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