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SB82 Cardiac Surgery
SB82 Cardiac Surgery - loosely taken from Fiser's ABSITE review
| Question | Answer |
|---|---|
| Right to left cardiac shunts cause _______. | Cyanosis |
| A shift from left-to-right shunt to a right-to-left shunt is a sign of increasing pulmonary vascular resistance and pulmonary hypertension, and is known as __________. | Eisenmenger's syndrome |
| This condition, if left untreated, can cause polycythemia, strokes, brain abscess, endocarditis, and hypertrophic osteoarthropathy | Cyanosis |
| The first sign of CHF in children is ________. | Hepatomegaly |
| Left to right cardiac shunts cause _____, clinically manifested as failure to thrive, tachycardia, tachypnea, and hepatomegaly. | CHF |
| _____________ is a connection between the descending aorta and the left pulmonary artery. | Ductus arteriosus |
| ________________ is a connection between the portal vein and IVC. | Ductus venosum |
| Ductus venosum causes blood to be shunted away from the _____ | Liver |
| Ductus arteriosus causes blood to be shunted away from the ________ in utero. | Lungs |
| The most common congenital heart defect _______ | VSD |
| VSDs usually close spontaneously by age ____________ | Six months |
| Medical treatment for symptomatic VSD is ______ and _____. | Diuretics digoxin |
| Indications for repair of VSD | CHF resulting in failure to thrive, PVR > 4-6 Woods units |
| Contraindication to repair of VSD | PVR > 10-12 Woods units |
| Most common congenital defect causing ASD _______ | Ostium secundum |
| Eighty percent of osmium secundum is caused by ___________ | PFO |
| Medical treatment for symptomatic ostium primum defects is ______ and _____. | Diuretics digoxin |
| Anomalies that contribute to oxygenation with ASD | Anomalous pulmonary venous return to right atrium or IVC, or IVC connecting to left atrium |
| This congenital cardiac anomaly is more inferior to the other, more common, cardiac defect causing ASD _______ | Ostium primum |
| Ostium primum is caused by deficiency in left horn of the _______________ | Sinus venosus |
| Ostium secundum becomes symptomatic when Qp / Qs is greater than ______________, resulting in CHF | Two |
| Adults with unrepaired ostium primum defects can get ________ and __________ | paradoxical emboli, arrhythmias |
| Ostium primum defects usually become symptomatic when Qp/Qs > 2, causing ________, ___________ and ____________ | fatigue, dyspnea, recurrent infections |
| Tetralogy of Fallot includes which congenital defects? | Overriding aorta, VSD, pulmonary HTN, and RV hypertrophy |
| Most common congenital defect resulting in cyanosis _________ | Tetralogy of Fallot |
| Morphologic abnormality causing Tetralogy of Fallot | Anterior and superior displacement of infundibular septum |
| Medical treatment for Tetralogy of Fallot is _____________ | Beta blockade |
| This type of shunt can be used for palliation to dely repair of Tetralogy of Fallot | Blalock Taussig |
| Tetralogy of Fallot should be repaired when this sign occurs ____ | Increased cyanosis |
| Definitive repair of Tetralogy of Fallot includes these three steps | Division of RV outflow tract obstruction (pulmonic stenosis), patch enlargement of outflow tract, VSD repair |
| The most common cyanotic disorder presenting during the first week of life is _________ | Transposition of the great vessels |
| In Transposition of the great vessels, mixing of oxygenated and de-oxygenated blood most often occurs through ___________ | ASD |
| Medical treatment of Transposition of the great vessels includes ____ | Atrial septostomy and PGE1 |
| In patients with Transposition of the great vessels and large VSDs, significant CHF and pulmonary HTN may occur by this age ______ | three months |
| Optimal timing of repair in transposition of the great vessels, and technique | Early (first 2-3 weeks of life), switch with posterior implantation of coronary arteries |
| Patients with Transposition of the great vessels and _________ are NOT candidates for early switch | LVOT obstruction |
| Patients with Transposition of the great vessels and LVOT obstruction should be treated with this intervention _________ | Blalock Taussig shunt |
| Timing for repair of large symptomatic VSD | prior to school age |
| Test to see if large VSD is reversible, and therefore amenable to repair | Trial of vasodilators |
| Indications for repair of ASD include Qp / Qs > __________ | 1.5 |
| What percentage of ostium primum defects require repair? | 100% |
| What is the timing of ASD repair? | Before school age |
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StudyBug82
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