CCDS IBHRE CORE EXAM TEST 2026 QUESTIONS AND
SOLUTIONS RATED A+
✔✔The connector - IS-1 and IS-4 - ✔✔IS-1 connector body incorporates a maximum
diameter of 3.23mm with cathodal pin diameter of 1.59mm, or .34mm larger than the
connector pin for the DF-1 connector. This prevents the low voltage lead from being
accidentally connected to a high voltage port in a defibrillator.
✔✔differences and similarities of IS-1, VS-1A, and IS-1B or VS-1B - ✔✔they are all
3.2mm diameter
VS-1A has longer receptacle for lead terminal
while VS-1B has sealing rings in header AND longer receptacle for lead terminal.
✔✔Tetralogy of Fallot - ✔✔- ventricular septal defect
- many levels of obstruction from the RV to the lungs(pulmonary stenosis)
- the aorta lies directly over the ventricular septal defect
- the RV develops thickened muscle
temporary surgical intervention: shunt between the aorta and the pulmonary artery
complete repair: close the ventricular septal repair, opens the RV outflow tract by
removing some thickened muscle below the pulmonary valve, repairing or removing the
pulmonary valve and enlarging the peripheral pulmonary arteries. Sometimes a tube is
placed between the RV and the pulmonary artery(Rastelli repair).
✔✔Transposition of the Great Arteries - ✔✔- the aorta and pulmonary artery are
reversed
- the aorta receives the oxygen-poor blood from the RV, then carried back to the body
without receiving more oxygen, the pulmonary artery receives the oxygen-rich blood
from the LV but carries it back o the lungs
surgical treatment: requires surgery early in life! Temp intervention: enlarge the PFO
and lets the blood mix
1. tunnel between the atria (atrial or venous switch= Mustard procedure=Senning
procedure)2. arterial switch operation(switching the aorta and the pulmonary artery
back). then reattach the coronary arteries also
✔✔Truncus Arteriosus - ✔✔- a large ventricular septal defect which single great vessel
carries blood both to the body and to the lungs
surgical intervention: close the ventricular septal defect, disconnect the pulmonary
arteries from the single great vessel, place a tube from the RV to the pulmonary arteries
✔✔atrial septal defect - ✔✔atrioventricular canal defect = endocardial cushion defect =
atrioventricular septal defect
one large valve allowing flow into the heart (instead of mitral and tricuspid)
, commonly seen in children with down syndrome
✔✔Coarctation of the aorta - ✔✔narrowing of a portion of the aorta and often seriously
decreases the blood flow from the heart out to the lower portion of the body
✔✔Hypoplastic left heart syndrome - ✔✔when the LV, mitral valve, and aortic valve are
underdeveloped and unable to pump blood adequately to the entire body
✔✔Patent ductus arteriosus - ✔✔the blood vessel(between pulmonary artery and the
aorta) in the developing fetus that diverts circulation away from the lungs and sends it
directly to the body. When ductus arteriosus does not close, it results in too much blood
flow to a newborn's lungs
common in premature babies
✔✔Pulmonary atresia - ✔✔pulmonic valve does not open at all or completely absent
or the pulmonary artery may be malformed and the RV can be abnormally small
✔✔pulmonary stenosis - ✔✔pulmonic valve is stiffened and has a narrowed opening
✔✔Total Anomalous pulmonary venous connection - ✔✔Failure of the pulmonary veins
to join the L atrium
-results in mixed blood returning to R atrium & shunted from the R to the L through an
ASD
-R side hypertrophies and L side remains small
-s/s of CHF my develop, worsening cyanosis, deteriorates rapidly
*surgery is necessary*
✔✔Tricuspid Atresia - ✔✔Absence of tricuspid valve and hypoplastic RV; \
Fontan procedure: direct the blood coming back from the body directly to the lungs,
without being pumped to the lungs by the heart(connect the RA to pulmonary artery)
✔✔Ventricular Septal Defect - ✔✔large hole between two ventricles lets venous blood
pass from the right to the left ventricle and out to the aorta without oxygenation
✔✔Possible outomes of programming in a "common ring" configuration in LV lead when
the anodal electrode of the RV lead is used as anodal electrode of the coronary sinus
lead - ✔✔- simultaneous biventricular activation
- but if the LV capture threshold is greater than the RV anodal capture threshold, then
there may be RV anodal only capture
✔✔observing biventricular pacing assoicated with LV versus RV capture - ✔✔- a
change from BV to LV capture was best identified as increasing positivity of the QRS in
lead III
SOLUTIONS RATED A+
✔✔The connector - IS-1 and IS-4 - ✔✔IS-1 connector body incorporates a maximum
diameter of 3.23mm with cathodal pin diameter of 1.59mm, or .34mm larger than the
connector pin for the DF-1 connector. This prevents the low voltage lead from being
accidentally connected to a high voltage port in a defibrillator.
