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

{“questions”:{“5w29h”:{“id”:”5w29h”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Authors: Nicole Ribeiro Marques MD, Felipe Medeiros MD, Destiny Chau MD\u2013 University of Arkansas for Medical Science\/Arkansas Children\u2019s Hospital, Little Rock \r\n\r\nA 32-year-old woman with a history of interrupted aortic arch and complex left ventricular outflow tract (LVOT) obstruction status post aortic arch reconstruction and apico-aortic valved-conduit insertion presents for emergent exploratory laparotomy due to ruptured tubal pregnancy. Preoperative transthoracic echocardiogram demonstrated moderate obstruction at the native LVOT, LV hypertrophy and dilation with mildly diminished function and difficulty in visualizing the conduit. New-onset ST segment elevation in leads II and V are evident after anesthetic induction with the following vital signs: BP 88\/38, HR 145, and SpO2 97%. Which medication is the MOST appropriate choice to manage this patient? “,”desc”:””,”hint”:””,”answers”:{“at4nb”:{“id”:”at4nb”,”image”:””,”imageId”:””,”title”:”A. Ephedrine”},”j7x0z”:{“id”:”j7x0z”,”image”:””,”imageId”:””,”title”:”B. Phenylephrine”,”isCorrect”:”1″},”bkmhd”:{“id”:”bkmhd”,”image”:””,”imageId”:””,”title”:”C. Labetalol”},”vw556″:{“id”:”vw556″,”image”:””,”imageId”:””,”title”:”D. Epinephrine”}}}},”results”:{“aqjrg”:{“id”:”aqjrg”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/ccasociety.org\/wp-content\/uploads\/2022\/04\/CCAS-QOW-Posted-4-21-22.pdf”}}}

{“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”}}}