Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine-Cardiovascular Disorders--->Congenital Heart Disease in Adults
Page: 1

Question 1# Print Question

A 36-year-old female with known Eisenmenger syndrome (ES) is admitted to the ICU after 2-day hospital course for worsening hypoxia. She is followed as an outpatient in the cardiology clinic, and it is noted that her oxygen levels are usually low. Her vital signs show a heart rate of 95 bpm, oxygen saturation of 86% on noninvasive positive pressure ventilation, blood pressure of 116/80 mm Hg, and a respiratory rate of 18. On examination, you note the female in mild respiratory distress with signs of cyanosis. Chest X-ray showed mild pleural effusions bilaterally but no concern for pulmonary edema. Transthoracic echocardiography done the prior day showed concern for biventricular dysfunction.

What is the next best step to confirm this patient’s diagnosis?

A. Transesophageal echocardiography
B. CTA of the chest
C. Cardiac catheterization
D. Repeat CXR

Question 2# Print Question

You are posted in the Neonatal intensive care unit of the hospital. You get an emergency page that a pregnant patient has just delivered in the Emergency Department, and the child has a congenital cardiac condition for which he will need a Fontan procedure. The Fontan surgery, which involves the anastomosis of the right atrium to the pulmonary artery, is a useful surgical treatment for each of the following congenital cardiac defects EXCEPT:

A. Tricuspid atresia
B. Hypoplastic left heart syndrome
C. Pulmonary valve stenosis
D. Truncus arteriosus
E. Pulmonary artery atresia

Question 3# Print Question

A 15-year-old male patient was admitted to the ICU with a diagnosis of stroke after he got some accidental air bubbles injection while receiving IV fluid resuscitation in the emergency department, where he was seen for a viral prodrome. The patient’s family mentions that he has a known cardiac condition from birth, even though they do not know the name. Accidental injection of air into a peripheral vein would be LEAST likely to result in arterial air embolism in the patient with which of the following anatomic cardiac defects?

A. Patent ductus arteriosus
C. Teratology of Fallot
D. Pulmonary atresia with ventricular septal defect
E. Tricuspid atresia

Question 4# Print Question

A patient with known pulmonary arterial hypertension (PAH) from congenital heart disease has recently been diagnosed with ES.

What is the most appropriate treatment that should be initiated in this patient?

A. Digoxin
B. Beta blocker therapy
C. Calcium channel blocker therapy
D. Bosentan

Question 5# Print Question

A 23-year-old male presents to the emergency department after collapsing during a pick-up basketball game. On examination you find a young male in no apparent distress. He exhibits a harsh, systolic crescendo-decrescendo murmur. His EKG is an unremarkable save for short, sharp Q-waves in the lateral leads.

Which of the following is most strongly associated with this diagnosis?

A. Family history
B. Smoking
C. Drug use
D. Alcohol use

Category: Critical Care Medicine-Cardiovascular Disorders--->Congenital Heart Disease in Adults
Page: 1 of 1