Congenital Cardiac Anesthesia Society
A Section of the the Society for Pediatric Anesthesia

{“questions”:{“yu071”:{“id”:”yu071″,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Authors: Meera Gangadharan, MD and Prabhat Mishra, MD –Arkansas Children\u2019s Hospital\/University of Arkansas for Medical Sciences, Little Rock, AR \r\n\r\nA 12-year-old male child with a medical history of proximal muscle weakness, intellectual impairment, and retinitis pigmentosa presents for dental rehabilitation. A transthoracic echocardiogram reveals hypertrophic cardiomyopathy with left ventricular outflow tract obstruction. There is a family history of male relatives with similar symptoms and early death in the second and third decade. What is the MOST likely diagnosis?”,”desc”:””,”hint”:””,”answers”:{“ezl9y”:{“id”:”ezl9y”,”image”:””,”imageId”:””,”title”:”A. Hurler syndrome”},”3kz4b”:{“id”:”3kz4b”,”image”:””,”imageId”:””,”title”:”B. Pompe disease”},”xogds”:{“id”:”xogds”,”image”:””,”imageId”:””,”title”:”C. Duchenne muscular dystrophy”},”woh8c”:{“id”:”woh8c”,”image”:””,”imageId”:””,”title”:”D. Danon disease”,”isCorrect”:”1″}}}},”results”:{“gktmn”:{“id”:”gktmn”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/ccasociety.org\/wp-content\/uploads\/2022\/04\/CCAS-QOW-Posted-4-14-2022.pdf”}}}

{“questions”:{“sglw8”:{“id”:”sglw8″,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Authors: Ashley Bartels, MD and Destiny F. Chau, MD – Arkansas Children\u2019s Hospital\/University of Arkansas for Medical Sciences, Little Rock, AR \r\n\r\nA 4-month-old female infant with pulmonary atresia, intact ventricular septum and right ventricle-dependent coronary circulation is listed for heart transplantation. In the interim, she remains mechanically ventilated while receiving dexmedetomidine, morphine, milrinone, and prostaglandin E_{1<\/sub> infusions. Though well-sedated, she appears irritable and has increasing swelling of the bilateral lower extremities. Bony radiographs demonstrate hyperostosis of the cortical bones. When administered on a long-term basis, which medication that the patient is currently receiving is MOST likely to cause cortical hyperostosis? “,”desc”:””,”hint”:””,”answers”:{“mgl8o”:{“id”:”mgl8o”,”image”:””,”imageId”:””,”title”:”A. Milrinone “},”85odw”:{“id”:”85odw”,”image”:””,”imageId”:””,”title”:”B. Prostaglandin E1<\/sub> “,”isCorrect”:”1″},”2tj6s”:{“id”:”2tj6s”,”image”:””,”imageId”:””,”title”:”C. Dexmedetomidine “},”r52g3”:{“id”:”r52g3″,”image”:””,”imageId”:””,”title”:”D. Morphine\r\n\r\n”}}}},”results”:{“esqip”:{“id”:”esqip”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/ccasociety.org\/wp-content\/uploads\/2022\/04\/CCAS-QOW-Posted-4-7-2022.pdf”}}}}

{“questions”:{“m53ma”:{“id”:”m53ma”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Author: Anna Hartzog, MD and Chinwe Unegbu, MD \u2013 Children\u2019s National Hospital \r\n\r\nA two-week-old neonate with double-outlet right ventricle, ventricular septal defect, L-looping of the ventricles, and levo-transposition of the great arteries is status post complete repair. On postoperative day twelve during a cardiac catheterization, the patient converts from normal sinus rhythm to complete heart block with a ventricular escape rate of 80 beats per minute. What is the MOST LIKELY factor that predisposes this patient to complete heart block? \r\n”,”desc”:””,”hint”:””,”answers”:{“flyvn”:{“id”:”flyvn”,”image”:””,”imageId”:””,”title”:”A. Coronary artery anomaly “},”g0gow”:{“id”:”g0gow”,”image”:””,”imageId”:””,”title”:”B. Residual ventricular septal defect”},”xec4i”:{“id”:”xec4i”,”image”:””,”imageId”:””,”title”:”C. L-looped ventricles”,”isCorrect”:”1″},”ocywb”:{“id”:”ocywb”,”image”:””,”imageId”:””,”title”:”D. L-transposition of the great arteries”}}}},”results”:{“s08qm”:{“id”:”s08qm”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/ccasociety.org\/wp-content\/uploads\/2022\/03\/CCAS-QOW-Posted-3-31-2022.pdf”}}}

