CCT CCT Cardiac Diagnostic Testing & Equipment 2 — Questions and Answers
Question 1: When setting up a patient for exercise stress testing, which finding is an absolute contraindication to proceeding?
- Unstable angina or recent MI within 2 days (Correct answer)
- Mild hypertension (150/90)
- Controlled diabetes
- Age over 65
Correct answer: Unstable angina or recent MI within 2 days
Unstable angina and recent MI represent high-risk myocardial instability; exercising the heart in this state can precipitate fatal arrhythmias or rupture.
Question 2: B-type natriuretic peptide (BNP) is elevated primarily in patients with:
- Heart failure with increased ventricular wall stress (Correct answer)
- Acute pericarditis
- Stable coronary artery disease
- Normal cardiac function
Correct answer: Heart failure with increased ventricular wall stress
BNP is released by ventricular myocytes in response to volume overload and increased wall tension, making it a sensitive marker of heart failure severity.
Question 3: On a 12-lead ECG, which leads provide a view of the inferior wall of the left ventricle?
- II, III, and aVF (Correct answer)
- I, aVL, V5, V6
- V1 and V2
- V3 and V4
Correct answer: II, III, and aVF
Leads II, III, and aVF are oriented toward the inferior surface of the heart and display changes associated with inferior wall ischemia or infarction.
Question 4: During a tilt-table test, syncope triggered by prolonged upright positioning with a drop in blood pressure and heart rate indicates:
- Vasovagal (neurocardiogenic) syncope (Correct answer)
- Ventricular tachycardia
- Hypertrophic cardiomyopathy
- Cardiac tamponade
Correct answer: Vasovagal (neurocardiogenic) syncope
The tilt-table test reproduces vasovagal syncope by provoking the cardioinhibitory and vasodepressor responses that cause sudden blood pressure and heart rate drops.
Question 5: Pulsus paradoxus, detected during blood pressure measurement, is a classic sign of:
- Cardiac tamponade (Correct answer)
- Hypertensive crisis
- Aortic regurgitation
- Mitral stenosis
Correct answer: Cardiac tamponade
Pulsus paradoxus is an exaggerated fall (>10 mmHg) in systolic blood pressure during inspiration, caused by pericardial fluid compressing the heart in tamponade.
Question 6: Which view in a transthoracic echocardiogram best visualizes all four cardiac chambers simultaneously?
- Apical four-chamber view (Correct answer)
- Parasternal long-axis view
- Subcostal view
- Suprasternal view
Correct answer: Apical four-chamber view
The apical four-chamber view positions the transducer at the cardiac apex, providing a simultaneous image of both atria and both ventricles for size and function comparison.
CCT CCT Cardiac Diagnostic Testing & Equipment 2
When setting up a patient for exercise stress testing, which finding is an absolute contraindication to proceeding?