Practice Test GeeksCSC - Cardiac Subspecialty Certification Exam Practice Test
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Case Studies & Practical Application Flashcards

7 cards from real CSC 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 67-year-old man post-anterior STEMI develops new hypotension, elevated JVP, clear lung fields, and new holosystolic murmur. Echo shows a ventricular septal defect. What is the next best step?

    Answer: Intra-aortic balloon pump and emergent surgical VSD repair

    Post-MI VSD with cardiogenic shock requires hemodynamic stabilization with IABP and emergent surgical repair, as mortality is very high without prompt intervention.

  2. A 60-year-old woman with known ATTR cardiac amyloidosis presents with progressive HFpEF and atrial fibrillation. What therapy has been shown to improve survival in transthyretin amyloid cardiomyopathy?

    Answer: Tafamidis

    Tafamidis stabilizes transthyretin tetramers and has demonstrated significant reductions in cardiovascular mortality and hospitalizations in ATTR cardiomyopathy (ATTR-ACT trial).

  3. A 55-year-old man with non-ischemic cardiomyopathy (EF 28%) on optimal GDMT develops NSVT on Holter monitoring. He has no syncope. What is the primary indication for ICD implantation in this patient?

    Answer: EF ≤35% despite ≥3 months of GDMT is the primary indication

    ICD implantation is indicated for primary prevention of SCD in non-ischemic cardiomyopathy when EF remains ≤35% after ≥3 months of optimal GDMT, regardless of NSVT.

  4. A 73-year-old woman presents with dyspnea. Right heart catheterization shows PCWP 28 mmHg, mPAP 42 mmHg, PVR 2.1 WU, and cardiac output 3.8 L/min. What type of pulmonary hypertension does she have?

    Answer: Group 2: PH due to left heart disease

    Elevated PCWP (>15 mmHg) with elevated mPAP defines Group 2 pulmonary hypertension due to left heart disease, the most common cause of PH.

  5. A 49-year-old man undergoes PCI of the RCA with a drug-eluting stent. Two weeks later he requires urgent tooth extraction. What antiplatelet strategy is most appropriate?

    Answer: Continue both aspirin and P2Y12 inhibitor throughout the dental procedure

    Within 3–6 months of DES implantation, DAPT should not be interrupted for minor surgical procedures; continuing both agents during tooth extraction is acceptable.

  6. A 38-year-old woman with no prior cardiac history presents with pleuritic chest pain, ST elevations in multiple leads without reciprocal changes, and elevated troponin. Echo is normal. What is the most likely diagnosis and first-line treatment?

    Answer: Acute pericarditis; aspirin and colchicine

    Diffuse ST elevation without reciprocal changes, pleuritic chest pain, and normal wall motion strongly suggest acute pericarditis, treated with aspirin plus colchicine.

  7. A 64-year-old man with coronary artery disease on aspirin and clopidogrel presents with melena and hemoglobin of 7.5 g/dL. EGD reveals a bleeding peptic ulcer treated with endoscopic hemostasis. When should antiplatelet therapy be resumed?

    Answer: Resume aspirin within 3–5 days; resume P2Y12 within 5–7 days after hemostasis

    After successful endoscopic hemostasis, aspirin can typically be resumed within 3–5 days and the P2Y12 inhibitor within 5–7 days, given high ischemic risk, alongside a PPI.