{"id":46693,"date":"2021-07-04T18:05:34","date_gmt":"2021-07-04T12:35:34","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=46693"},"modified":"2021-07-04T18:05:34","modified_gmt":"2021-07-04T12:35:34","slug":"cardiology-mcqs-3","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/cardiology-mcqs-3\/","title":{"rendered":"Cardiology MCQs"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/0ctBfu2N7go\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Cardiology MCQs<\/span><\/h2>\n<p><span style=\"color: #0000ff;\"><strong>Modified Blalock-Taussig shunt is:<\/strong><\/span><\/p>\n<ol>\n<li>End to side anastomosis of subclavian artery to a pulmonary artery<\/li>\n<li>Side to side anastomosis of main pulmonary artery to aorta<\/li>\n<li>Side to side anastomosis of subclavian artery to a pulmonary artery using a conduit<\/li>\n<li>Anastomosis of superior vena cava to right pulmonary artery<\/li>\n<\/ol>\n<p><span style=\"color: #008000;\"><strong>Correct answer: 3. Side to side anastomosis of subclavian artery to a pulmonary artery using a conduit<\/strong><\/span><\/p>\n<p>In classic Blalock-Taussig shunt, the subclavian artery is divided and anastomosed to the pulmonary artery as an end to side anastomosis. In modified Blalock \u2013 Taussig shunt, a Gore \u2013 Tex graft is used to connect the subclavian artery to the pulmonary artery. In Davidson shunt, a Gore-Tex graft is used to connect ascending aorta to main pulmonary artery [Tomasian A, Malik S, Shamsa K, Krishnam MS. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19513718\/\">Congenital heart diseases: post-operative appearance on multi-detector CT-a pictorial essay<\/a>. Eur Radiol. 2009 Dec;19(12):2941-9]. Glenn shunt connects the superior vena cava to right pulmonary artery.<\/p>\n<figure id=\"attachment_44884\" aria-describedby=\"caption-attachment-44884\" style=\"width: 746px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-44884 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2021\/04\/Modified-Blalock-Taussig-shunt-in-a-person-with-right-aortic-arch-and-tetralogy-of-Fallot1.jpg\" sizes=\"auto, (max-width: 746px) 100vw, 746px\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2021\/04\/Modified-Blalock-Taussig-shunt-in-a-person-with-right-aortic-arch-and-tetralogy-of-Fallot1.jpg 746w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2021\/04\/Modified-Blalock-Taussig-shunt-in-a-person-with-right-aortic-arch-and-tetralogy-of-Fallot1-300x278.jpg 300w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2021\/04\/Modified-Blalock-Taussig-shunt-in-a-person-with-right-aortic-arch-and-tetralogy-of-Fallot1-140x130.jpg 140w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2021\/04\/Modified-Blalock-Taussig-shunt-in-a-person-with-right-aortic-arch-and-tetralogy-of-Fallot1-60x57.jpg 60w\" alt=\"Modified Blalock-Taussig shunt in a person with right aortic arch and tetralogy of Fallot1\" width=\"746\" height=\"692\"><figcaption id=\"caption-attachment-44884\" class=\"wp-caption-text\">Schematic diagram of modified Blalock-Taussig shunt in a person with right aortic arch and tetralogy of Fallot<\/figcaption><\/figure>\n<p><strong><span style=\"color: #0000ff;\">Complication of Fontan procedure:<\/span><\/strong><\/p>\n<ol>\n<li>Plastic bronchitis<\/li>\n<li>Protein losing enteropathy<\/li>\n<li>Heart failure<\/li>\n<li>All of the above<\/li>\n<li>None of the above<\/li>\n<\/ol>\n<p><strong><span style=\"color: #008000;\">Correct answer: 4. All of the above<\/span><\/strong><\/p>\n<p>Heart failure was the mode of death in 34% in a series of 600 adult Fontan survivors. Arrhythmia or sudden death was the reason in 24% [Ohuchi H, Inai K, Nakamura M, Park IS, Watanabe M, Hiroshi O, Kim KS, Sakazaki H, Waki K, Yamagishi H, Yamamura K, Kuraishi K, Miura M, Nakai M, Nishimura K, Niwa K; JSACHD Fontan Investigators. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/30201381\/\">Mode of death and predictors of mortality in adult Fontan survivors: A Japanese multicenter observational study<\/a>. Int J Cardiol. 