CCI RCIS - PRACTICE EXAM Newest 2026/2027 | 150 UNIQUE Questions CORRECTED
PRACTICE EXAM - 150 UNIQUE - ZERO REPEATS - DISTINCT ANSWERS - REAL EXAM FORMAT
DOMAIN 1: PATIENT CARE PRACTICE
Question 1
What is patent hemostasis for radial?
A. Incorrect: violates CCI RCIS standards
B. Wrong: not per cardiovascular invasive specialist curriculum
C. Maintain radial patency during hemostasis using TR Band with minimal pressure to prevent radial
occlusion
D. Contraindicated: unsafe for patient
Answer: C
Rationale: Patent hemostasis: inflate TR Band with air to stop bleeding but maintain antegrade flow verified by
plethysmography. Reduces radial artery occlusion from 5-10% to <1%.
DOMAIN 1: PATIENT CARE PRACTICE
Question 2
What is vascular closure device Angio-Seal?
A. Collagen plug anchor and suture closure for femoral artery hemostasis, allows earlier ambulation
B. Wrong: not per cardiovascular invasive specialist curriculum
C. Incorrect: violates CCI RCIS standards
D. Contraindicated: unsafe for patient
Answer: A
Rationale: Angio-Seal: anchor inside artery, collagen plug outside, dissolves in 60-90 days. Perclose suture
mediated closure. Vascade collagen patch. Contraindicated if femoral artery <5 mm or significant disease.
DOMAIN 1: PATIENT CARE PRACTICE
Question 3
Contrast allergy premedication protocol?
A. Incorrect: violates CCI RCIS standards
B. Contraindicated: unsafe for patient
C. Prednisone 50 mg at 13 hrs, 7 hrs, 1 hr before contrast plus diphenhydramine 50 mg 1 hr before
D. Wrong: not per cardiovascular invasive specialist curriculum
Answer: C
,Rationale: Premedication for prior contrast reaction: steroids reduce risk. For emergent cases: hydrocortisone
200 mg IV q4h plus Benadryl. Use iso-osmolar contrast, have emergency equipment.
DOMAIN 2: ANATOMY PRACTICE
Question 4
What is coronary sinus?
A. Incorrect: violates CCI RCIS standards
B. Venous drainage of heart: great cardiac vein, middle cardiac vein, small cardiac vein drain into
coronary sinus in posterior AV groove to RA
C. Contraindicated: unsafe for patient
D. Wrong: not per cardiovascular invasive specialist curriculum
Answer: B
Rationale: Coronary sinus is landmark for triangle of Koch, used for LV pacing, retrograde cardioplegia,
electrophysiology. Ostium in RA near IVC.
DOMAIN 2: ANATOMY PRACTICE
Question 5
What is fossa ovalis?
A. Incorrect: violates CCI RCIS standards
B. Wrong: not per cardiovascular invasive specialist curriculum
C. Depression in interatrial septum at site of foramen ovale, location for transseptal puncture
D. Contraindicated: unsafe for patient
Answer: C
Rationale: Fossa ovalis is thin portion of interatrial septum, safest site for transseptal puncture. Bounded by
limbus. TEE/ICE guidance to avoid aortic puncture.
DOMAIN 3: PATHOPHYSIOLOGY PRACTICE
Question 6
What is cardiac tamponade hemodynamics?
A. Wrong: not per cardiovascular invasive specialist curriculum
B. Equalization of diastolic pressures: RA = RVEDP = PA diastolic = PCWP within 5 mmHg, plus
pulsus paradoxus >10 mmHg
C. Contraindicated: unsafe for patient
D. Incorrect: violates CCI RCIS standards
,Answer: B
Rationale: Tamponade: pericardial fluid compresses heart, restricts filling, equalizes diastolic pressures,
reduces CO, hypotension, JVD, muffled heart sounds, pulsus paradoxus. Treatment pericardiocentesis.
DOMAIN 3: PATHOPHYSIOLOGY PRACTICE
Question 7
What is constrictive pericarditis hemodynamics?
A. Incorrect: violates CCI RCIS standards
B. Equalization of diastolic pressures similar to tamponade but with dip and plateau sign square root
sign and ventricular interdependence
C. Wrong: not per cardiovascular invasive specialist curriculum
D. Contraindicated: unsafe for patient
Answer: B
Rationale: Constrictive: thickened pericardium restricts filling, dip and plateau in diastolic pressure tracing,
respiratory variation in ventricular pressures opposite, septal bounce. Different from restriction.
DOMAIN 4: HEMODYNAMICS PRACTICE
Question 8
What is Gorlin formula for valve area?
A. Wrong: not per cardiovascular invasive specialist curriculum
B. Contraindicated: unsafe for patient
C. Valve area = CO / (44.3 x sqrt mean gradient) for aortic, mitral uses 37.7 constant, accounts for HR
and diastolic filling period
D. Incorrect: violates CCI RCIS standards
Answer: C
Rationale: Gorlin: Area = flow / (constant x sqrt gradient). Flow = CO / (SEP x HR) for aortic, CO / (DFP x HR)
for mitral. SEP systolic ejection period, DFP diastolic filling period. Hakki simplified area = CO / sqrt gradient.
