary goal of intra-aortic balloon pump (IABP) counterpulsation therapy?

Accepted Answer

Increase diastolic coronary perfusion pressure and reduce LV afterload via counterpulsation

Answer

IABP inflates during diastole to augment coronary perfusion pressure and deflates before systole to reduce LV afterload, improving the balance of myocardial oxygen supply and demand.

CCI - Cardiovascular Credentialing International Practice Test

CCI - Cardiovascular Credentialing International Practice Test

CCI Cardiac Pharmacology and Hemodynamic Monitoring 3