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2018 Board Review Pre-Test:
Adult Congenital Heart Disease for the HF Specialist
Adult Congenital Heart Disease for the HF Specialist - Eric V. Krieger, MD
Please complete this brief Pre-Test to give a baseline for learning .
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1.
A 48-year-old with L-loop transposition of the great arteries and no prior interventions presents for worsening exertional intolerance. BP 110/70, HR 85, SaO2 100%. A grade 3 holosystolic murmur is heard over the precordium. TTE shows mild (systemic) right ventricular dysfunction, visually estimated EF 42%, severe tricuspid regurgitation into a dilated left atrium, PASP 45 mmHg. Cardiopulmonary exercise test shows normal chronotropic response and a VO2max is 16 ml/kg/min.
What is the best next step?
(Required.)
A. Lisinopril
B. Carvedilol
C. Referral for transplantation
D. Tricuspid valve replacement
E. Placement of a BiV - ICD
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2.
A 42-year-old man with an unrepaired VSD and Eisenmenger syndrome presents to clinic with increased dyspnea on exertion. BP is 102/65, SaO2 88%. He has a right ventricular lift, loud P2, no murmurs. Echocardiogram shows large VSD with low velocity bidirectional flow and moderate right ventricular dysfunction. 6-minute walk distance is 180 meters. Hematocrit is 61%, serum iron 110 mcg/dL, transferrin saturation 28%.
Which of the following is most likely to improve the patient’s symptoms?
(Required.)
A. Iron supplementation
B. Lisinopril
C. Phlebotomy
D. Bosentan
E. Continuous oxygen therapy
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3.
Please provide your first and last name.
Pre-test questions will not be scored, your name is required solely to confirm completion.
(Required.)
First Name
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Last Name