DOMAIN 4: HEMODYNAMICS PRACTICE
Question 9
What is Qp/Qs shunt calculation?
A. Incorrect: violates CCI RCIS standards
B. Contraindicated: unsafe for patient
C. Qp/Qs = (Ao sat - Mixed venous sat) / (PV sat - PA sat), Qp/Qs >1.5 significant left-to-right shunt
D. Wrong: not per cardiovascular invasive specialist curriculum
, Answer: C
Rationale: Qp pulmonary flow, Qs systemic flow. Mixed venous from SVC/IVC, PV sat from pulmonary vein or
wedge, PA sat from PA, Ao sat from aorta. Step-up in sat indicates left-to-right shunt location.
DOMAIN 5: INTERVENTIONS PRACTICE
Question 10
What is rotational atherectomy burr-to-artery ratio?
A. Contraindicated: unsafe for patient
B. 0.5-0.6 burr to artery ratio, e.g., 1.5 mm burr for 3.0 mm artery, avoid >0.7 ratio increases
perforation risk
C. Incorrect: violates CCI RCIS standards
D. Wrong: not per cardiovascular invasive specialist curriculum
Answer: B
Rationale: Rotablator: diamond coated burr 1.25-2.5 mm, 140-180k RPM, pecking motion, continuous flush
with Rotaglide, avoid decelerations >5000 RPM. Indicated for heavily calcified lesions uncrossable or
undilatable.
DOMAIN 5: INTERVENTIONS PRACTICE
Question 11
What is DK crush technique for bifurcation?
A. Double kissing crush: side branch stent crush by main vessel balloon, first kissing, main vessel
stent, final kissing, for true bifurcation Medina 1,1,1
B. Contraindicated: unsafe for patient
C. Incorrect: violates CCI RCIS standards
D. Wrong: not per cardiovascular invasive specialist curriculum
Answer: A
Rationale: DK crush improves outcomes for left main bifurcation vs provisional. Steps: side branch stent
protruding, crush with main balloon, first kissing, main stent, POT, side branch rewire, final kissing, final POT.
DOMAIN 6: STRUCTURAL PRACTICE
Question 12
What is TAVR paravalvular leak grading?
A. Incorrect: violates CCI RCIS standards
B. Trace, mild, moderate, severe based on circumferential extent of leak <10% mild 10-29% moderate
≥30% severe
PRACTICE EXAM - 150 UNIQUE - ZERO REPEATS - DISTINCT ANSWERS - REAL EXAM FORMAT
DOMAIN 1: PATIENT CARE PRACTICE
Question 1
What is patent hemostasis for radial?
A. Incorrect: violates CCI RCIS standards
B. Wrong: not per cardiovascular invasive specialist curriculum
C. Maintain radial patency during hemostasis using TR Band with minimal pressure to prevent radial
occlusion
D. Contraindicated: unsafe for patient
Answer: C
Rationale: Patent hemostasis: inflate TR Band with air to stop bleeding but maintain antegrade flow verified by
plethysmography. Reduces radial artery occlusion from 5-10% to <1%.
DOMAIN 1: PATIENT CARE PRACTICE
Question 2
What is vascular closure device Angio-Seal?
A. Collagen plug anchor and suture closure for femoral artery hemostasis, allows earlier ambulation
B. Wrong: not per cardiovascular invasive specialist curriculum
C. Incorrect: violates CCI RCIS standards
D. Contraindicated: unsafe for patient
Answer: A
Rationale: Angio-Seal: anchor inside artery, collagen plug outside, dissolves in 60-90 days. Perclose suture
mediated closure. Vascade collagen patch. Contraindicated if femoral artery <5 mm or significant disease.
DOMAIN 1: PATIENT CARE PRACTICE
Question 3
Contrast allergy premedication protocol?
A. Incorrect: violates CCI RCIS standards
B. Contraindicated: unsafe for patient
C. Prednisone 50 mg at 13 hrs, 7 hrs, 1 hr before contrast plus diphenhydramine 50 mg 1 hr before
D. Wrong: not per cardiovascular invasive specialist curriculum
Answer: C
,Rationale: Premedication for prior contrast reaction: steroids reduce risk. For emergent cases: hydrocortisone
200 mg IV q4h plus Benadryl. Use iso-osmolar contrast, have emergency equipment.
DOMAIN 2: ANATOMY PRACTICE
Question 4
What is coronary sinus?
A. Incorrect: violates CCI RCIS standards
B. Venous drainage of heart: great cardiac vein, middle cardiac vein, small cardiac vein drain into
coronary sinus in posterior AV groove to RA
C. Contraindicated: unsafe for patient
D. Wrong: not per cardiovascular invasive specialist curriculum
Answer: B
Rationale: Coronary sinus is landmark for triangle of Koch, used for LV pacing, retrograde cardioplegia,
electrophysiology. Ostium in RA near IVC.
