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CT Surgery Christmas Quiz 2021

Total questions: 76

Worksheet time: 25mins

Name
Class
Date
1.

You have seen a patient in ED with severe blunt trauma to the chest. Angiogram has shown leaking contrast from left common carotid artery. How best to approach this vessel for a repair?

a)

Median Sternotomy

b)

Left Neck Incision

c)

Left Anterior Thoracotomy

d)

Left Posterolateral Thoracotomy

2.

Which of the following about chest wall tumours is FALSE?

a)

Needle biopsy can be used for diagnosis

b)

They are not radiosensitive

c)

Malignant tumours require Wide excision

d)

Fibrous dysplasia is a benign tumour

3.

What is the most pronounced finding in Poland Syndrome

a)

Absence of anterior scalene muscle

b)

Fusion of first 4 ribs

c)

Abnormal blood supply to the chest wall

d)

Absence of head of Pectoralis major muscle

4.

What is the cause of most traumatic injuries to the diaphragm

a)

RTA

b)

Falls

c)

Stab wounds

d)

iatrogenic

5.

What cardiac pacing mode to select for a dual chamber pacemaker patient going for Cardiac Surgery

a)

DDD

b)

VVI

c)

DOO

d)

AOO

6.

Hypertrophic pulmonary osteoarthropathy is associated with?

a)

Squamous Cell Carcinoma

b)

Adenocarcinoma

c)

Neuroendocrine Tumours

d)

Small Cell Carcinoma

7.

German Registry of Acute Aortic Dissection (GERAADA) has shown Septuagenarians had early mortality rate of 15.8% but the mortality rate in octogenarians was much higher

a)

21%

b)

28%

c)

35%

d)

42%

8.

The risk of prosthetic valve thrombosis is highest with the valve in which position?

a)

Pulmonary

b)

Aortic

c)

Mitral

d)

Tricuspid

9.

33 yrs old former IVDU underwent Tricuspid Valve Replacement 3 months ago. He presents 2 weeks history of low grade fever. 0.5 cm vegetation can be seen on the valve on TOE. 2 separate blood cultures isolated aspergillosis. What is the next best management option?

a)

IV Micafungin

b)

IV Amphotericin B

c)

Observation

d)

Redo Surgery

10.

65 yrs old gentleman with Mechanical Aortic Valve presented to A&E with life threatening GI bleeding. Systolic BP is 90 mmhg. HR 130 bpm. Hb 5.4 and HCT 18.

INR 9.2

What is the best approach to reverse the bleeding

a)

10mg IV Vit K

b)

12 Units FFP's

c)

Plasma Complex Concentrate

d)

Desmopressin followed by Cryoprecipitate

11.

What is the first organ to compensate in hemorrhagic shock?

a)

Kidneys

b)

Skin

c)

GI Tract

d)

Brain

12.

Christian Barnard performed first heart transplant in which year?

a)

1954

b)

1961

c)

1967

d)

1971

13.

Commonest organism causing native valve endocarditis?

a)

S Aureus

b)

S Epidermidis

c)

HACEK Group

d)

S Viridans

14.

PAPVD is associated with?

a)

VSD

b)

AV Canal

c)

Coarctation of Aorta

d)

Sinus Venosus ASD

15.

Which organism is considered contraindication for Lung Transplantation

a)

Chronic Pseudomonas

b)

MRSA

c)

Aspergillus

d)

Burkholderia

16.

Antegrade Cerebral Perfusion is optimal at which rate?

a)

5 ml/kg/min

b)

10 ml/kg/min

c)

15 ml/kg/min

d)

20 ml/kg/min

17.

Thymic tumours are sensitive to chemotherapy

True or False

a)

True

b)

False

18.

Bochdalek hernias occur more commonly on the posterior right side.

a)

True

b)

False

19.

Which cusp of the aortic valve is attached entirely to fibrous tissue

a)

RCC

b)

LCC

c)

NCC

20.

The major antinflammatory cytokine during CPB is

a)

IL2

b)

IL6

c)

IL9

d)

IL12

21.

Ostium secundum ASDs represent 80-90% of ASDs

a)

True

b)

False

22.

Identify the Radiograph!

a)

Boot shaped heart

b)

Woodpecker Sign

c)

Thymic Sail Sign

d)

Cervicothoracic Sign

23.

Diamond at the bottom of forest plot signify?

a)

Point estimate of all studies

b)

Results of all studies combined

c)

Point estimate of individual studies

24.

Air crescent sign is present in which condition

a)

TB

b)

Bronchiectasis

c)

Hydatid Cyst

d)

Aspergillus

25.

