Practice Test GeeksCSC - Cardiac Subspecialty Certification Exam Practice Test
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CSC 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 68-year-old with chronic kidney disease and new-onset atrial fibrillation requires anticoagulation. His CrCl is 28 mL/min. Which DOAC requires the most significant dose adjustment?

    Answer: Dabigatran

    Dabigatran is 80% renally cleared and is contraindicated when CrCl <30 mL/min (FDA) or <15 mL/min (European guidelines), making renal function the critical determinant of dosing.

  2. Which hemodynamic change characteristically occurs with inspiration during cardiac tamponade?

    Answer: Paradoxical pulse with ≥10 mmHg drop in systolic BP during inspiration

    Pulsus paradoxus (≥10 mmHg inspiratory fall in SBP) occurs in tamponade because inspiratory RV filling competes with LV in the constrained pericardial space, reducing LV output.

  3. A patient is started on amiodarone for recurrent VT. Which side effect requires monitoring with annual pulmonary function tests and chest radiography?

    Answer: Pulmonary toxicity

    Amiodarone pulmonary toxicity (0.1–0.5%/year) is potentially fatal and requires surveillance with annual PFTs and CXR, including DLCO measurement.

  4. Which finding on cardiac MRI is most diagnostic of cardiac sarcoidosis?

    Answer: Mid-wall or epicardial late gadolinium enhancement in a non-ischemic pattern

    Cardiac sarcoidosis shows non-ischemic late gadolinium enhancement (mid-wall/epicardial, typically basal-septal or lateral), distinguishing it from ischemic cardiomyopathy's subendocardial pattern.

  5. A patient with HFrEF (EF 30%) develops worsening kidney function after starting an ACE inhibitor. Creatinine increases 25%. What is the appropriate management?

    Answer: Continue ACE inhibitor if creatinine rise is ≤30% and potassium remains <5.5 mEq/L

    A creatinine rise up to 30% above baseline after RAAS inhibitor initiation is acceptable and expected due to reduced efferent arteriolar tone; discontinuation is only needed for larger rises or hyperkalemia.

  6. A 40-year-old woman with systemic lupus erythematosus develops new mitral regurgitation and vegetations on the mitral valve without fever or positive blood cultures. Which diagnosis best explains these findings?

    Answer: Libman-Sacks endocarditis

    Libman-Sacks endocarditis is a non-infective verrucous endocarditis associated with SLE and antiphospholipid syndrome, typically involving both surfaces of valve leaflets.

  7. Which maneuver would cause the murmur of hypertrophic obstructive cardiomyopathy (HOCM) to increase in intensity?

    Answer: Standing from squatting position

    Standing from squatting reduces venous return and LV volume, increasing LVOT obstruction and intensifying the HOCM murmur; squatting does the opposite.