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Quizzes > Quizzes for Business > Healthcare

Interventional Cardiology Procedure Knowledge Test

Sharpen Your Skills in Catheterization Procedures

Difficulty: Moderate
Questions: 20
Learning OutcomesStudy Material
Colorful paper art depicting a quiz on Interventional Cardiology Procedure Knowledge Test.

Dive into this Interventional Cardiology Procedure Knowledge Test designed to challenge both novices and seasoned clinicians with realistic PCI quiz scenarios. Joanna Weib invites you to explore essential catheterization concepts and sharpen procedural decision-making skills. Perfect for cardiology fellows preparing for boards or professionals seeking a refresher, this quiz covers access techniques, stent deployment, and complication management. Feel free to modify questions and customize difficulty in our editor. Plus, you can compare your results with other practice materials like the Criminal Procedure Knowledge Test or the Automotive Technician Safety and Procedure Quiz, and browse all our quizzes for more disciplines.

Which coronary access site is most commonly used for routine percutaneous coronary interventions to reduce bleeding complications?
Femoral artery
Radial artery
Brachial artery
Ulnar artery
Radial artery access reduces bleeding risk and allows earlier ambulation compared to femoral access. It has become the preferred route for many operators during PCI.
On coronary angiography, what percentage of luminal diameter stenosis is generally considered severe?
50 - 69%
≥70%
100%
<50%
A stenosis of 70% or greater in vessel diameter is typically classified as severe and often warrants revascularization. Lesser degrees are considered mild or moderate depending on the percentage.
Which catheter shape is most commonly used to selectively engage the left coronary artery in diagnostic angiography?
Multipurpose
Judkins Right
Amplatz Left
Judkins Left
The Judkins Left catheter is specifically shaped to engage the left coronary ostium. Other shapes are designed for different coronary anatomy or support characteristics.
Which anticoagulant is most commonly administered during PCI to achieve systemic anticoagulation?
Warfarin
Low molecular weight heparin
Bivalirudin
Unfractionated heparin
Unfractionated heparin is the standard anticoagulant in PCI due to its rapid onset and easy reversibility. Other agents are used in specific scenarios but are not first-line systemic anticoagulants in this setting.
Which acute complication of coronary angiography is characterized by contrast staining outside the vessel contour indicating an intimal tear?
Thrombus formation
Coronary spasm
Coronary dissection
Perforation
Coronary dissection appears as contrast staining or a flap outside the vessel lumen. Spasm causes luminal narrowing without extraluminal staining.
In fractional flow reserve (FFR) assessment, which FFR value is generally used as the threshold to indicate hemodynamically significant coronary stenosis requiring intervention?
≤0.50
≤0.80
>0.90
≤0.70
An FFR of 0.80 or less indicates that a stenosis is likely causing ischemia and warrants revascularization. Higher values generally reflect non”flow”limiting lesions.
Which catheter is typically selected for engagement of the right coronary artery during diagnostic coronary angiography?
Amplatz Left
Tiger
Judkins Left
Judkins Right
The Judkins Right catheter has a curve designed for selective engagement of the right coronary ostium. Other shapes are optimized for different anatomies.
Which guidewire characteristic is most beneficial when navigating tight, tortuous coronary lesions?
Large lumen profile
Hydrophilic-coated tip
Blunt-tip stiffness
Non-coated smooth surface
A hydrophilic-coated tip reduces friction and enhances trackability through complex, tortuous vessels. Stiffer or uncoated wires increase resistance and risk of vessel injury.
When sizing a coronary stent for deployment, what is the recommended stent-to-artery diameter ratio?
1.2 : 1
0.8 : 1
1 : 1
1.5 : 1
A 1 : 1 stent-to-vessel ratio ensures appropriate apposition without oversizing that could damage the vessel. Undersizing or oversizing can both lead to complications.
