Clinical Questions for Boards – ABCP UPDATED ACTUAL Questions and
CORRECT Answers
1. Who was grant- UNOS (United Network of Organ Sharing)
ed a federal con-
tract in 1986
to operate the
organ procure-
ment and trans-
plantation net-
work?
2. In the 1980" wide spread use of anti-rejection medications
there was an sud-
den increase in
organ transplan-
tation, Why?
3. Why get a "used" 1) NHLBI- end stage cardiac disease
heart? 2) NYHA class III and IV CHF
a) refractory to max medical treatment
b) continuous mechanical or inotropic support required
c) Peak O2 uptake (VO2 max) <14ml/kg/min
d) LVEF< 20%
3) Refractory angina pectoris- inoperable CAD
4) Refractory ventricular arrhythmias- life threatening
5) Myocardial tumor- w/o metastasis
4. Who gets new 1) Status 1A- 1st to get heart: critically ill, in ICU, adv life support
hearts? 2) Status 1B: 2nd: Require IV inotropes, hospital or home care
3) Status 2: 3rd in line: No IV meds required, usually not hospitalized
5. Who absolute- 1) terminal malignancy
ly contraindicat- 2) severe, irreversible major organ disease- multi-organ failure
3) Active infection
, ed to receive 4) HIV
heart transplant? 5) current alcohol or IV drug use
6. Who have rela- 1) old people >65
tive contraindica- 2) severe CVD or PVD
tions for heart 3) IDDM- insulin deppendent DM
transplant? 4) Pulmonary infarction or hypertension
5) morbid obesity
6) major psychiatric disorder- won't be compliant w/ meds
7. Why can't a pa- because cyclosporin is metabolized in liver
tient drink alco-
hol and receive a
heart transplant?
8. Who can donate 1) confirmed brain death and organ viability
a heart? 2) EKG evaluation of heart function
3) coronary angiogram male>40 female>45: no severe CAD
4) ABO blood group matching <20% reactive antibodies or is plasmapheresed
9. Who absolutely 1) syphilis, HTLV-4, HIV
can't donate a 2) malignancy w/ extracranial metastasis
heart? 3) LVEF <40%
4) Significant valvular abnormality
5) significant CAD
10. Who has rela- 1) Thoracic trauma
tive contraindica- 2) Sepsis
tions to heart do- 3) HepB surface antigen -positive
nation? 4) repeated CPR
5) high dose inotrpic support > 24 hrs
11.
, What is the heart 1) kidneys and liver removed 1st
haversting pro- 2) donor heparinized
cedure? 3) heart excised "en bloc"
4) SVC and IVC ligated 1st: allows for exsanguination
5) Aorta X-clamped: is cross-clamp time
6) Cold CPG administered
7) Aorta and PA transected: left as long as possible
8) Pulmonary Veins individually divided
9) Pericardium preserved
12. What are 4 types 1) Orthotopic :98%: replace w/ new donor heart
of heart trans- 2) Heterotopic: 2%: 2 hearts in parallel circulation
plants? 3) Live donor: donor hrt and lung goes in and reciepient hrt to someone else
4) deceased donor
13. What is the can- 1) redo's: femoral
nulation for or- 2) Aortic
thotopic heart 3) bicaval venous
transplant?
14. In the original 1) native RA and LA preserved to preserveSA node and native rate
bi-atrial surgery, 2) created a clot haven and has 2nd P-wave
how is the recipi-
ent heart surgery
performed? Why
was this a prob-
lem?
15. In Bicaval can- 1) LA cutt w/ PV's: make an island
nulation heart 2) SVC and IVC cutts: make an island
surgery, how
is the recipi-
, ent heart surgery
performed?
16. What are the 1) decrease the distortion of tricuspid valve
benefits of bicav- 2) improve right heart function
al "island" cuffs in 3) decrease risk of thrombolic emboli
heart transplan- 4) lower right sided pressures
tation? 5) won't need pacemaker as often
6) decreases regurgitance
7) no 2nd P-wave
17. What is the se- 1) LA: island
quence of events 2) RA cutt or IVC then SVC
in orthotopic 3) Aorta
donor implanta- 4) PA
tion?
18. Where is the 1) in right anterior thorax: in parallel circulation
donor heart 2) Aortas anastamosed: donor LV provides most output
placed in Hetero- 3) Conduit joins PAs" Native RV provides most output
topic heart trans- 4) LA of donor and recipient are mearged together
plant? 5) donor SVC= recipent RA
6) Donor IVC is closed up
19. What are advan- 1) recipients w/ severe pulm HTN
tages to hetero- 2) small donor to recipient size ratio: crossmatch except for size
ropic heart trans-
plant?
