繼續教育考題
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1.
(D) |
All of the following
statement s regarding ventricular septal defects (VSD) are true
EXCEPT: |
A | It is the most common form of
congenital heart disease in infants and children. |
B | The most common VSD occurs in
the membranous septum. |
C | Spontaneous VSD closure occurs
in 45 percent of patients by the age of 3 years. |
D | Spontaneous closure occurs
primarily by continued growth of the muscular septum. |
E | Complete heart block following
surgical repair is uncommon |
2.
(B) |
Each of the following
is considered a high-risk lesion that predisposes to infective
endocarditis EXCEPT: |
A | Aortic stenosis |
B | Mitral valve prolapse with
systolic click (no murmur) |
C | Patent ductus arteriosus |
D | Ventricular septal defect |
E | Chronic aortic regurgitation |
3.
(C) |
The statements
regarding the use of aortic valve homografts in the surgical
management of aortic valve disease including all to the following
EXCEPT: |
A | Homografts have low
thrombogenicity and do not require chronic anticoagulation
therapy. |
B | Homografts are the
prostheses of choice for patients in need of urgent cardiac surgery
for infective endocarditis of the aortic valve. |
C | The rate of structural
degeneration of homografts is significantly less than that of
porcine prosthetic valves. |
D | Homografts offer a more
favorable hemodynamic profile than mechanical valves. |
E | The operative mortality of
aortic homografts placement is similar to that of mechanical and
bioprosthetic valve replacement. |
4.
(D) |
Which of the following
statements about infective endocarditis is TRUE? |
A | Endocarditis is not present if
valvular vegetations are absent by transthoracic
echocardiography. |
B | Endocarditis caused by S.
aureus is an absolute indication for surgery. |
C | In patients with endocarditis,
a vegetation > 10mm, in diameter represents an absolute indication
for surgery. |
D | The likelihood of
subsequent embolic events will decrease with appropriate antibiotic
therapy. |
E | Even if intractable
heart failure develops, corrective valve surgery should be postponed
until well after blood cultures have sterile. |
5.
(C) |
True statements about
the natural history of untreated VSD include all of the following
EXCEPT: |
A | The natural history of
VSD may differ depending on the size of the defect and the magnitude
of the pulmonary vascular resistance. |
B | Regardless of size, the
presence of a VSD confers an increased risk of endocarditis. |
C | Progressive pulmonary vascular
disease with reversal of shunting (Eisenmenger complex) usually
occurs during the fifth decade of life in those patients with VSD
who will develop this complication. |
D | Infundibular pulmonary
stenosis may develop gradually in occasional adult patients with
isolated VSD. |
E | Women with VSD that lead to
ratios of pulmonary to systemic flow < 2:1 gradually tolerate
pregnancy well. |
6.
(E) |
Which of the following
statements about endocarditis caused by S. aureus is TRUE? |
A | Central nervous system
complications are rare, occurring in fewer than 5 percent. |
B | S. aureus native valve
endocarditis is an absolute indication for surgical debridement. |
C | The prognosis of right-sided
S. aureus naive valve endocarditis is similar to that of left-sided
S. aureus endocarditis. |
D | Vancomycin is the antibiotic
of choice for treatment of S. aureus endocarditis. |
E | Prosthetic valve endocarditis
with S. aureus is associated with a high mortality rate in patients
treated medically. |
7.
(B) |
Which of the following
statements regarding various congenital heart diseases is
TRUE? |
A | Isolated VSD is more common in
adolescents and adults than in infants and children. |
B | The non-cardiac features of
atrioventricular septal defect have the most influence on management
in adolescence and adult life. |
C | Survival in unoperated
patients with tetralogy of Fallot (TOF) is fairly normal until age
40. |
D | Adults with TOF are not
suitable surgical candidates. |
E | The decreasing benefits with
age of surgical repair for pulmonary stenosis is dependent on the
use of ventriculotomy and outflow patches. |
8.
(B) |
Which of the following
statements regarding the management of patients with prosthetic
heart valves is TRUE? |
A | The most important cause of
postoperative ventricular dysfunction is previous myocardial damage. |
B | The most common cause for
dysfunction of mechanical prosthetic valves is thrombotic
obstruction. |
C | Coronary bypass surgery should
not be performed at the time of valve replacement, due to greater
risk of operative mortality. |
D | Bioprosthetic aortic valve
failure is more common and occurs more rapidly in older patients
than younger patients. |
E | Echocardiography/Doppler
ultrasound is not necessary unless the patient shows signs of valve
dysfunction. |
9.
(A) |
Which of the following
statements regarding a VSD is TRUE? |
A | The VSD may be associated with
coarctation of the aorta. |
B | In most infants, VSDs
can lead to right ventricular failure. |
C | Surgical closure of a VSD with
aortic regurgitation does not lower the risk of infective
endocarditis. |
D | Most VSDs remain large
at age of 6 months will still undergo spontaneous closure. |
E | Patients with a VSD who have
survived to 5 to 10 years of age are no longer candidates for
surgical closure of the defect. |
10.
(D) |
According to the Duke
criteria, which of the following patients is most likely to have
infective endocarditis? |
A | The patient in whom the
manifestation of endocarditis have resolved fully by the 4th day of
antibiotic therapy. |
B | The patient who has
Roth’s spots, fever, and a predisposition to infective
endocarditis. |
C | The patient who has an
oscillating intracardiac mass and a predisposition to infective
endocarditis. |
D | The patient who has
oscillating intracardiac mass and two positive blood cultures. |
E | The patient who fulfills three
minor Duke criteria. |