2019 Feb 1;276:74-80]. Protein losing enteropathy is an important complication of Fontan circulation. Atrioventricular valve regurgitation is often associated with ventricular failure and it can be progressive. Pleural effusion, chylothorax and plastic bronchitis are important pulmonary complications associated with Fontan circulation. Predisposition to thrombosis and thromboembolism are also well known. It contributed to 7.9% of the late deaths in one study [Khairy P, Fernandes SM, Mayer JE Jr, Triedman JK, Walsh EP, Lock JE, Landzberg MJ. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18071068\/\">Long-term survival, modes of death, and predictors of mortality in patients with Fontan surgery<\/a>. Circulation. 2008 Jan 1;117(1):85-92].<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Gold standard for myocardial viability:<\/strong><\/span><\/p>\n<ol>\n<li>Systolic thickening of myocardial segment on echocardiography<\/li>\n<li>Absence of late gadolinium enhancement on magnetic resonance imaging<\/li>\n<li>Preserved metabolic activity on positron emission tomography<\/li>\n<li>Myocardial scar detected on multidetector computed tomography<\/li>\n<\/ol>\n<p><span style=\"color: #008000;\"><strong>Correct answer: 3. Preserved metabolic activity on positron emission tomography<\/strong><\/span><\/p>\n<p>Preserved metabolic activity on positron emission tomography is considered the gold standard in myocardial viability assessment. [Tamaki N, Kawamoto M, Tadamura E, Magata Y, Yonekura Y, Nohara R, Sasayama S, Nishimura K, Ban T, Konishi J. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/7882476\/\">Prediction of reversible ischemia after revascularization. Perfusion and metabolic studies with positron emission tomography<\/a>. Circulation. 1995 Mar 15;91(6):1697-705]. Segmental thickening and absence of scarring detected by other imaging modalities are also useful indicators of viability.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Wrong statement about coronary subclavian steal syndrome:<\/strong><\/span><\/p>\n<ol>\n<li>Occurs after CABG using left internal mammary artery (LIMA)<\/li>\n<li>Diversion of blood flow from coronary circulation to exercising left upper limb<\/li>\n<li>High grade stenosis or occlusion of left subclavian artery distal the origin of LIMA<\/li>\n<li>Can manifest with angina<\/li>\n<\/ol>\n<p><span style=\"color: #008000;\"><strong>Correct answer: 3. High grade stenosis or occlusion of left subclavian artery distal the origin of LIMA<\/strong><\/span><\/p>\n<p>Coronary subclavian steal syndrome occurs when there is a high grade stenosis or occlusion of left subclavian artery proximal to the origin of the LIMA. Cardiovascular manifestation of coronary subclavian steal syndrome could be angina, myocardial infarction, malignant arrhythmias or heart failure [Cua B, Mamdani N, Halpin D, Jhamnani S, Jayasuriya S, Mena-Hurtado C. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28416323\/\">Review of coronary subclavian steal syndrome<\/a>. J Cardiol. 2017 Nov;70(5):432-437]. Cerebral symptoms can occur due to steal from the cerebral circulation through the vertebral artery.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Which of the following is NOT a usual feature of acute aortic regurgitation?<\/strong><\/span><\/p>\n<ol>\n<li>Long and loud diastolic murmur<\/li>\n<li>Mitral valve preclosure<\/li>\n<li>Peripheral signs of AR not seen<\/li>\n<li>Diastolic mitral regurgitation may occur<\/li>\n<\/ol>\n<p><span style=\"color: #008000;\"><strong>Correct answer: 1.&nbsp;Long and loud diastolic murmur<\/strong><\/span><\/p>\n<p>The classical decrescendo early diastolic murmur and peripheral signs of chronic aortic regurgitation are not features of acute AR. An early diastolic murmur if it is heard, is usually softer and shorter in acute AR. High left ventricular diastolic pressure causes mitral valve preclosure. But when the left ventricular diastolic pressure becomes very high in severe acute AR, mitral valve reopens in late diastole, causing diastolic mitral regurgitation [Hamirani YS, Dietl CA, Voyles W, Peralta M, Begay D, Raizada V. <a href=\"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/circulationaha.112.113993\">Acute aortic regurgitation<\/a>. Circulation. 2012 Aug 28;126(9):1121-6].<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Which was the phase 3 trial of Selexipag, a drug for treatment of pulmonary hypertension?