Solitary Fibrous Tumour of the Pleura is associated with?

a)

Hypocalcaemia

b)

Hyponatraemia

c)

Hyperkalaemia

d)

Hypoglycaemia

26.

Heparin does not work in absence of ?

a)

Factor Xa

b)

ATIII

c)

Prothrombin

d)

Factor VIII

27.

Most common cyanotic heart lesion is?

a)

TGA

b)

DORV

c)

PDA

d)

TOF

28.

Median Survival after Heart Tx is

a)

7.5 yrs

b)

10 yrs

c)

13.5 yrs

d)

21 yrs

29.

Transpulmonary Gradient is calculated by?

a)

MAP - PCWP

b)

MPAP - PCWP

c)

CVP - PCWP

d)

MPAP - CVP

30.

What value of TPG (Transpulmonary Gradient) is considered contraindication for Heart Transplantation

a)

> 8 mmhg

b)

> 10 mmhg

c)

> 12 mmhg

d)

> 14 mmhg

31.

Heparin-induced thrombocytopenia (HIT) predisposes to

a)

Haemorrhage

b)

Thrombosis

32.

Gerbode defect is a shunt between which chambers of heart?

a)

RA to LA

b)

LV to RA

c)

RV to LA

d)

RV to LV

33.

Median survival after Lung Transplantation

a)

3 yrs

b)

4.5 yrs

c)

5.5 yrs

d)

7 yrs

34.

Most common anomaly in Down's Syndrome is?

a)

VSD

b)

ASD

c)

PDA

d)

TGA

35.

Stich Trial investigated role of CABG in patients with

a)

COPD

b)

LVF

c)

CKD

d)

CVA

36.

Criteria for STICH Trial: CABG in patients with EF < ..........%

a)

25%

b)

30%

c)

35%

d)

40%

37.

Which of the following is not a feature of disseminated intravascular coagulation (DIC)

a)

Decreased fibrinogen and elevated fibrin and fibrinogen degradation products

b)

Diffuse Bleeding

c)

Consumption of coagulation factors

d)

Thrombocytosis

38.

What is progressive prolongation of PR interval until a QRS complex is not generated on EKG?

a)

1 Degree HB

b)

Mobitz Type I

2nd Degree AV Block

c)

Mobitz Type II

2nd Degree AV Block

d)

Complete HB

39.

Which of the following is true of a traumatic tear of the Aorta after Blunt Trauma

a)

Widened Mediastinum is present in All x rays

b)

Majority make it to ED

c)

If not treated results in Aneurysm

d)

Most common site is just above the annulus

40.

What is the most important prognostic indicator of Lung Cancer Resection Survivors?

a)

pT

b)

pN

c)

Chest Wall involvement

d)

Central Location

41.

Nicks Aortic Root enlargement is extending aortotomy to?

a)

Mid point of NCC

b)

Left coronary commissure

c)

Right coronary commissure

d)

Between Left & Right coronary commissures

42.

What is true regarding Cranial N XI injury after Sternotomy

a)

Too much neck extension during surgery

b)

Opening sternal retractor too wide

c)

Purely due to inflammation

d)

Position of shoulders with sternum elevated with a wedge

43.

Double Aortic Knob sign is seen in which condition?

a)

Aortic Transection

b)

Aortic Dissection

c)

Aortic Aneurysm

d)

Syphilitic Aortitis

44.

Indication for BAV (Balloon Aortic Valvuloplasty) in Adults includes all EXCEPT

a)

Bridge to AVR or TAVI

b)

Old Age (>90yrs) and Poor Surgical candidate

c)

Severe AS with cardiogenic Shock requiring CABG

d)

Rheumatic AS

45.

What is best way to approach injury to proximal 1 cm of Left Main Bronchus

a)

Left Thoracotomy

b)

Median Sternotomy

c)

Anterior Thoracotomy

d)

Right Thoracotomy

46.

Which Papillary muscle of the Mitral Valve is likely to rupture in coronary artery disease

a)

Anterolateral

b)

Posteromedial

47.

What is a know adverse effect of Ginkgo Biloba

a)

Seizure

b)

Blood Clot

c)

Bleeding

d)

Headache

48.

Which Virus is associated with PTLD

a)

EBV

b)

CMV

c)

HPV

d)

HIV

49.

Which congenital heart disease will present with a positive schamroth sign?

a)

VSD

b)

ASD

c)

Coarctation of Aorta

d)

TOF

50.

