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(Most Recent!!) | VERSION 2 - PRACTICE EXAM
150 ADDITIONAL UNIQUE - ZERO REPEATS - VERSION 2 - PRACTICE EXAM - CCI RCIS - REALISTIC
OPTIONS - CORRECTED
DOMAIN: CCI RCIS
Question 1
What is pseudoaneurysm vs hematoma?
A. Only hematoma exists
B. Pseudoaneurysm false aneurysm with neck to artery pulsatile, hematoma extravasated blood no
communication
C. No difference
D. Same thing
Answer: B - Pseudoaneurysm false aneurysm with neck to artery pulsatile, hematoma extravasated
blood no communication
Rationale: Pseudoaneurysm vs hematoma: Pseudoaneurysm false aneurysm due to arterial wall puncture not sealing
forms cavity with neck communicating artery pulsatile bruit requires ultrasound thrombin injection compression
surgery. Hematoma extravasated blood in tissue no communication resolves.
DOMAIN: CCI RCIS
Question 2
What is coronary dissection treatment?
A. Stent to seal dissection flap, if flow compromised
B. Only observation always
C. No treatment
D. Only heparin
Answer: A - Stent to seal dissection flap, if flow compromised
Rationale: Coronary dissection: Intimal tear dissection flap from catheter wire balloon can cause occlusion. Treatment
stent to tack flap seal dissection if flow compromised TIMI <3. May need CABG if extensive.
DOMAIN: CCI RCIS
Question 3
What is no-reflow phenomenon?
A. Only slow flow always normal
B. Only epicardial spasm
C. No phenomenon
D. Failure to restore myocardial flow despite open epicardial artery due microvascular dysfunction
,Answer: D - Failure to restore myocardial flow despite open epicardial artery due microvascular
dysfunction
Rationale: No-reflow phenomenon PCI: Failure to restore myocardial tissue perfusion despite open epicardial
coronary artery due microvascular dysfunction embolization edema. Treatment intracoronary adenosine verapamil
nitroprusside aspiration.
DOMAIN: CCI RCIS
Question 4
What is intra-aortic balloon pump IABP?
A. Only for hypertension
B. No device
C. Only for bleeding
D. Counterpulsation device inflates diastole deflates systole augments coronary perfusion reduces afterload
Answer: D - Counterpulsation device inflates diastole deflates systole augments coronary
perfusion reduces afterload
Rationale: IABP Intra-aortic balloon pump: Counterpulsation device placed descending thoracic aorta inflates in
diastole augments diastolic pressure coronary perfusion, deflates in systole reduces afterload LV workload.
Indications cardiogenic shock high-risk PCI. Timing ECG or pressure trigger.
DOMAIN: CCI RCIS
Question 5
What is Impella device?
A. No device
B. Percutaneous ventricular assist device axial flow pump supports LV e.g., Impella CP 2.5-4.0 L/min
C. Only IABP exists
D. Only ECMO
Answer: B - Percutaneous ventricular assist device axial flow pump supports LV e.g., Impella CP
2.5-4.0 L/min
Rationale: Impella: Percutaneous ventricular assist device microaxial flow pump placed across aortic valve supports
LV e.g., Impella 2.5 2.5 L/min, CP 4.0 L/min, 5.0 surgical, provides forward flow unloads LV. Used cardiogenic shock
high-risk PCI. Requires anticoagulation.
DOMAIN: CCI RCIS
Question 6
What is fractional flow reserve FFR?
A. No FFR
B. Only IVUS
, C. Only anatomical stenosis
D. FFR = Pd/Pa distal pressure divided by aortic pressure during hyperemia <0.80 significant ischemia
Answer: D - FFR = Pd/Pa distal pressure divided by aortic pressure during hyperemia <0.80
significant ischemia
Rationale: FFR Fractional Flow Reserve: Physiologic assessment coronary stenosis significance FFR = Pd/Pa distal
coronary pressure divided by aortic pressure during maximal hyperemia adenosine. FFR <0.80 indicates
hemodynamically significant lesion ischemia warranting PCI. FFR >0.80 defer PCI.
DOMAIN: CCI RCIS
Question 7
What is balloon inflation pressure?
A. No pressure
B. 100 atm always
C. Only 1 atm
D. Inflate to nominal pressure e.g., 8-12 atm to deploy stent, rated burst pressure higher
Answer: D - Inflate to nominal pressure e.g., 8-12 atm to deploy stent, rated burst pressure higher
Rationale: Balloon inflation PCI: Inflate balloon to nominal pressure e.g., 8-12 atm to expand stent, rated burst
pressure e.g., 18-20 atm must not exceed. Monitor pressure inflation device.
DOMAIN: CCI RCIS
Question 8
What is drug-eluting stent DES vs BMS?
A. Same as BMS
B. DES coated with antiproliferative drug e.g., everolimus reduces restenosis but requires longer DAPT
C. BMS better always
D. No difference
Answer: B - DES coated with antiproliferative drug e.g., everolimus reduces restenosis but requires
longer DAPT
Rationale: DES vs BMS: Drug-eluting stent coated with antiproliferative drug everolimus zotarolimus sirolimus
reduces neointimal hyperplasia restenosis vs bare metal stent BMS. Requires longer dual antiplatelet therapy DAPT
12 months DES vs 1 month BMS but now 6-12 both per guidelines.
DOMAIN: CCI RCIS
Question 9
What is dual antiplatelet therapy DAPT?
A. Aspirin plus P2Y12 inhibitor clopidogrel ticagrelor prasugrel after PCI to prevent stent thrombosis
B. Only aspirin
, C. No therapy
D. Only warfarin
Answer: A - Aspirin plus P2Y12 inhibitor clopidogrel ticagrelor prasugrel after PCI to prevent stent
thrombosis
Rationale: DAPT: Aspirin plus P2Y12 inhibitor clopidogrel Plavix ticagrelor Brilinta prasugrel Effient after PCI to
prevent stent thrombosis. Duration 12 months ACS DES, 6 months stable CAD DES per guidelines bleeding risk.
DOMAIN: CCI RCIS
Question 10
What is complications of cardiac cath?
A. No complications
B. Only bleeding minimal
C. Bleeding hematoma pseudoaneurysm AV fistula dissection thrombosis stroke contrast allergy
D. Only stroke
Answer: C - Bleeding hematoma pseudoaneurysm AV fistula dissection thrombosis stroke contrast
allergy
Rationale: Complications cardiac cath: Vascular bleeding hematoma pseudoaneurysm arteriovenous fistula,
dissection coronary artery, thrombosis embolism stroke MI, contrast allergy nephropathy, arrhythmia, death 0.1%.
DOMAIN: CCI RCIS
Question 11
What is pseudoaneurysm vs hematoma?
A. Same thing
B. Pseudoaneurysm false aneurysm with neck to artery pulsatile, hematoma extravasated blood no
communication
C. No difference
D. Only hematoma exists
Answer: B - Pseudoaneurysm false aneurysm with neck to artery pulsatile, hematoma extravasated
blood no communication
Rationale: Pseudoaneurysm vs hematoma: Pseudoaneurysm false aneurysm due to arterial wall puncture not sealing
forms cavity with neck communicating artery pulsatile bruit requires ultrasound thrombin injection compression
surgery. Hematoma extravasated blood in tissue no communication resolves.
DOMAIN: CCI RCIS
Question 12
What is coronary dissection treatment?
A. No treatment