cardiothoracic surgery

Question 1

CABG

Answer 1

coronary artery bypass grafts
graft vessel=saphenous vein or intermammary (thoracic) artery, radial artery

Question 2

complications CABG

Answer 2

death
stroke
infection
AKI
cognitive impairment
MI
AF

Question 3

most common indication for valve replacement

Answer 3

aortic stenosis

Question 4

types of valve replacement

Answer 4

biprosthetic: lifespan 10y, porcine=pig
mechanical: lifespain 20y

Question 5

INR range mechanical valve

Answer 5

2.5 to 3.5

Question 6

complications mechanical valve

Answer 6

thrombus
IE
haemolysis->anaemia

Question 7

what is TAVI used for

Answer 7

aortic stenosis

Question 8

TAVI

Answer 8

catheter and biprosthetic valve through femoral artery -> aortic valve

Question 9

ix for congenital heart defects

Answer 9

echo

Question 10

cyanotic heart disease

Answer 10

R->L shunt

Question 11

eisenmenger syndrome

Answer 11

original L->R shunt, pulmonary pressure increases, R->L shunt

Question 12

complications congenital heart disease

Answer 12

HF
arrhthymia
endocarditis
stroke
pulmonary HTN
eisenmengers

Question 13

ASD sx

Answer 13

mid systolic crescendo decrescendo murmur L sternal edge
fixed split S2
SOB
stroke: DVT travels to brain through hole
AF

Question 14

VSD causes

Answer 14

congenital - downs syndrome, turners
after MI

Question 15

sx VSD

Answer 15

pan systolic murmur L sternal edge

Question 16

causes pansystolic murmur

Answer 16

VSD
mitral regurg
tricuspid regurg

Question 17

coaractation aorta

Answer 17

narrowing of aortic arch - usually around ductus arterioisis
in turners syndrome

Question 18

sx coaractation aorta

Answer 18

HTN
systolic murmur under L clavicle
lowe BP in legs and L arm
L ventricular heave

Question 19

transudative causes pericardial effusion

Answer 19

increased venous pressure: congestive HF, pulmonary HTN

Question 20

exudative causes pericardial effusion

Answer 20

inflammation: infectio, AI (SLE), uraemia, cancer, methorexate

Question 21

types of causes pericardal effusion

Answer 21

transudative
exudative
cardiac tamponade: MI, trauma, aortic dissection

Question 22

sx pericardial effusion

Answer 22

chest pain,
sob
orthopnea
phrenic nerve compression: hiccups
compression oesophagus: dysphagea
compression recurrent laryngeal nerve: hoarse voice
O/E: quiet HS, pulsus paradoxus, low BP, increased JVP

Question 23

mx pericardial effusion

Answer 23

tx cause
drain: needle pericardiocentesis, surgery

Question 24

false aneurysm

Answer 24

inner 2 layers (intima and media) rupture and vessel dilates
often after trauma

Question 25

RF thoracic aortic aneurysm

Answer 25

M marfans smoking

Question 26

sx thoracic aortic aneurusm

Answer 26

none compression=pain, sob, hiccups, dysphagia, hoarse voice

Question 27

mx thoracic aortic aneurysm

Answer 27

observe TEVAR

Question 28

sx ruptured thoracic aprtic aneurysm

Answer 28

bleeding chest/back pain haemodynamic instability collapse death

Question 29

indications for heart transplant

Answer 29

congestive HF secondary to IHD cardiomyopathy congenital heart disease

Question 30

complications heart transplant

Answer 30

cardiac autograft vasculopathy (narrowing coronary arteries of donor heart)

Question 31

complications lung transplant

Answer 31

primary graft dysfunction bronchiolitis obliterans syndrome dehiscence of bronchial anastomosis