<\/strong><\/span><\/p>\n<ol>\n<li>TASTE trial<\/li>\n<li>PRAMI trial<\/li>\n<li>GRIPHON trial<\/li>\n<li>VITAL trial<\/li>\n<\/ol>\n<p><span style=\"color: #008000;\"><strong>Correct answer: 3. GRIPHON Trial<\/strong><\/span><\/p>\n<p>TASTE trial was Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction. PRAMI was Preventive Angioplasty in Myocardial Infarction. VITAL trial was on role of vitamin D in cardiovascular disease. [Prostacyclin (PGI<sub>2<\/sub>) Receptor Agonist In Pulmonary Arterial Hypertension (GRIPHON) study: Sitbon O, Channick R, Chin KM, Frey A, Gaine S, Gali\u00e8 N, Ghofrani HA, Hoeper MM, Lang IM, Preiss R, Rubin LJ, Di Scala L, Tapson V, Adzerikho I, Liu J, Moiseeva O, Zeng X, Simonneau G, McLaughlin VV; GRIPHON Investigators. <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/nejmoa1503184\">Selexipag for the Treatment of Pulmonary Arterial Hypertension<\/a>. N Engl J Med. 2015 Dec 24;373(26):2522-33].<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Wrong statement about third heart sound:<\/strong><\/span><\/p>\n<ol>\n<li>In mitral regurgitation S3 need not indicate left ventricular dysfunction<\/li>\n<li>S3 occurs just after the opening of the atrioventricular valve<\/li>\n<li>It is due to rapid acceleration of transmitral blood flow as the ventricles fill<\/li>\n<li>It corresponds in timing to shortly after the peak of the early diastolic E wave of transmitral flow<\/li>\n<\/ol>\n<p><span style=\"color: #008000;\"><strong>Correct answer: 3. It is due to rapid acceleration of transmitral blood flow as the ventricles fill<\/strong><\/span><\/p>\n<p>Third heart sound (S3) occurs in early diastole due to rapid <strong><span style=\"color: #ff0000;\">deceleration<\/span> <\/strong>of transmitral blood flow as the ventricles fill [Manson AL, Nudelman SP, Hagley MT, Hall AF, Kov\u00e1cs SJ. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/7634453\/\">Relationship of the third heart sound to transmitral flow velocity deceleration<\/a>. Circulation. 1995 Aug 1;92(3):388-94].<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Takayasu arteritis is an inflammatory disorder affecting aorta and its major branches. Takayasu was:<\/strong><\/span><\/p>\n<ol>\n<li>Vascular surgeon<\/li>\n<li>Ophthalmologist<\/li>\n<li>Physician<\/li>\n<li>Cardiologist<\/li>\n<\/ol>\n<p><span style=\"color: #008000;\"><strong>Correct answer: 2. Ophthalmologist<\/strong><\/span><\/p>\n<p>Takayasu was an ophthalmologist, who noted characteristic fundal arteriovenous anastomoses in a young female in 1905 and published it in <span class=\"ref-journal\">Acta of the Opthalmic Society of Japan<\/span> in 1908 (<span class=\"ref-vol\">12<\/span>:554\u20135). Onishi and Kagosha described similar cases associated with absent radial pulses in the same year [Johnston SL, Lock RJ, Gompels MM. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1769710\/\">Takayasu arteritis: a review<\/a>. J Clin Pathol. 2002 Jul;55(7):481-6].<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Cardiology MCQs Modified Blalock-Taussig shunt is: End to side anastomosis of subclavian artery to a pulmonary artery Side to side anastomosis of main pulmonary artery to aorta Side to side anastomosis of subclavian artery to a pulmonary artery using a conduit Anastomosis of superior vena cava to right pulmonary artery Correct answer: 3. Side to [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":31008,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[3,5],"tags":[],"class_list":["post-46693","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiology-mcq","category-dm-dnb-cardiology-entrance"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Cardiology MCQs - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/cardiology-mcqs-3\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cardiology MCQs - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"Cardiology MCQs Modified Blalock-Taussig shunt is: End to side anastomosis of subclavian artery to a pulmonary artery Side to side anastomosis of main pulmonary artery to aorta Side to side anastomosis of subclavian artery to a pulmonary artery using a conduit Anastomosis of superior vena cava to right pulmonary artery Correct answer: 3. 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