All of these are complications of Libman-Sacks Endocarditis EXCEPT?

a)

CVA

b)

Endocarditis

c)

Acute Limb Ischaemia

d)

Dental Abscess

51.

Which medication causes increase in levels of Bradykinin?

a)

Captopril

b)

Nifedipine

c)

Esmolol

d)

Clonidine

52.

Most Common Location of Bronchogenic Cyst?

a)

Anterior Mediastinum

b)

Middle

Mediastinum

c)

Posterior

Mediastinum

53.

Which is the most common subtype of Hodgkin's Lymphoma seen in Mediastinum?

a)

Nodular Sclerosing

b)

Lymphocyte predominant

c)

Lymphocyte Depleted

d)

Mixed Cellularity

54.

Surfactant is secreted by Type I Pneumocytes

a)

True

b)

False

55.

Subarterial VSD is associated with which aortic valve leaflet prolapse?

a)

RCC

b)

LCC

c)

NCC

56.

Air Embolism is suspected during central line insertion. What is the most appropriate step?

a)

Administer IV Fluids

b)

Flush the line

c)

Turn the patient on left side

d)

Intubate and ventilate

57.

How best to diagnose left sided cardiac herniation after Pneumonectomy

a)

Lateral CXR

b)

CXR PA View

c)

Supine CXR

d)

Prone CXR

58.

75 yrs old lady with CHF have severe AS. Her EF is only 20%. Select the best method to determine her aortic stenosis severity?

a)

DSE

b)

Left heart catheter to measure pressure gradient

c)

Left heart catheter to calculate valve area

d)

MUGA

59.

Which drug is used to treat refractory paroxysmal SVT?

a)

Verapamil

b)

Lidocaine

c)

Nifedipine

d)

Procainamide

60.

Statistical test to compare between the means of three groups

a)

Chi Square

b)

ANOVA

c)

Mann Whitney U Test

d)

Fisher's Exact Test

61.

Masaoka staging: If Thymoma invading pericardium?

a)

Stage I

b)

Stage II

c)

Stage III

d)

Stage IV

62.

Least Common structure to be injured in penetrating chest Trauma?

a)

RA

b)

RV

c)

LA

d)

LV

63.

Casoni test is used for diagnosis of which condition?

a)

Hydatid Disease

b)

Aspergillus

c)

TB

d)

Chagas Disease

64.

Herringbone pattern is seen in which cancer?

a)

Osteosarcoma

b)

Wilms Tumour

c)

Fibrosarcoma

d)

Desmoid Tumour

65.

All are useful in treating Torsades de Pointes, EXCEPT

a)

Reversing hypokalaemia and hypomagnesaemia

b)

Override Pacing

c)

Electrical Cardioversion

d)

Calcium channel blockers

66.

Patient with previous TIA has significant Carotid artery disease. Coronary Angiogram showed 3VD. How you will plan operation?

a)

Carotid surgery first followed by CABG in same setting

b)

Staged procedure

Carotid surgery first then CABG

c)

Staged procedure

CABG first then Carotid surgery

d)

Stent coronary lesions followed by Carotid surgery

67.

In the absence of a shunt, what is the ideal method of measuring cardiac output?

a)

Echo

b)

Fick Method

c)

Angiography

d)

Thermodilution method

68.

Aortic aneurysm dimension to intervene in bicuspid aortic valve is?

a)

4.5 cm

b)

5.0 cm

c)

5.5 cm

d)

6.0 cm

69.

Custodial cardioplegia causes intracellular

a)

Hyperkalaemia

b)

Hypernatraemia

c)

Hyponatraemia

d)

Hypocalcaemia

70.

Hemoptysis is considered "Massive" when volume of blood is?

a)

200 ml/24 hrs

b)

300 ml/24 hr

c)

600 ml/24 hr

d)

800 ml/24 hr

71.

Absolute contraindication of tracheal resection include what % of its total length?

a)

25%

b)

35%

c)

50%

d)

60%

72.

Name the mechanical prosthesis

a)

SJM

b)

On-X

c)

carbomedics

d)

Omnicarbon

73.

Name the instrument

a)

Periosteal Elevator

b)

Watson Cheyne

c)

osteotome

d)

Doyens

74.

Name the procedure

a)

David I

b)

Bentall

c)

Yacoub

d)

David V

75.

John Gibbon performed first open heart procedure on his CPBP machine in which year?

a)

1948

b)

1953

c)

1957

d)

1964

76.

Nicks Aortic Root enlargement is extending aortotomy to?

a)

Mid point of NCC

b)

Left coronary commissure

c)

Right coronary commissure

d)

Between Left & Right coronary commissures

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