✔✔differences and similarities of IS-1, VS-1A, and IS-1B or VS-1B - ✔✔they are all
3.2mm diameter
VS-1A has longer receptacle for lead terminal
while VS-1B has sealing rings in header AND longer receptacle for lead terminal.
✔✔Tetralogy of Fallot - ✔✔- ventricular septal defect
- many levels of obstruction from the RV to the lungs(pulmonary stenosis)
- the aorta lies directly over the ventricular septal defect
- the RV develops thickened muscle
temporary surgical intervention: shunt between the aorta and the pulmonary artery
complete repair: close the ventricular septal repair, opens the RV outflow tract by
removing some thickened muscle below the pulmonary valve, repairing or removing the
pulmonary valve and enlarging the peripheral pulmonary arteries. Sometimes a tube is
placed between the RV and the pulmonary artery(Rastelli repair).
✔✔Transposition of the Great Arteries - ✔✔- the aorta and pulmonary artery are
reversed
- the aorta receives the oxygen-poor blood from the RV, then carried back to the body
without receiving more oxygen, the pulmonary artery receives the oxygen-rich blood
from the LV but carries it back o the lungs
surgical treatment: requires surgery early in life! Temp intervention: enlarge the PFO
and lets the blood mix
1. tunnel between the atria (atrial or venous switch= Mustard procedure=Senning
procedure)2. arterial switch operation(switching the aorta and the pulmonary artery
back). then reattach the coronary arteries also
✔✔Truncus Arteriosus - ✔✔- a large ventricular septal defect which single great vessel
carries blood both to the body and to the lungs
surgical intervention: close the ventricular septal defect, disconnect the pulmonary
arteries from the single great vessel, place a tube from the RV to the pulmonary arteries
✔✔atrial septal defect - ✔✔atrioventricular canal defect = endocardial cushion defect =
atrioventricular septal defect
one large valve allowing flow into the heart (instead of mitral and tricuspid)
, commonly seen in children with down syndrome
✔✔Coarctation of the aorta - ✔✔narrowing of a portion of the aorta and often seriously
decreases the blood flow from the heart out to the lower portion of the body
✔✔Hypoplastic left heart syndrome - ✔✔when the LV, mitral valve, and aortic valve are
underdeveloped and unable to pump blood adequately to the entire body
✔✔Patent ductus arteriosus - ✔✔the blood vessel(between pulmonary artery and the
aorta) in the developing fetus that diverts circulation away from the lungs and sends it
directly to the body. When ductus arteriosus does not close, it results in too much blood
flow to a newborn's lungs
common in premature babies
✔✔Pulmonary atresia - ✔✔pulmonic valve does not open at all or completely absent
or the pulmonary artery may be malformed and the RV can be abnormally small
✔✔pulmonary stenosis - ✔✔pulmonic valve is stiffened and has a narrowed opening
✔✔Total Anomalous pulmonary venous connection - ✔✔Failure of the pulmonary veins
to join the L atrium
-results in mixed blood returning to R atrium & shunted from the R to the L through an
ASD
-R side hypertrophies and L side remains small
-s/s of CHF my develop, worsening cyanosis, deteriorates rapidly
*surgery is necessary*
✔✔Tricuspid Atresia - ✔✔Absence of tricuspid valve and hypoplastic RV; \
Fontan procedure: direct the blood coming back from the body directly to the lungs,
without being pumped to the lungs by the heart(connect the RA to pulmonary artery)
✔✔Ventricular Septal Defect - ✔✔large hole between two ventricles lets venous blood
pass from the right to the left ventricle and out to the aorta without oxygenation
✔✔Possible outomes of programming in a "common ring" configuration in LV lead when
the anodal electrode of the RV lead is used as anodal electrode of the coronary sinus
lead - ✔✔- simultaneous biventricular activation
- but if the LV capture threshold is greater than the RV anodal capture threshold, then
there may be RV anodal only capture
✔✔observing biventricular pacing assoicated with LV versus RV capture - ✔✔- a
change from BV to LV capture was best identified as increasing positivity of the QRS in
lead III