20. What are disad- 1) high mortality rate
vantages for het- 2) continued medical treatment for failing native heart
erotopic heart 3) native heart: Clot haven (sludgy heart)
transplants? 4) compromised pulmonary function: donor heart placement
CORRECT Answers
1. Who was grant- UNOS (United Network of Organ Sharing)
ed a federal con-
tract in 1986
to operate the
organ procure-
ment and trans-
plantation net-
work?
2. In the 1980" wide spread use of anti-rejection medications
there was an sud-
den increase in
organ transplan-
tation, Why?
3. Why get a "used" 1) NHLBI- end stage cardiac disease
heart? 2) NYHA class III and IV CHF
a) refractory to max medical treatment
b) continuous mechanical or inotropic support required
c) Peak O2 uptake (VO2 max) <14ml/kg/min
d) LVEF< 20%
3) Refractory angina pectoris- inoperable CAD
4) Refractory ventricular arrhythmias- life threatening
5) Myocardial tumor- w/o metastasis
4. Who gets new 1) Status 1A- 1st to get heart: critically ill, in ICU, adv life support
hearts? 2) Status 1B: 2nd: Require IV inotropes, hospital or home care
3) Status 2: 3rd in line: No IV meds required, usually not hospitalized
5. Who absolute- 1) terminal malignancy
ly contraindicat- 2) severe, irreversible major organ disease- multi-organ failure
3) Active infection
, ed to receive 4) HIV
heart transplant? 5) current alcohol or IV drug use
6. Who have rela- 1) old people >65
tive contraindica- 2) severe CVD or PVD
tions for heart 3) IDDM- insulin deppendent DM
transplant? 4) Pulmonary infarction or hypertension
5) morbid obesity
6) major psychiatric disorder- won't be compliant w/ meds
7. Why can't a pa- because cyclosporin is metabolized in liver
tient drink alco-
hol and receive a
heart transplant?
8. Who can donate 1) confirmed brain death and organ viability
a heart? 2) EKG evaluation of heart function
3) coronary angiogram male>40 female>45: no severe CAD
4) ABO blood group matching <20% reactive antibodies or is plasmapheresed
9. Who absolutely 1) syphilis, HTLV-4, HIV
can't donate a 2) malignancy w/ extracranial metastasis
heart? 3) LVEF <40%
4) Significant valvular abnormality
5) significant CAD
10. Who has rela- 1) Thoracic trauma
tive contraindica- 2) Sepsis
tions to heart do- 3) HepB surface antigen -positive
nation? 4) repeated CPR
5) high dose inotrpic support > 24 hrs
11.
, What is the heart 1) kidneys and liver removed 1st
haversting pro- 2) donor heparinized
cedure? 3) heart excised "en bloc"
4) SVC and IVC ligated 1st: allows for exsanguination
5) Aorta X-clamped: is cross-clamp time
6) Cold CPG administered
7) Aorta and PA transected: left as long as possible
8) Pulmonary Veins individually divided
9) Pericardium preserved
12. What are 4 types 1) Orthotopic :98%: replace w/ new donor heart
of heart trans- 2) Heterotopic: 2%: 2 hearts in parallel circulation
plants? 3) Live donor: donor hrt and lung goes in and reciepient hrt to someone else
4) deceased donor
13. What is the can- 1) redo's: femoral
nulation for or- 2) Aortic
thotopic heart 3) bicaval venous
transplant?
14. In the original 1) native RA and LA preserved to preserveSA node and native rate
bi-atrial surgery, 2) created a clot haven and has 2nd P-wave
how is the recipi-
ent heart surgery
performed? Why
was this a prob-
lem?
15. In Bicaval can- 1) LA cutt w/ PV's: make an island
nulation heart 2) SVC and IVC cutts: make an island
surgery, how
is the recipi-
, ent heart surgery
performed?
16. What are the 1) decrease the distortion of tricuspid valve
benefits of bicav- 2) improve right heart function
al "island" cuffs in 3) decrease risk of thrombolic emboli
heart transplan- 4) lower right sided pressures
tation? 5) won't need pacemaker as often
6) decreases regurgitance
7) no 2nd P-wave
17. What is the se- 1) LA: island
quence of events 2) RA cutt or IVC then SVC
in orthotopic 3) Aorta
donor implanta- 4) PA
tion?
18. Where is the 1) in right anterior thorax: in parallel circulation
donor heart 2) Aortas anastamosed: donor LV provides most output
placed in Hetero- 3) Conduit joins PAs" Native RV provides most output
topic heart trans- 4) LA of donor and recipient are mearged together
plant? 5) donor SVC= recipent RA
6) Donor IVC is closed up
19. What are advan- 1) recipients w/ severe pulm HTN
tages to hetero- 2) small donor to recipient size ratio: crossmatch except for size
ropic heart trans-
plant?
20. What are disad- 1) high mortality rate
vantages for het- 2) continued medical treatment for failing native heart
erotopic heart 3) native heart: Clot haven (sludgy heart)
transplants? 4) compromised pulmonary function: donor heart placement