During PCI, what is the typical target activated clotting time (ACT) range to maintain adequate anticoagulation?
250 - 300 seconds
200 - 250 seconds
150 - 200 seconds
>350 seconds
An ACT target of 250 - 300 seconds is commonly used to balance bleeding risk with thrombotic protection during PCI. Lower or higher values can increase the risk of complications.
Which clinical factor most strongly favors selecting a radial access approach over femoral access?
High bleeding risk
Need for large bore sheath
Severe peripheral arterial disease in the arm
Obesity
High bleeding risk is a key indication for radial access because it significantly lowers access-site hemorrhagic complications. Other factors may influence access choice but are less decisive.
Which angiographic finding is most suggestive of a coronary artery perforation during PCI?
Linear filling defect within the lumen
Slow contrast washout
Transient vessel spasm
Extravasation of contrast into pericardial space
Contrast extravasation outside the vessel lumen indicates a perforation. Other findings, like filling defects, suggest different complications such as dissection or thrombus.
What is the first-line management maneuver for a small vessel coronary perforation detected during PCI?
Immediate CABG referral
Prolonged low-pressure balloon inflation
High-pressure stent deployment
Emergency pericardiocentesis
Prolonged low-pressure balloon inflation is the initial step to seal small perforations. More invasive measures are reserved for larger or persistent perforations.
Which intracoronary pharmacologic agent is commonly used to treat the no-reflow phenomenon during PCI?
Norepinephrine
Adenosine
Dopamine
Milrinone
Intracoronary adenosine is effective at reversing microvascular spasm and improving flow in the no-reflow phenomenon. Vasoconstrictors like norepinephrine worsen it.
Which P2Y12 receptor antagonist is a reversible inhibitor often used as part of dual antiplatelet therapy post-PCI?
Clopidogrel
Ticagrelor
Prasugrel
Abciximab
Ticagrelor reversibly inhibits the P2Y12 receptor and is used along with aspirin for DAPT. Clopidogrel and prasugrel bind irreversibly, while abciximab is a GP IIb/IIIa inhibitor.
Which non-hyperemic pressure ratio (NHPR) uses resting flow velocities without pharmacologic vasodilation to assess intermediate coronary lesions?
iFR
CFR
QFR
FFR
iFR measures the pressure gradient during the wave-free period of diastole without adenosine. FFR requires pharmacologic hyperemia, while CFR and QFR are different modalities.
To minimize radial artery spasm during transradial coronary procedures, which intra-arterial cocktail is typically administered?
Sodium bicarbonate and saline
Lidocaine and adrenaline
Nitroglycerin and verapamil
Heparin and nitrates
A combination of nitroglycerin and verapamil provides vasodilation and reduces spasm in the radial artery. Heparin is used for anticoagulation but does not prevent spasm.
A patient with a tortuous proximal subclavian artery exhibits poor backup support from a Judkins Right catheter. Which guide catheter is preferred to enhance support for PCI?
Amplatz Right catheter
Extra Backup (EBU) catheter
Multipurpose catheter
Simmons catheter
An EBU catheter provides extra backup support and is designed to improve guide stability in challenging anatomies. Judkins shapes offer less support in tortuous vessels.
If a patient receives excessive unfractionated heparin during PCI resulting in an excessively prolonged ACT, which reversal agent should be administered?
Alteplase
Idarucizumab
Vitamin K
Protamine sulfate
Protamine sulfate neutralizes unfractionated heparin rapidly and is used to reverse anticoagulation if ACT is excessively elevated. Vitamin K reverses warfarin, not heparin.
During PCI, acute stent thrombosis is identified. Which immediate management step is most appropriate?
Delay further intervention
IV antibiotics
Increase statin dose
Glycoprotein IIb/IIIa inhibitor administration with thrombectomy
Acute stent thrombosis requires prompt antiplatelet therapy and mechanical thrombus removal. GP IIb/IIIa inhibitors plus thrombectomy address the thrombotic occlusion immediately.
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Learning Outcomes

  1. Analyse angiography images to assess lesion severity
  2. Identify appropriate access techniques for coronary interventions
  3. Demonstrate correct guidewire and catheter selection
  4. Evaluate stent deployment parameters in PCI
  5. Apply anticoagulation protocols during procedures
  6. Master complication recognition and management strategies

Cheat Sheet

  1. Master Angiographic Lesion Assessment - Dive into the art of interpreting coronary angiograms by spotting lesion length, morphology, and calcification. Sharpen your visual radar to predict procedural hurdles and plan treatment routes like a pro. Don't be intimidated by those squiggly lines - think of them as your treasure map to patient care! PubMed: Lesion Severity Assessment
  2. Understand Access Techniques - Explore the radial and femoral highways to the heart and learn when to choose each path for maximum patient comfort and procedural success. Get to know the pros and cons of each access point so you can navigate vessels with confidence. Your choice of entry can make all the difference in recovery time and complication rates! NCBI: Vascular Access Methods
  3. Select Appropriate Guidewires and Catheters - Match your guidewire's tip stiffness and torque control to the lesion's complexity, then pick a catheter that hugs the vessel curves without causing drama. This is like choosing the right tool for a tricky level in a video game - precision is everything. With the perfect duo, you'll breeze through tortuous anatomy and reach your target faster! PCRonline: Guide Catheters and Wires
  4. Optimize Stent Deployment - Aim for a balloon-to-artery ratio of about 1:1 to ensure your stent sits snugly against the vessel wall and delivers uniform support. Over- or under-sizing can lead to complications, so measure twice and inflate once! Mastering this step helps you leave no gaps and achieve optimal blood flow restoration. ClinicalPub: Basics of PCI
  5. Implement Anticoagulation Protocols - Keep thrombus formation at bay by choosing the right anticoagulant - be it unfractionated heparin or bivalirudin - and adjusting doses based on patient weight and procedure length. It's like fine-tuning your engine oil for peak performance and safety. Staying on top of protocols minimizes clot risk and keeps everyone happy and healthy! AHA Journals: Anticoagulation in PCI
  6. Recognize and Manage Complications - Be the first to spot vessel dissection, perforation, or abrupt closure and have a plan for rapid response. From guidewire entrapment escapes to bailout stenting, practice your emergency moves like a firefighter drills for a blaze. Quick thinking and preparation can turn scary moments into saved lives! Open Access Journals: PCI Complications
  7. Utilize Intravascular Imaging - Light up your procedure with IVUS or OCT to see inside the artery walls, assess plaque composition, and guide stent placement with pinpoint accuracy. It's like turning on a flashlight in a cave - suddenly you spot every nook and cranny. Better imaging leads to smarter decisions and improved patient outcomes! PMC: Intravascular Imaging
  8. Understand Balloon Catheter Types - Know when to use compliant balloons for gentle pre-dilation and switch to noncompliant ones for firm post-dilation to nail that perfect stent expansion. Think of compliant balloons as stretch goals and noncompliant balloons as the final boss - each has its time to shine. Proper balloon choice keeps your stent from underperforming or causing vessel trauma! NCBI: Balloon Catheter Varieties
  9. Stay Updated on Guidelines - Bookmark the latest recommendations from societies like the AHA, ACC, and ESC to keep your practice sharp and evidence-based. Guidelines evolve faster than smartphone updates, so regular reviews are key. Being in-the-know means delivering cutting-edge care and earning trust from peers and patients alike! AHA Journals: PCI Guidelines
  10. Practice Radiation Safety - Shield yourself and your patient by mastering dose-reduction techniques, wearing proper protective gear, and optimizing fluoroscopy settings. Think of radiation safety as your invisible armor in the cath lab. Small habits like collimation and pulsed fluoroscopy can drastically cut exposure over a long career! NCBI: Radiation Safety in Fluoroscopy
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