DOMAIN 2: ANATOMY PRACTICE
Question 5
What is fossa ovalis?
A. Incorrect: violates CCI RCIS standards
B. Wrong: not per cardiovascular invasive specialist curriculum
C. Depression in interatrial septum at site of foramen ovale, location for transseptal puncture
D. Contraindicated: unsafe for patient
Answer: C
Rationale: Fossa ovalis is thin portion of interatrial septum, safest site for transseptal puncture. Bounded by
limbus. TEE/ICE guidance to avoid aortic puncture.
DOMAIN 3: PATHOPHYSIOLOGY PRACTICE
Question 6
What is cardiac tamponade hemodynamics?
A. Wrong: not per cardiovascular invasive specialist curriculum
B. Equalization of diastolic pressures: RA = RVEDP = PA diastolic = PCWP within 5 mmHg, plus
pulsus paradoxus >10 mmHg
C. Contraindicated: unsafe for patient
D. Incorrect: violates CCI RCIS standards
,Answer: B
Rationale: Tamponade: pericardial fluid compresses heart, restricts filling, equalizes diastolic pressures,
reduces CO, hypotension, JVD, muffled heart sounds, pulsus paradoxus. Treatment pericardiocentesis.
DOMAIN 3: PATHOPHYSIOLOGY PRACTICE
Question 7
What is constrictive pericarditis hemodynamics?
A. Incorrect: violates CCI RCIS standards
B. Equalization of diastolic pressures similar to tamponade but with dip and plateau sign square root
sign and ventricular interdependence
C. Wrong: not per cardiovascular invasive specialist curriculum
D. Contraindicated: unsafe for patient
Answer: B
Rationale: Constrictive: thickened pericardium restricts filling, dip and plateau in diastolic pressure tracing,
respiratory variation in ventricular pressures opposite, septal bounce. Different from restriction.
DOMAIN 4: HEMODYNAMICS PRACTICE
Question 8
What is Gorlin formula for valve area?
A. Wrong: not per cardiovascular invasive specialist curriculum
B. Contraindicated: unsafe for patient
C. Valve area = CO / (44.3 x sqrt mean gradient) for aortic, mitral uses 37.7 constant, accounts for HR
and diastolic filling period
D. Incorrect: violates CCI RCIS standards
Answer: C
Rationale: Gorlin: Area = flow / (constant x sqrt gradient). Flow = CO / (SEP x HR) for aortic, CO / (DFP x HR)
for mitral. SEP systolic ejection period, DFP diastolic filling period. Hakki simplified area = CO / sqrt gradient.
DOMAIN 4: HEMODYNAMICS PRACTICE
Question 9
What is Qp/Qs shunt calculation?
A. Incorrect: violates CCI RCIS standards
B. Contraindicated: unsafe for patient
C. Qp/Qs = (Ao sat - Mixed venous sat) / (PV sat - PA sat), Qp/Qs >1.5 significant left-to-right shunt
D. Wrong: not per cardiovascular invasive specialist curriculum
, Answer: C
Rationale: Qp pulmonary flow, Qs systemic flow. Mixed venous from SVC/IVC, PV sat from pulmonary vein or
wedge, PA sat from PA, Ao sat from aorta. Step-up in sat indicates left-to-right shunt location.
DOMAIN 5: INTERVENTIONS PRACTICE
Question 10
What is rotational atherectomy burr-to-artery ratio?
A. Contraindicated: unsafe for patient
B. 0.5-0.6 burr to artery ratio, e.g., 1.5 mm burr for 3.0 mm artery, avoid >0.7 ratio increases
perforation risk
C. Incorrect: violates CCI RCIS standards
D. Wrong: not per cardiovascular invasive specialist curriculum
Answer: B
Rationale: Rotablator: diamond coated burr 1.25-2.5 mm, 140-180k RPM, pecking motion, continuous flush
with Rotaglide, avoid decelerations >5000 RPM. Indicated for heavily calcified lesions uncrossable or
undilatable.
DOMAIN 5: INTERVENTIONS PRACTICE
Question 11
What is DK crush technique for bifurcation?
A. Double kissing crush: side branch stent crush by main vessel balloon, first kissing, main vessel
stent, final kissing, for true bifurcation Medina 1,1,1
B. Contraindicated: unsafe for patient
C. Incorrect: violates CCI RCIS standards
D. Wrong: not per cardiovascular invasive specialist curriculum
Answer: A
Rationale: DK crush improves outcomes for left main bifurcation vs provisional. Steps: side branch stent
protruding, crush with main balloon, first kissing, main stent, POT, side branch rewire, final kissing, final POT.
DOMAIN 6: STRUCTURAL PRACTICE
Question 12
What is TAVR paravalvular leak grading?
A. Incorrect: violates CCI RCIS standards
B. Trace, mild, moderate, severe based on circumferential extent of leak <10% mild 10-29% moderate
≥30% severe
