Free General Surgery Objective Type Questions And Answers

31. Which of the following statements about the surgical repair of double-outlet right ventricle are true?
A. In double-outlet right ventricle with a subaortic or doubly committed VSD, a tunnel-type repair connecting a committed VSD with its respective great artery is usually employed.
B. Repair of the Taussig-Bing malformation can be accomplished using an intraventricular tunnel technique or by performing a straight patch closure of the VSD combined with an arterial switch procedure.
C. The hospital mortality rate is highest when a subaortic VSD is present.
D. Some hearts with double-outlet right ventricle and a noncommitted VSD must be repaired using a modification of the Fontan procedure.
Ans: A,B,D


32. Management of a patient with tricuspid atresia within the first month of life may include:
A. Creation of a systemic artery\96to\96pulmonary artery shunt.
B. Observation.
C. Creation of a bidirectional superior cavopulmonary anastomosis.
D. Pulmonary artery banding.
E. Fontan procedure.
Ans: A,B,D


33. Which of the following should contraindicate performance of the Fontan procedure?
A. Patient age of 25 years.
B. Severe mitral insufficiency.
C. Left ventricular end-diastolic pressure of 18 mm. Hg.
D. Right pulmonary artery stenosis.
E. Pulmonary vascular resistance of 6 Woods units.
Ans: C,E

34. Initial management of a newborn infant with hypoplastic left heart syndrome should include:
A. Intravenous administration of PGE 1.
B. Supplemental oxygen.
C. Routine intubation and mechanical ventilation to achieve a PCO 2 between 30 and 35 mm. Hg.
D. Cardiac catheterization and balloon atrial septostomy.
Ans: A

35. The performance of a bidirectional superior cavopulmonary (Glenn) anastomosis as the second stage in the reconstructive approach to hypoplastic left heart syndrome:
A. Provides early relief of volume load on the single right ventricle.
B. Increases peripheral oxygen saturations to greater than 90%.
C. Permits concomitant repair of pulmonary artery or aortic arch stenoses.
D. Improves mortality and morbidity of subsequent Fontan procedure.
Ans: A,C,D


36. Which of the following statements about truncus arteriosus are true?
A. Most infants survive without operations until late childhood.
B. Most infants present with cyanosis.
C. Most infants present with congestive heart failure.
D. Repair requires a conduit from right ventricle to pulmonary arteries.
Ans: B,C,D


37. Truncus arteriosus is a diagnosis with anatomic components including:
A. VSD.
B. Abnormal origin of pulmonary arteries.
C. Subaortic stenosis.
D. Single ventricular outflow valve.
Ans: A,B,D


38. Optimal treatment for the neonate who presents with transposition of the great arteries {S,D,D}* and intact ventricular septum includes:
A. PGE 1 infusion to maintain duct patency.
B. Administration of intravenous fluid to increase intravascular volume.
C. Hyperventilation to decrease pulmonary resistance.
D. Oxygen administration to increase arterial oxygen tension.
E. Atrial balloon septostomy to improve atrial mixing.
Ans: A,B,E

39. Factors that preclude the use of a single-stage arterial switch reconstruction of dextrotransposition of the great vessels include:
A. Age older than 6 weeks with a left ventricular pressure of less than 50% of systemic pressure.
B. Dynamic left ventricular outflow tract obstruction.
C. Intramural coronary artery anatomy.
D. Valvar pulmonic stenosis.
E. Subpulmonary VSD.
Ans: A,D

40. Complications commonly associated with the atrial (Senning and Mustard) repairs of transposition of the great arteries include:
A. Atrial arrhythmias.
B. Systemic or pulmonary venous obstruction.
C. Right ventricular outflow tract obstruction.
D. Systemic ventricular failure.
E. Progressive elevation of pulmonary vascular resistance.
Ans: A,B,D

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