Cardiology MCQ: Plastic bronchitis
Plastic bronchitis is seen after:
a) ASD repair
b) Arterial switch
c) Fontan repair
d) VSD closure
Correct answer: c) Fontan repair
Plastic bronchitis is characterised by marked obstruction of the large airways due to the formation of bronchial casts with rubber like consistency. Elevated central venous pressure leading to endobronchial lymph leakage is thought to be the mechanism of plastic bronchitis in post Fontan state. Plastic bronchitis can occur in those without heart disease as well. In those due to inflammatory lung disease, the casts are cellular (type I casts) while in those with underlying heart disease, the ca...
Source: Cardiophile MD - November 28, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiac Surgery Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Cardiology MCQ: Platypnea-orthodeoxia
Platypnea-orthodeoxia has been described in:
a) Pulmonary arteriovenous malformation
b) Cirrhosis liver
c) Aortic aneurysm
d) All of the above
Correct answer: d) All of the above
Platypnea-orthodeoxia is characterized by dyspnoea and systemic oxygen desaturation on assuming the sitting or standing position. It was originally described by Burchell et al in 1949 [Burchell HB et al. Reflex orthostatic dyspnea associated with pulmonary hypertension. Am J Physiol. 1949; 159: 563–564]. The basic requirement for the condition is an interatrial communication in the form of a patent foramen ovale, atrial septal defect or an atria...
Source: Cardiophile MD - November 26, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Cardiology MCQ: Gibson’s area
Gibson’s area is:
a) 1st left intercostal space, left sternal edge
b) 2nd left intercostal space, left sternal edge
c) 3rd left intercostal space, left sternal edge
d) 4th left intercostal space, left sternal edge
Correct answer: a) 1st left intercostal space, left sternal edge
Gibson’s area: 1st left intercostal space, left sternal edge, where the Gibson’s murmur (continuous murmur of patent ductus arteriosus) is best heard.
2nd left intercostal space, left sternal edge is the pulmonary area where the events from the pulmonary valve like pulmonary component of second heart sound, murmurs of pulmonary ste...
Source: Cardiophile MD - November 23, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
VSD with pulmonary atresia : Management issues
VSD with Pulmonary atresia is a complex form of cyanotic heart disease .Though it’s a close companion of Tetrology of Fallot physiologically, it is a vastly different entity in embryological and anatomic terms.
TOF is cono truncal anomaly where abnormal anterior displacement of conal septum result in malalignment VSD, RVOT obstruction ,aortic override and RVH.
While ,pulmonary atresia with VSD is not a primary cono truncal anomaly, the defect occurs much earlier than TOF in fetal life , where the origin of PA fails to materialise,(Fetal arteritis?) and which triggers a series of anatomical disarray in pulmona...
Source: Dr.S.Venkatesan MD - November 23, 2014 Category: Cardiology Authors: dr s venkatesan Tags: cardiology congenital heart disese aorto pulmonary collaterals hemoptysis in mapcas pulmonary atresia and vsd K S murthy KM cherian madras medical mission Innova children's hospital pulmonary atresia vsd tetrology single vs multiple stage unifocal Source Type: blogs
ECG in DORV
(double outlet right ventricle) varies with the clinical type. In tetralogy like DORV which has a subaortic ventricular septal defect with pulmonary stenosis, the ECG shows right axis deviation. TGA like (transposition like) DORV has a subpulmonic VSD without pulmonary stenosis. In this type, ECG shows left ventricular volume overload and right axis deviation. VSD like DORV has subaortic ventricular septal defect with no pulmonary stenosis. This condition has left ventricular volume overload on the ECG with left axis deviation.
The post ECG in DORV appeared first on Cardiophile MD. (Source: Cardiophile MD)
Source: Cardiophile MD - October 24, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: ECG / Electrophysiology Source Type: blogs
Cardiology MCQ 321: Ellis-van Creveld syndrome
Most common cardiac anomaly in Ellis-van Creveld syndrome:
a) Ventricular septal defect
b) Patent ductus arteriosus
c) Single atrium
d) Single ventricle
["Click here for the answer with explanation", "Correct Answer:"]
c) Single atrium
Single atrium is seen in 40% cases of Ellis-van Creveld syndrome. Mutations in two genes – EVC and EVC2 situated on the same chromosome have been documented in Ellis-van Creveld syndrome. It is an autosomal recessive disorder. Other features are short stature and polydactyly.
The post Cardiology MCQ 321: Ellis-van Creveld syndrome appeared first on Cardiophile MD. (Source: Cardiophile MD)
Source: Cardiophile MD - September 22, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Scottish Independence Will Kill Socialism on Both Sides of the Border
Marian L. Tupy
Much has been said about the impact of Scottish independence on British politics. With the predominantly socialist parliamentarians from Scotland gone, the Conservative Party would likely come to dominate British politics for the foreseeable future. The much needed economic reforms and, perhaps, withdrawal from the European Union would become very likely.
What about the impact of independence on Scotland? The breakup of the Czech and Slovak Federal Republic some 21 years ago provides an interesting example.
The 1992 elections produced dramatically different results in the two parts of the former Czech...
Source: Cato-at-liberty - September 17, 2014 Category: American Health Authors: Marian L. Tupy Source Type: blogs
A hole in the heart . . . and a hole in the road !
This article was written in a flash.
I used to get questions from anxious parents of children with holes in the heart .(Asymptomatic small VSDs or ASDs who come for periodic echo-cardiograms) .I reassure and convey the message , most of these holes are tiny and will close automatically and they need not worry.Even if it doesn’t, it poses little problem.
But .after watching that haunting TV show, I have started to warn the parents that holes in the heart may not be that dangerous but be wary of holes in the roads and unclosed bore wells in our country !
Every single parent wa...
Source: Dr.S.Venkatesan MD - September 6, 2014 Category: Cardiology Authors: dr s venkatesan Tags: Public health issues asd vsd pda bore-well deaths in India congenital heart disease hippocrates oath hole in the heart hole in the heart and hole in the road Indian association of pediatrics iap safety issues for children who child safet Source Type: blogs
IRBBB: Incomplete right bundle branch block
. The electrical conduction system of the heart has two branches for each of the two lower chambers of the heart – right bundle branch and the left bundle branch. They are branches of the bundle of His. Right bundle branch supplies the right ventricle (lower muscular chamber of the heart). and the left bundle branch supplies the left ventricle. Conduction delay in the right bundle branch can be either complete or incomplete. In complete right bundle branch block the QRS complex in the ECG (electrocardiogram) is wide (120 milliseconds or more), while in incomplete right bundle branch block, it is less than 120 millise...
Source: Cardiophile MD - August 31, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: ECG / Electrophysiology Heart Disease FAQ Source Type: blogs
Cardiology MCQ 285: ECG Quiz
This ECG is suggestive of:
a) Wenckebach phenomenon
b) Ashman phenomenon
c) Katz-Wachtel phenomenon
d) None of the above
["Click here for the answer with explanation", "Correct Answer:"]
c) Katz-Wachtel phenomenon
The Katz-Wachtel sign is tall diphasic RS complexes at least 50 mm in height in lead V2, V3 or V4 – mid precordial leads [Circulation 1963;27;1118-1127 (Free full text at: http://circ.ahajournals.org/cgi/reprint/27/6/1118.pdf); original description by Katz and Wachtel was published in 1937: Katz LN and Wachtel H. The diphasic QRS type of electrocardiogram in congenital heart disease. Am Heart J; 1937, 1...
Source: Cardiophile MD - August 25, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs
TGA like physiology
– cyanotic heart disease with high pulmonary blood flow
Following congenital heart diseases have cyanosis with high pulmonary blood flood flow (TGA like physiology or transposition like physiology):
Dextro transposition of great arteries (D- TGA) with ventricular septal defect (VSD) and no pulmonary stenosis (PS)
Double outlet right ventricle (DORV) with VSD and no PS
Tricuspid atresia with VSD and no PS
TGA like physiologies can present with cyanosis and heart failure in very early life due to increased pulmonary blood flow as there is no pulmonary stenosis to restrict the pulmonary blood flow. D-TGA with VSD and no P...
Source: Cardiophile MD - August 4, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Arterial switch operation cyanotic heart disease cyanotic heart disease with high pulmonary blood flow d-TGA dextro transposition of great arteries DORV Jatene's operation PS Pulmonary stenosis TGA like physiology Source Type: blogs
Fallot like physiology
– cyanotic heart disease with low pulmonary blood flow:
Basic components of this physiology are a large ventricular septal defect (or single ventricle) and severe pulmonary stenosis so that there is right to left shunt across the VSD and low pulmonary blood flow due to the pulmonary stenosis. They can develop hypercyanotic spells and cerebrovascular accidents while they seldom go in for heart failure, unlike the congenital cyanotic heart diseases with increased pulmonary blood flow. Chest X-ray shows pulmonary oligemia and cardiac size is seldom enlarged. The conditions included in this physiology are:
Tetralogy of Fall...
Source: Cardiophile MD - August 4, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology CCHD with low pulmonary blood flow cyanotic congenital heart disease with low pulmonary blood flow cyanotic heart disease with low pulmonary blood flow Fallot like physiology Gasul phenomenon Gasul variant Tetralogy of Fal Source Type: blogs
Pulmonary artery banding
Pulmonary artery banding is used to reduce the pulmonary blood flow in situations of high pulmonary blood flow as a result of left to right shunts. Classical example is a large ventricular septal defect (VSD) where immediate surgical repair is not feasible. “Swiss cheese VSD” in which there are multiple muscular VSDs, adequate surgical repair may not be easy. Some of these defects may even have multiple right ventricular openings for a single left ventricular opening. When the surgical VSD closure is done from the right ventricle, when one VSD is closed, another one may be seen puffing from nearby. Pulmonary ...
Source: Cardiophile MD - August 2, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiac Surgery Arterial switch Balloon expandable pulmonary artery bands corrected transposition of great arteries cTGA d-TGA d-transposition of great arteries double switch operation l-TGA l-transposition of great arteries large vent Source Type: blogs
