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

{“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”}}}

{“questions”:{“q7yf7”:{“id”:”q7yf7″,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Author: Anna Hartzog MD\u2013 Children\u2019s National Hospital, Chinwe Unegbu MD \u2013 Children\u2019s National Hospital <\/br><\/br>\r\nAn 8-day-old, full term neonate with dextro-Transposition of the Great Arteries (d-TGA), aortic coarctation, ventricular septal defect (VSD), and a left circumflex coronary artery arising from a right coronary artery with an intramural course is now status post arterial switch operation, arch reconstruction, and VSD closure. In this patient, which of the following associated anomalies is the MOST LIKELY factor contributing to an increased risk of myocardial ischemia in the post-operative period? \r\n”,”desc”:””,”hint”:””,”answers”:{“vptik”:{“id”:”vptik”,”image”:””,”imageId”:””,”title”:”A. Aortic coarctation”},”7sjxu”:{“id”:”7sjxu”,”image”:””,”imageId”:””,”title”:”B. Ventricular Septal Defect”},”kono1″:{“id”:”kono1″,”image”:””,”imageId”:””,”title”:”C. Intramural course of a coronary artery”,”isCorrect”:”1″},”lu717″:{“id”:”lu717″,”image”:””,”imageId”:””,”title”:”D. Left circumflex artery arising from the right coronary artery”}}}},”results”:{“9jd3s”:{“id”:”9jd3s”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/ccasociety.org\/wp-content\/uploads\/2022\/03\/CCAS-QOW-Posted-3-10-2022.pdf”}}}