Insertion Of An Implantable Cardioverter Defibrillator

Insertion Of An Implantable Cardioverter Defibrillator
Order 5983120
Insertion Of An Implantable Cardioverter Defibrillator
1 Which of the following statements regarding endomyocardial biopsy or temporary pacemaker lead
placement is false?
(A) The rate of perforation during right ventricular
biopsy is 0.3% to 5%
(B) Tamponade and circulatory collapse follow
right ventricular perforation 75% of the time
(C) Pericardial haemorrhage complicates 0.1% to
3.3% of left ventricular biopsies
(D) Presence of right rather than left bundle branch
block configuration suggests pacemaker lead
penetration of the RV
14 During the insertion of an implantable cardioverter
defibrillator the patient becomes acutely hypotensive
and an echo confirms the presence of an effusion.
Which finding in the hemodynamic tracing in the
following figure does not support a diagnosis of
pericardial tamponade?
(A) Presence of an elevated right atrial pressure
(B) Blunting of the Y descent in expiration
Percutaneous Balloon Pericardiotomy for Patients with Pericardial Effusion and Tamponade 265
(C) Absence of respiratory variation in the right
atrial tracing
(D) Pericardial pressure approaching right atrial
diastolic pressure in expiration
15 Which of the following statements regarding the
pericardium is incorrect?
(A) The pericardial space contains 15 to 35 mL
serous fluid
(B) Pericardial inflammation may produce vagal
mediated responses
(C) The parietal pericardium is attached to both the
diaphragm and the sternum
(D) Aspirin is more effective at reducing symptoms and recurrence of acute pericarditis than
colchicine
16 With regard to an association between the procedure
depicted in the following figure and pericardial
tamponade, which of the following is true?
(A) Performing the procedure in a biplane catheterization laboratory does not reduce the association with tamponade
(B) Presence of a small left atrium is associated with
a greater incidence of tamponade
(C) Onset of symptoms of tamponade rarely occur
more than an hour after the procedure
(D) Tamponade occurs without associated chest
pain in most cases
17 Which of the following parameters significantly determines pericardial pressure in the setting of a pericardial effusion?
(A) Volume of the effusion
(B) Rate of accumulation of the effusion
(C) Pericardial elasticity
(D) All of the above
18 Among patients with an active malignancy or a history of cancer and a significant pericardial effusion,
which of the following statements is correct?
(A) Pericardial disease is the most common indication for cardiology consultation among patients
with cancer who are hospitalized
(B) Presence of abnormal fluid cytology is not associated with a significant reduction in survival
(C) Patients with malignancy-related pericardial
effusions are twice as likely to require repeat pericardial intervention as those with
nonmalignancy-related effusions
(D) Pericardial fluid cytology is abnormal in approximately 75% of cases
19 Regarding percutaneous approach to pericardiocentesis, which of the following statements is
false?
(A) A right xiphocostal approach is associated with
right atrium and inferior vena cava injury
(B) Puncture of the left pleura and lingual is more
frequent with an apical approach
(C) Puncture of the left anterior descending coronary artery and left internal mammary artery is
more common with the parasternal approach
(D) Left chest wall approach should not be used
when performed with echo-guided procedures
20 Regarding percutaneous balloon pericardiotomy,
which of the following is incorrect?
(A) Thoracocentesis is required following balloon
pericardiotomy in 30% to 40% of cases
266 900 Questions: An Interventional Cardiology Board Review
(B) Drainage of >100 mL fluid per 24 hours, 3 days
after standard catheter drainage indicates the
need for more definitive intervention
(C) Surgical window may be preferred if a loculated
fibrinous effusion is present
(D) Reaccumulation of pericardial fluid with recurrent tamponade is considered a strong indication for performing percutaneous balloon
pericardiotomy
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