CMC Certification Cardio Vascular 5

Question 1

Which imaging modality is considered the gold standard for quantifying myocardial viability before revascularization in ischemic cardiomyopathy?

Accepted Answer

Cardiac MRI with gadolinium late enhancement

Answer

Cardiac MRI with late gadolinium enhancement precisely quantifies transmural scar extent; myocardium with <50% LGE transmurality predicts functional recovery after revascularization.

Question 2

A patient with known peripheral artery disease and hypertension requires an antihypertensive. Which class should be avoided due to risk of worsening claudication?

Accepted Answer

Non-selective beta-blockers

Answer

Non-selective beta-blockers can worsen peripheral artery disease symptoms by blocking beta-2-mediated vasodilation and leaving alpha-mediated vasoconstriction unopposed.

Question 3

Which finding on invasive coronary angiography defines a fractional flow reserve (FFR) measurement indicating a hemodynamically significant lesion?

Accepted Answer

FFR ≤0.80

Answer

An FFR ≤0.80 measured during maximal hyperemia with adenosine is the validated threshold for hemodynamically significant coronary stenosis warranting revascularization.

Question 4

A patient with aortic regurgitation has a widened pulse pressure of 80 mmHg. Which physical exam finding is directly caused by the wide pulse pressure?

Accepted Answer

Water-hammer (Corrigan) pulse

Answer

The Corrigan or water-hammer pulse is a bounding, rapid-rise and collapse peripheral pulse directly caused by the wide pulse pressure of significant aortic regurgitation.

Question 5

In a patient with known long QT syndrome type 2 (LQT2), which trigger most commonly precipitates life-threatening arrhythmias?

Accepted Answer

Sudden auditory stimuli (e.g., alarm clock)

Answer

LQT2 is caused by KCNH2 mutations affecting the IKr channel; sudden auditory stimuli are the classic trigger for torsades de pointes in this genotype.

CMC - Cardiac Medicine Certification Practice Test

CMC - Cardiac Medicine Certification Practice Test

CMC Certification Cardio Vascular 5