Practice Test Geeks(CCS) Certified Cardiovascular Specialist Practice Test
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Clinical Procedures & Protocols Flashcards

7 cards from real CCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Clinical Procedures & Protocols flashcards as text

  1. A patient presents with complete heart block after inferior STEMI. Temporary transvenous pacing is initiated. What is the appropriate initial pacing rate and output setting?

    Answer: Rate 60–80 bpm, output 3–5× capture threshold

    Temporary pacing for complete heart block is typically set at 60–80 bpm with output 3–5 times the capture threshold to ensure reliable pacing.

  2. During fractional flow reserve (FFR) measurement, intravenous adenosine is infused to achieve maximal hyperemia. What FFR value is the threshold for revascularization based on landmark DEFER and FAME trials?

    Answer: ≤0.80

    An FFR ≤0.80 is the validated threshold below which coronary revascularization improves outcomes compared with medical therapy alone.

  3. A patient with hypertrophic obstructive cardiomyopathy (HOCM) undergoes alcohol septal ablation. Which procedural complication is most feared?

    Answer: Complete heart block requiring permanent pacemaker

    Complete heart block requiring permanent pacemaker implantation occurs in up to 20% of alcohol septal ablation procedures due to damage to the conduction system.

  4. When performing intravascular ultrasound (IVUS)-guided PCI, which finding most reliably indicates adequate stent expansion?

    Answer: Minimum stent area (MSA) ≥80% of the distal reference lumen area

    MSA ≥80% of the distal reference lumen area is the primary IVUS criterion for adequate stent expansion and is associated with reduced restenosis and stent thrombosis.

  5. A patient with symptomatic bradycardia undergoes dual-chamber pacemaker implantation. Post-implant, the device is noted to pace the ventricle in every beat despite normal sinus activity. What programming adjustment should be made?

    Answer: Extend the AV delay to promote intrinsic conduction

    Extending the programmed AV delay allows intrinsic AV conduction to occur before the pacemaker delivers a ventricular output, minimizing unnecessary RV pacing.

  6. Which antiplatelet regimen is recommended immediately following drug-eluting stent (DES) implantation for stable coronary artery disease per current ACC/AHA guidelines?

    Answer: Aspirin 81 mg plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) for at least 6 months

    Current guidelines recommend dual antiplatelet therapy (aspirin plus a P2Y12 inhibitor) for at least 6 months after DES in stable CAD, with duration tailored to bleeding and ischemic risk.

  7. A patient undergoes coronary angiography via radial access. After catheter removal, she develops acute arm pain, pallor, and absent radial pulse. What is the most appropriate immediate management?

    Answer: Heparin infusion and urgent vascular surgery consultation

    Acute radial artery occlusion with limb ischemia after catheterization requires systemic anticoagulation and urgent vascular surgery evaluation for possible thrombectomy.