{“questions”:{“4pkhc”:{“id”:”4pkhc”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Author: Anna Hartzog, MD and Chinwe Unegbu, MD \u2013 Children\u2019s National Hospital \r\n\r\nA 3-month-old infant presents with tachypnea, poor weight gain, and diaphoresis with feeds. Parents deny any recent febrile illness. Chest radiograph demonstrates cardiomegaly and the electrocardiogram is notable for a QR pattern, ST segment depression, and T-wave inversion in leads I, II, and aVL. A transthoracic echocardiogram reveals severe left atrial dilation, severe mitral regurgitation, and left ventricular dysfunction with an EF of 15%-20% with preserved right ventricular function. Color flow doppler demonstrates retrograde flow in the left coronary artery. Four extremity blood pressures are normal. What is the MOST LIKELY diagnosis”,”desc”:””,”hint”:””,”answers”:{“tdjqp”:{“id”:”tdjqp”,”image”:””,”imageId”:””,”title”:”A. Coarctation of the aorta”},”jzgcd”:{“id”:”jzgcd”,”image”:””,”imageId”:””,”title”:”B. Viral myocarditis”},”29uka”:{“id”:”29uka”,”image”:””,”imageId”:””,”title”:”C. Anomalous left coronary artery from the pulmonary artery (ALCAPA)”,”isCorrect”:”1″},”1qh2a”:{“id”:”1qh2a”,”image”:””,”imageId”:””,”title”:”D. Kawasaki\u2019s disease “}}}},”results”:{“rn8hs”:{“id”:”rn8hs”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/ccasociety.org\/wp-content\/uploads\/2022\/03\/CCAS-QOW-Posted-3-24-2022.pdf”}}}

{“questions”:{“hewmh”:{“id”:”hewmh”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Author: Anna Hartzog MD and Chinwe Unegbu MD \u2013 Children\u2019s National Hospital \r\n\r\nAn 8-month-old male with Tetralogy of Fallot (TOF) with hypercyanotic spells presents for complete surgical repair. Preoperatively, the patient has a baseline heart rate of 160-170. Induction of anesthesia is uneventful, and the patient is initiated on a dexmedetomidine infusion following intubation. After 120 minutes on cardiopulmonary bypass with a cross clamp time of 79 minutes, the patient is separated from bypass and is noted to be in normal sinus rhythm, have a core temperature of 37.8\u00b0C, and have a low calcium level. Which factor in this patient is MOST LIKELY to be protective against the development of postoperative junctional ectopic tachycardia (JET)? \r\n”,”desc”:””,”hint”:””,”answers”:{“1cvxf”:{“id”:”1cvxf”,”image”:””,”imageId”:””,”title”:”A. Preoperative heart rate “},”481h5”:{“id”:”481h5″,”image”:””,”imageId”:””,”title”:”B. Postbypass calcium level “},”5t96m”:{“id”:”5t96m”,”image”:””,”imageId”:””,”title”:”C. Early initiation of an intraoperative dexmedetomidine infusion “,”isCorrect”:”1″},”zl6j1″:{“id”:”zl6j1″,”image”:””,”imageId”:””,”title”:”D. Core temperature of 37.8\u00b0C. in the postbypass period”}}}},”results”:{“9thsu”:{“id”:”9thsu”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:” https:\/\/ccasociety.org\/wp-content\/uploads\/2022\/03\/CCAS-QOW-Posted-3-17-2022.pdf”}}}