Practice Test GeeksCMC - Cardiac Medicine Certification Practice Test
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Risk Assessment & Management Flashcards

7 cards from real CMC 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 stable angina has a fractional flow reserve (FFR) of 0.78 during coronary angiography. What is the clinical implication?

    Answer: Hemodynamically significant ischemia; revascularization is indicated

    An FFR ≤ 0.80 indicates hemodynamically significant ischemia, and revascularization has been shown to improve outcomes compared to medical therapy alone.

  2. Which lipid parameter, beyond LDL-C, is most useful for residual cardiovascular risk assessment in a patient with elevated triglycerides and low HDL?

    Answer: Non-HDL cholesterol

    Non-HDL cholesterol (total cholesterol minus HDL-C) captures all atherogenic lipoproteins including VLDL remnants and is superior to LDL-C alone in hypertriglyceridemia.

  3. In a patient with aortic stenosis being evaluated for transcatheter aortic valve replacement (TAVR), the STS-PROM score is 8%. How is this risk categorized?

    Answer: High surgical risk (> 8% STS-PROM)

    An STS-PROM of > 8% is classified as high surgical risk, supporting TAVR over SAVR in eligible patients with severe symptomatic aortic stenosis.

  4. Which medication class, when added to maximally tolerated statin therapy in patients with atherosclerotic cardiovascular disease and LDL > 70 mg/dL, has demonstrated reduction in cardiovascular events?

    Answer: PCSK9 inhibitors (evolocumab or alirocumab)

    PCSK9 inhibitors reduce LDL-C by 50–60% and have demonstrated significant reductions in cardiovascular events in patients with established ASCVD on maximally tolerated statins (FOURIER and ODYSSEY OUTCOMES trials).

  5. A patient with a mechanical mitral valve replacement has an INR of 1.8. What is the most appropriate next step?

    Answer: Increase warfarin dose; target INR is 2.5–3.5 for mechanical mitral valves

    Mechanical mitral valves require a higher INR target of 2.5–3.5 due to higher thrombogenicity; an INR of 1.8 is subtherapeutic and warfarin dose should be increased.

  6. In a patient with STEMI, which feature on admission identifies highest 30-day mortality risk according to the Killip classification?

    Answer: Killip Class IV (cardiogenic shock)

    Killip Class IV (cardiogenic shock) carries 30-day mortality approaching 50–80% and is the highest-risk category in the Killip classification of acute MI.

  7. A 48-year-old woman with no traditional risk factors has an elevated Lp(a) level of 95 mg/dL. What is the clinical significance of this finding?

    Answer: Lp(a) > 50 mg/dL is a risk-enhancing factor for ASCVD

    Lp(a) ≥ 50 mg/dL is a recognized risk-enhancing factor per 2018 ACC/AHA guidelines and can tip borderline-risk patients toward initiating or intensifying statin therapy.