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Invasive Catheterization Procedures Flashcards

7 cards from real CCI 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 hypertrophic obstructive cardiomyopathy (HOCM) undergoes catheterization. Which maneuver will increase the outflow tract gradient?

    Answer: Valsalva maneuver or standing (decreased preload)

    The Valsalva maneuver decreases LV preload (venous return), which reduces LV cavity size and worsens dynamic LVOT obstruction in HOCM.

  2. What does the 'Brockenbrough-Braunwald-Morrow sign' demonstrate during catheterization?

    Answer: Increased post-extrasystolic LV systolic pressure with decreased aortic pulse pressure — pathognomonic of HOCM

    The Brockenbrough sign shows that after a premature ventricular beat, LV systolic pressure increases while aortic pulse pressure paradoxically decreases, pathognomonic for dynamic LVOT obstruction in HOCM.

  3. During transseptal puncture, which anatomical landmark is used to confirm correct needle position before puncture?

    Answer: The 'tenting' of the fossa ovalis observed on fluoroscopy and confirmed by pressure monitoring

    Tenting of the fossa ovalis seen fluoroscopically and confirmed by a right atrial pressure waveform at the needle tip confirms correct positioning before transseptal puncture.

  4. Which finding on coronary angiography is described as TIMI 2 flow?

    Answer: Partial perfusion with contrast filling the distal vessel slowly, not clearing by the end of 3 cardiac cycles

    TIMI 2 flow describes partial perfusion where contrast fills the distal coronary bed beyond the lesion but clears more slowly than normal (not within 3 cardiac cycles).

  5. What is the primary role of the Allen test prior to transradial cardiac catheterization?

    Answer: Confirming adequate ulnar collateral circulation to the hand before radial artery cannulation

    The Allen test assesses ulnar artery collateral flow to ensure the hand will remain perfused if the radial artery becomes occluded during or after the procedure.

  6. A patient develops a large retroperitoneal hematoma after femoral arterial access. Which initial presentation finding should raise suspicion for this complication?

    Answer: Unexplained hypotension and ipsilateral flank or back pain without an obvious groin hematoma

    Retroperitoneal hematoma classically presents with hypotension and ipsilateral flank/back pain but may have minimal external signs because bleeding is contained within the retroperitoneal space.

  7. In the Fick method for cardiac output calculation, what happens to the calculated output if the arteriovenous oxygen difference is doubled while oxygen consumption remains constant?

    Answer: Cardiac output is halved

    By the Fick principle, CO = VO₂ ÷ (CaO₂ – CvO₂); doubling the AV O₂ difference while keeping VO₂ constant halves the calculated cardiac output.