Adult Cardiac 2

1. What is the most common complication in infective endocarditis (IE)?

2. Which of the following is true regarding infective endocarditis (IE) management?

3. A 34-year-old woman presents to the emergency department with a fever. Chest x-ray demonstrates multiple patchy infiltrates in te bilateral lungs. Echocardiography and blood cultures suggest acute bacterial endocarditis involving the tricuspid valve. Which of the following is the most likely etiology?

4. An 82-year-old female recently underwent permanent pacemaker placement for sick sinus syndrome. She presents to the emergency department with shortness of breath, fever, and erythema with purulent drainage around the incision site. Echocardiograph demonstrates a large friable aortic valve vegetation. What is the best definitive management for this patient?

5. A 72-year-old man presents to the emergency department with chest pain, fever, fatigue, and arthralgias. His past medical history is significant for rheumatic heart disease and a tooth extraction a few weeks before admission. He is without physical findings of endocarditis on exam, although endocarditis is suspected. Which of the following is the most likely organism?

6. Based on infective endocarditis (IE) diagnostic criteria, which of the following are the two most important parameters for diagnosis?

7. A patient that had mitral valve replacement (MVR) 25 days prior was admitted to the hospital from the clinic with persistent fever and malaise. Endocarditis is suspected. What the most likely causative organism?

8. Which of the following is the strongest indication for surgical intervention in infective endocarditis (IE)?

9. Which of the following is true regarding the etiology of endocarditis?

10. A 23 year old female with a history of intravenous drug abuse (IVDA) presents with fever, chills, and shortness of breath. She used heroin five days ago. Vital signs include temperature 39°C, pulse 110, and blood pressure 109/68. There is a grade II/VI systolic murmur heard best at the lower right sternal border. There are no splinter hemorrhages, peripheral petechiae, or erythematous patches on the palms or soles. No abnormalities are seen on fundoscopic exam. Neurological exam is normal. A chest x-ray shows no evidence of pneumonia. Three sets of blood cultures are drawn, and the patient is started on empiric antibiotic therapy with vancomycin and gentamicin. Which of the following is the most appropriate next step in the management of this patient?

11. Which of the following is true regarding hypothermia duration during circulatory arrest (DHCA) in type A aortic dissection repair?

12. A patient with acute type A aortic dissection has a pulseless right leg. The following is correct:

13. The false lumen in acute type A aortic dissection can be distinguished from the true lumen by CT angiography based on which of the following features?

14. Which of the following is true regarding acute type A aortic intramural hematoma (IMH) as compared to acute type A aortic dissection?

15. Which of the following is true about femoral cannulation for surgery to repair acute type A aortic dissection?

16. Risk factors for long-term dilation of a medically treated type B aortic dissection include which of the following:

17. Which of the following is true regarding treatment of acute type B aortic dissection complicated by mesenteric ischemia due to dynamic compression by the false lumen?

18. Where is the most common site for intimal tear in acute type A aortic dissection?

19. Strong risk factors for aortic dissection include all of the following except:

20. Sudden death in acute type A aortic dissection can occur due to which of the following: