Cardiac/Vascular

Question 1

Size indication for AAA repair

Answer 1

5.5cm (men), 4.5cm (women)

Question 2

Immediate diarrhea following AAA suggests

Answer 2

Inferior mesenteric ischemia

Question 3

Brisk GI bleeding following AAA repair suggests ____

Answer 3

aortoenteric fistula (duodenal usually)

Question 4

Diagnosis of aortic dissection

Answer 4

CT

Question 5

Management of aortic dissection involving ascending aorta

Answer 5

emergent surgery

Question 6

Management of aortic dissection involving descending aorta

Answer 6

BP/HR lowering; surgery/stent for compromise of renal/mesenteric/iliac vessels

Question 7

Normal ankle-brachial index

Answer 7

> 0.9

Question 8

Indications for surgery in PVD

Answer 8

rest pain, gangrene, threatened limb

Question 9

Which pathology? post-prandial abdominal pain and weight loss

Answer 9

Chronic intestinal ischemia

Question 10

Diagnosis of chronic intestinal ischemia

Answer 10

Duplex US or CTA/MRA

Question 11

Lab findings in reperfusion syndrome

Answer 11

hyperkalemia, metabolic acidosis, myoglobinemia

Question 12

Indications for carotid endarterectomy

Answer 12

> 50% symptomatic; >60-70% asymptomatic

Question 13

Indication for IVC filter

Answer 13

C/I to anti-coagulation or PE in spite of anti-coagulation

Question 14

Diagnosis of varicose veins

Answer 14

Doppler US of saphenofemoral junction

Question 15

First-line treatment of chronic venous insufficiency

Answer 15

Compression stockings and wound care

Question 16

Which diagnosis? Diffuse painless chronic enlargement of extremities

Answer 16

Lymphedema

Question 17

Which diagnosis? stridor, respiratory distress, difficulty swallowing

Answer 17

Vascular Ring

Question 18

Diagnosis of vascular ring

Answer 18

Barium swallow or bronchoscopy

Question 19

Which congenital defect? recognized in late infancy, frequent colds, fixed split S2

Answer 19

ASD

Question 20

Which congenital defect? pan systolic murmur at LUSB and prominent pulmonary markings on CXR

Answer 20

VSD

Question 21

_____ VSD typically close by age 2-3, while _____ VSD typically require surgical closure

Answer 21

Muscular septum; membranous septum

Question 22

Which congenital defect? symptomatic within days, bounding peripheral pulses

Answer 22

PDA

Question 23

Indications for indomethacin for PDA

Answer 23

Prematurity

Question 24

Which congenital defect? small for age, acrocyanosis, clubbing, relief with squatting

Answer 24

Tetralogy of Fallot

Question 25

Which congenital defect? 1-2 day old child developing cyanosis

Answer 25

Transposition of Great Vessels

Question 26

Indications for aortic valve repair in stenosis

Answer 26

> 50mmHg gradient, CHF/angina/syncope

Question 27

Indications for aortic valve repair in insufficiency

Answer 27

LV dilatation

Question 28

Which diagnosis? DOE, orthopnea, cough, paroxysmal nocturnal dyspnea

Answer 28

Mitral stenosis

Question 29

EKG abnormality in mitral stenosis

Answer 29

Atrial fibrillation

Question 30

Treatment of mitral insufficiency

Answer 30

Annuloplasty

Question 31

Indication for cardiac interventions

Answer 31

Stenosis >70%

Question 32

Low CO following cardiac surgery means ____ if low PCWP and ____ if high PCWP

Answer 32

hypovolemia; ventricular failure

Question 33

Which diagnosis? DOE, ascites, hepatomegaly, cardiac cause

Answer 33

Constrictive Pericarditis

Question 34

Which diagnosis? Square root sign on cardiac catheterization (equalization of pressures)

Answer 34

Chronic Constrictive Pericarditis

Question 35

Work-up of coin lesion

Answer 35

CT and sputum cytology; bronchoscopy or VATS/wedge resection if indeterminant

Question 36

Operability of lobectomy

Answer 36

Must have residual minimal FEV1 of 800ml

Question 37

____ metastases in lung cancer are amenable to pneumonectomy

Answer 37

Hilar