Cardiac surgery

Question 1

Methods intended for direct myocardial oxygenation, except for:
A) Aorto-coronary bypass grafting (ACBG)
B) Coronary thromboendarterectomy
C) PTCA (percutaneous transluminal coronary angioplasty)
D) IABP (intra-aortic balloon pump)
E) Pacemaker implantation

Answer 1

E) Pacemaker implantation

Question 2

Surgical access methods for cardiac procedures, except for:
A) median sternotomy
B) left sided standard, antero-lateral thoracotomy
C) parasternal mediastinotomy
D) subcostal mediastinotomy
E) right sided postero-lateral subscapulary thoracotomy

Answer 2

E) right sided postero-lateral subscapulary thoracotomy

Question 3

Your patient has fever following mechanical heart valve surgrey. Suggested methods of investigation are necessary, except for:
A) echocardiography
B) blood cultures
C) antibiotic therapy
D) diagnostic pericardial fluid sampling
E) redo valve surgery in presence of vegetations

Answer 3

D) diagnostic pericardial fluid sampling

Question 4

Cardio-vascular mortality in Hungary:
A) is not significant
B) significant, but is comparable to current european trends
C) statistic data is not available
D) is second following mortality of malignancies
E) is on top of the mortality list

Answer 4

E) is on top of the mortality list

Question 5

Haemoptysis can be a sign of the following cardio-pulmonary disorders, except for:
A) mitral regurgitation
B) mitral stenosis
C) aortic stenosis
D) pulmonary embolism

Answer 5

C) aortic stenosis

Question 6

What is the exact location of the coarctation of the aorta?
A) between the right subclavian and the right carotid arteries
B) between the right and the left carotid arteries
C) between the left carotid and the left subclavian arteries
D) between the left subclavian artery and the duct of Botallo

Answer 6

D) between the left subclavian artery and the duct of Botallo

Question 7

Symptoms of pericardial tamponade, except for:
A) elevated central venous pressure
B) decreased cardiac output
C) low blood pressure
D) elevated left ventricular filling pressure

Answer 7

D) elevated left ventricular filling pressure

Question 8

Which of the following devices is capable of supporting circulation and providing oxygenisation at the same time following cardiac surgery?
A) intra-aortic balloon pump (IABP)
B) single or biventricular circulatory assist device (VAD)
C) extracorporeal membrane oxygenisator (ECMO)

Answer 8

C) extracorporeal membrane oxygenisator (ECMO)

Question 9

The following congenital cardiac defects depend on ductal circulation, except for:
A) pulmonary atresia
B) hypoplastic left heart syndrome
C) interruption of the aortic arch
D) ventricular septal defect

Answer 9

D) ventricular septal defect

Question 10

Which procedure is palliative heart surgery?
A) aortic valve replacement
B) closure of ventricular septal defect
C) Blalock-Taussig shunt
D) coarctectomy

Answer 10

C) Blalock-Taussig shunt

Question 11

Surgical correction procedure of the transposition of the great arteries:
A) arterial switch
B) closure of atrial septal defects
C) coarctectomy

Answer 11

A) arterial switch

Question 12

Lifelong anticoagulation is necessary following the implantation of:
A) a stentless biological (tissue) heart valve
B) a mechanical heart valve
C) a homograft
D) a stented biological (tissue) heart valve

Answer 12

B) a mechanical heart valve

Question 13

In which case is the implantation of a mechanical heart valve contraindicated?
A) poor left ventricular function
B) there is a contraindication for chronic anticoagulant therapy
C) chronic atrial fibrillation

Answer 13

B) there is a contraindication for chronic anticoagulant therapy

Question 14

Emergency surgery is NOT indicated in acute myocardial infarction with the following mechanical complications:
A) left ventricular aneurysm
B) acut mitral regurgitation caused by papillary muscle rupture
C) rupture of the ventricular free wall
D) postinfarct ventricular septal defect

Answer 14

A) left ventricular aneurysm

Question 15

Coronary angiography is necessary prior to surgery, except for:
1) patients older than 60 years of age with degenerative aortic valve stenosis
2) patients with angina pectoris
3) patients with persisting ischaemic symptoms following myocardial infarction
4) patients with mitral stenosis younger than 40 years of age

A) the 1st, 2nd and 3rd answers are correct
B) the 1st and 3rd answers are correct
C) the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 15

D) only the 4th answer is correct

Question 16

Surgical procedures for correcting mitral stenosis are the following, except for
1) commissurotomy
2) implantation of artificial chordae
3) prosthesis implantation
4) implantation of an annuloplastic ring

A) the 1st, 2nd and 3rd answers are correct
B) the 1st and 3rd answers are correct
C) the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 16

C) the 2nd and 4th answers are correct

Question 17

Mandatory elements of cardio-pulmonary bypass circuits:
1) oxygenator
2) arterial pump
3) set of tubes
4) heparin

A) the 1st, 2nd and 3rd answers are correct
B) the 1st and 3rd answers are correct
C) the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

Answer 17

E) all of the answers are correct

Question 18

Sewing rings of stented bioprosthesis (tissue valves) are thrombogenous, so patients receiving them need life-long anticoagulation therapy.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

Answer 18

C) the statement is true, but the explanation is false;

Question 19

Endothel functions of in situ used internal thoracic (mammary) arteries are preserved, that is why patency rates at ten years are the best of all coronary bypass conduits.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

Answer 19

A) both the statement and the explanation are true and a causal relationship exists between them;