Mcqs In Cardiothoracic Surgery

SMCQs for Cardiothoracic SurgeryThis website is under construction.Please send your MCQs to:Examples:1. Bileaflet mechanical valves:A. Are made of pyrolytic carbon disksB. The open valve consists of three orificesC. Require life long Warfarin treatmentD. In the mitral position, bileaflet valves are implanted in an orientation perpendicular to the normal plane of the mitral valveE. All are correctAnswer: E2.

Which of the following about ball-cage valves is correct?A. The only one in clinical use is the Starr-Edwards 1260B.

Antegrade blood flows around the silastic ballC. Ball-cage valves are associated with significant turbulent and shear stressesD. The hemodynamic performance of the ball-cage valves are excellentAnswer: A, B & C.3.

Which of the following histologies or conditions can result in a false-negative PET scan in a patient with a solitary pulmonary nodule?A. Carcinoid tumorB.

Uncontrolled diabetesC. Well differentiated adenocarcinoma of the lungD. All of the aboveE. A and C onlyAnswer: E4. All of the following are titlting-disc valves except:A.

Jude MedicalAnswer: D.

A 61 year old is admitted to A&E with sudden onset of a painful, cold, white right leg. His radial pulse rate is 86 bpm and its rhythm follows no discernable pattern throughout 30 seconds of palpation. Abdominal examination is normal. No pulses are palpable in the right leg and ankle Doppler signals are absent. An ECG confirms the arrythmia but shows no signs of acute ischaemia. Which is the single most likely diagnosis?.

Abdominal aortic aneurysm. Aorto-iliac dissection. Atrial fibrillation.

DVT. MI.

A 70-year-old woman develops a cold, painful, right leg. No pulsesare palpable throughout the right leg.

She has several risk factorsfor atherosclerotic disease. A medical student asks how best to differentiatebetween acute and chronic ischaemia. Which is the single mostappropriate advice?A History of 40 pack-years of smokingB History of intermittent claudicationC History of thrombotic strokeD Presence of femoro-popliteal bypass scar in the left legE Presence of foot pulses in the left leg.

A 55-year-old man who smokes 40 cigarettes per day presents witha history of pain in his left calf after walking 100 metres. The paingoes with rest. He has no symptoms in his thigh or buttock.

He has agood volume femoral pulse but no popliteal or pedal pulses are palpable.Neurological examination is normal. He undergoes duplex Doppler ultrasound. Which is the single most likely finding of this investigation?A Left common iliac artery occlusionB Left internal iliac artery stenosisC Left posterior tibial artery occlusionD Left profunda femoris artery stenosisE Left superficial femoral artery occlusion. A 69-year-old man is referred to the vascular clinic after anabdominal aortic aneurysm was detected coincidentally on ultrasoundexamination. The patient is nervous about the diagnosis, has beenresearching it on the Internet and has several questions. Which singlestatement is correct?A Abdominal aortic aneurysms are associated with tobacco smoking,hypertension, family history, and diabetes mellitusB Abdominal aortic aneurysms are considered for treatment by surgicalor endovascular repair when they reach a size of ≥5.5cm, in a patientfit for interventionC Abdominal aortic aneurysms most commonly involve the aorta at thelevel of the renal arteries and belowD Abdominal aortic aneurysms occur in 10% of the population agedover 65E Abdominal aortic aneurysm screening is undertaken in the UK usingCT scanning.

A 75-year-old woman has a painful non-healing ulcer over theleft medial malleolus. It measures 4cm in diameter, with a shallow,superficially infected base, but little evidence of granulation tissue.Despite meticulous nursing care with compression bandaging in thecommunity, the ulcer has shown no sign of improvement over 4 months.She is hypertensive, has angina, chronic obstructive pulmonary disease,and had a deep vein thrombosis in her left leg 10 years ago. She reportsno symptoms of intermittent claudication or rest pain.

Cardiothoracic Surgery San Antonio

On examinationthe feet are warm bilaterally, capillary refill time is less than 2sec, bothpopliteal pulses are palpable but foot pulses are impalpable in both feet.The ankle brachial pressure index is 0.78 on the left and 0.76 on the right.Which single option is the most likely underlying cause for her persistentulceration?A Chronic lower limb ischaemiaB Diabetic foot diseaseC Mixed arterial-venous diseaseD Neuropathic ulcerE Venous insufficiency. A 79-year-old man on an inpatient ward becomes acutely shortof breath 36h after a right carotid endarterectomy. He has experiencedrapidly worsening shortness of breath over the last 4min.

His previousmedical history includes a transient ischaemic attack 3 weeks ago,myocardial infarction 12 months ago, hypertension, deep vein thrombosisaged 50, and he has been a lifelong smoker. He has a respiratory rateof 45 breaths per minute, oxygen saturation of 89% on air, pulse rateof 120bpm, and blood pressure is 143/78mmHg. He has bruising andswelling around the wound in his neck. Which is the single most likelydiagnosis?A Ipsilateral cerebrovascular accidentB Myocardial infarctionC Pulmonary embolusD Vagus nerve injuryE Wound haematoma. A 48-year-old man with type 1 diabetes and peripheral vasculardisease develops an infected ulcer in his right foot. The infectionspreads to involve the soft tissues of the foot resulting in necrosis, hedevelops rigors and his diabetes becomes harder to control with insulin.An amputation is planned and a medical student asks about the procedureand its likely outcome. Which is the single most appropriateadvice?A Above-knee amputation is preferred to supracondylar (Gritti–Stokes)amputation for bilateral amputeesB Diabetics are 50 times more likely than non-diabetics to undergomajor lower limb amputationC Likelihood of mobility following below-knee amputation is significantlybetter than following above-knee amputationD Postoperative phantom-limb pain is less common in below-kneeamputations than above-knee amputationsE Stump healing rates following below-knee amputation are higher thanfollowing above-knee amputation.

E Lymphoedema. This lady has a history suggestive of congenital unilateral lymphoedema (Milroy’s disease), associated with hypoplasia of the lymphatic trunks. Long-term lymphoedema predisposes to skin changes including leg ulcers, fungal infections, and increased risk of cellulitis.

Mcq In Thoracic Surgery

The mainstay of conservative management is treatment with compression and expectant management of superficial skin infections with early antibiotic treatment. Lymphoscintigraphy may be helpful in confirming the diagnosis.