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

{“questions”:{“fn770”:{“id”:”fn770″,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Author: Michael A. Evans, MD \u2013 Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Northwestern Feinberg School of Medicine \r\n\r\nA 16-year-old male with a history of orthotopic heart transplantation presents to the cardiac catheterization lab for annual surveillance catherization. While the skin is prepped with chlorhexidine and several minutes after the patient is under monitored anesthesia care with bolus doses of intravenous midazolam and dexmedetomidine, the blood pressure is greatly increased from a normal baseline to165\/110 mmHg with no change in the heart rate. In this patient, agonism of which receptors is MOST LIKELY responsible for the increase in blood pressure?\r\n”,”desc”:””,”hint”:””,”answers”:{“4yhqy”:{“id”:”4yhqy”,”image”:””,”imageId”:””,”title”:”A. Alpha-1 “},”g5u7e”:{“id”:”g5u7e”,”image”:””,”imageId”:””,”title”:”B. Alpha-2″,”isCorrect”:”1″},”uv0f0″:{“id”:”uv0f0″,”image”:””,”imageId”:””,”title”:”C. Beta-1″},”w7fhf”:{“id”:”w7fhf”,”image”:””,”imageId”:””,”title”:”D. Beta-2 “}}}},”results”:{“c593b”:{“id”:”c593b”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/ccasociety.org\/wp-content\/uploads\/2022\/02\/CCAS-QOW-January-31-final-AC-and-SG-edits-Evans.Revisions.CCAS_.Week_.5.pdf”}}}

{“questions”:{“0kabl”:{“id”:”0kabl”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Authors: Michael A. Evans, MD and Eric Vu, MD \u2013 Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Northwestern Feinberg School of Medicine\r\n \r\nA 23-year-old woman with Hallerman-Streif syndrome, mixed mitral valve disease, and restrictive cardiomyopathy presents to the cardiac intensive care unit due to acute on chronic heart failure. Her home medication regimen consists of metoprolol, digoxin, aldactone, and enalapril. During her inpatient stay, she is transitioned from enalapril to sacubitril\/valsartan. What is the mechanism of action of sacubitril? \r\n”,”desc”:””,”hint”:””,”answers”:{“z9v8k”:{“id”:”z9v8k”,”image”:””,”imageId”:””,”title”:”A. Antagonism of Beta-1 receptors “},”mvb3v”:{“id”:”mvb3v”,”image”:””,”imageId”:””,”title”:”B. Inhibition of angiotensin-converting enzyme “},”g2yi5”:{“id”:”g2yi5″,”image”:””,”imageId”:””,”title”:”C. Inhibition of neprilysin enzyme “,”isCorrect”:”1″},”gqd39″:{“id”:”gqd39″,”image”:””,”imageId”:””,”title”:”D. Inhibition of the sodium-potassium-chloride co-transporter in the loop of Henle “}}}},”results”:{“g5seo”:{“id”:”g5seo”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/ccasociety.org\/wp-content\/uploads\/2022\/01\/Final-AC-and-SG-edits-Evans.January.Week4-Entresto.pdf”}}}

{“questions”:{“odzkd”:{“id”:”odzkd”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Author: Michael A. Evans, MD \u2013 Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Northwestern Feinberg School of Medicine \r\n\r\nA 17-year-old child with an automated implantable cardioverter defibrillator (AICD) placed for congenital long QT syndrome presents to the operating room emergently for fixation of a right-sided open radial fracture. The surgeon plans to use electrocautery for the procedure. Device reprogramming by the electrophysiology service is not possible due to the emergent nature of the procedure. Which of the following strategies is MOST EFFECTIVE to minimize the source of electromagnetic interference with the AICD?\r\n”,”desc”:””,”hint”:””,”answers”:{“bl8vu”:{“id”:”bl8vu”,”image”:””,”imageId”:””,”title”:”A. Placement of the electrocautery current return pad next to the device”},”s47l9″:{“id”:”s47l9″,”image”:””,”imageId”:””,”title”:”B. Use of monopolar electrocautery”},”vyap3″:{“id”:”vyap3″,”image”:””,”imageId”:””,”title”:”C. Use of bipolar electrocautery”,”isCorrect”:”1″},”rdd91″:{“id”:”rdd91″,”image”:””,”imageId”:””,”title”:”D. Placement of a magnet over the AICD”}}}},”results”:{“3j1n5”:{“id”:”3j1n5″,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/ccasociety.org\/wp-content\/uploads\/2022\/01\/Question-of-the-Week-January-17-2022-CIED.pdf”}}}

{“questions”:{“axizs”:{“id”:”axizs”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Author: Michael A. Evans, MD \u2013 Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Northwestern Feinberg School of Medicine \r\n\r\nA 6-month-old infant with a history of perimembranous ventricular septal defect (VSD) undergoes VSD closure on cardiopulmonary bypass (CPB). After separating from CPB, additional residual muscular VSDs are demonstrated on transesophageal echocardiography (TEE). \r\n\r\nIn order to ascertain the hemodynamic significance of the residual VSDs, calculation of the ratio of pulmonary flow to systemic flow (Q_{p<\/sub>:Qs<\/sub>) is necessary. The table below demonstrates data from a venous and arterial blood gases. The surgeon also obtains pulmonary arterial blood from the field, which yields a saturation of 85% on blood gas analysis. \r\n\r\n\r\n\r\n\r\nAssuming no pulmonary venous desaturation, which of the following BEST represents the Qp<\/sub>:Qs<\/sub> in this patient?”,”desc”:””,”hint”:””,”answers”:{“yxq38”:{“id”:”yxq38″,”image”:””,”imageId”:””,”title”:”A. 1:1″},”wlbub”:{“id”:”wlbub”,”image”:””,”imageId”:””,”title”:”B. 1.5:1″},”e41ji”:{“id”:”e41ji”,”image”:””,”imageId”:””,”title”:”C. 2.0:1″,”isCorrect”:”1″},”m8phv”:{“id”:”m8phv”,”image”:””,”imageId”:””,”title”:”D. 2.5:1″}}}},”results”:{“k5pp0”:{“id”:”k5pp0″,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/ccasociety.org\/wp-content\/uploads\/2022\/01\/CCAS-Question-of-the-Week-January-12-2022.pdf”}}}}

{“questions”:{“gvdza”:{“id”:”gvdza”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Author: Michael A. Evans, MD \u2013 Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Northwestern Feinberg School of Medicine \r\n\r\nA 5-year-old male child with a history of Mucopolysaccharidosis Type I-H (Hurler Syndrome) presents for an elective MRI. Upon exam, the anesthesiologist auscultates a previously undiagnosed murmur. A preprocedural transthoracic echocardiogram is ordered prior to the MRI. Which lesion is MOST LIKELY to be found on echocardiogram in a patient with Mucopolysaccharidosis Type I-H?\r\n”,”desc”:””,”hint”:””,”answers”:{“zk19v”:{“id”:”zk19v”,”image”:””,”imageId”:””,”title”:”A. Atrial Septal Defect”},”1omj9″:{“id”:”1omj9″,”image”:””,”imageId”:””,”title”:”B. Ventricular Septal Defect”},”ji188″:{“id”:”ji188″,”image”:””,”imageId”:””,”title”:”C. Patent Ductus Arteriosus”},”66ngm”:{“id”:”66ngm”,”image”:””,”imageId”:””,”title”:”D. Mitral regurgitation”,”isCorrect”:”1″}}}},”results”:{“64t9g”:{“id”:”64t9g”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/ccasociety.org\/wp-content\/uploads\/2022\/01\/CCAS-Question-of-the-Week-January-6-2022.pdf”}}}