Wednesday, June 27, 2012

Quiz #20: Cardiac Catheterization

PA and Lateral frames of venous and arterial catheters are given below.

Question 1: Trace the course of venous catheter. What diagnosis does this catheter-course lead you to?

Question 2: Trace the course of the arterial catheter. What side is the aortic arch? (Beware, this question is a trick question).

Click on the image to enlarge.

Saturday, June 2, 2012

Quiz #19: Echocardiogram - Aortic arch view

This is a suprasternal notch view of the aortic arch from a newborn baby.
Question 1: What is abnormal in Panel 1?
Question 2: Based on Panel 1 image, what vascular anomaly should be looked for?

Clue 1: Baby in Panel 1 has Tetralogy of Fallot with right aortic arch.
Clue 2: Panel 2 is the same view of aortic arch from a normal baby.

Link to the answer

(Click on the image to enlarge)


 

Saturday, May 26, 2012

Quiz #18: EKG Rhythm Strip

This is an EKG recorded in a 2-day baby (Tetralogy of Fallot) after cardiac catheterization.
Question: What is this catheter-induced rhythm?


(Click on the image to enlarge)

Saturday, May 19, 2012

Quiz #17: Arterial pulse trace


Below is ICU monitor display for a teen ager.
Question 1: What is the name of the pulse for the pattern shown in the arterial line trace?
Question 2: Name 3 causes for this pattern of pulse in any patient?


(Click on the image to enlarge)

Tuesday, May 15, 2012

Quiz #16: Echocardiogram - Pericardial effusion - M mode

Image below is M-mode recording in parasternal short axis view, in a patient with pericardial effusion. What ominous sign is being demonstrated in this image?

(Click on the image for larger image)


Sunday, May 6, 2012

Quiz #15: 12-lead EKG - Inverted P

Question: What is the diagnosis for the inverted P?
(Clue: You may compare with the EKG in Quiz #14)

Click on the image to enlarge.

Sunday, April 29, 2012

Quiz #14: 12-lead EKG

Question 1: What is the diagnosis?

Question 2: Please provide 2 salient findings that support the diagnosis.

(Click on the image for enlarge)


Monday, April 23, 2012

Quiz #13: Statistics - Z-score

A newborn (weight 3 kg, length 50 cm) has aortic valve annulus of 6.0 mm. One published report states the following normal values for aortic valve annulus in newborns of same body size: Mean 7.3 mm & Range of 6.38 mm – 8.22 mm (Range is reported as 2 standard deviations from the mean).
Question 1: What is the Z-score of our patient with 6.0 mm diameter?
Bonus Question: Please provide the steps of deriving the Z-score.

Link to the answer

Sunday, April 8, 2012

Quiz #11: CVP trace

The two snap shots were taken 1 minute apart from a postoperative patient.
What is the difference between the CVP traces in each of the panels? (Top panel - Clock time is 13:44 Hrs and Bottom panel - Clock time is 13:45 Hrs).
Click on the image to enlarge.


Link to the answer




Saturday, March 31, 2012

Quiz #10: Clinical Examination

Question 1: What is the sign in figure 1 called?

Question 2: What is the sign in figure 2 called?

Question 3: According to new diagnostic criteria for this condition, if both these signs are positive in a child, how many "System Score" points does the child get?

Link to the answer










Saturday, March 24, 2012

Quiz #9: Where is the tip of the PA line?

This patient returned from operating room 20 minutes ago. He has a pulmonary artery line. What is the location of the PA line tip based on the CXR and the PA pressure trace?
Clue: PA line pressure trace holds the answer. CXR helps to corroborate.

(To see a larger image, click on the image)
Link to answer











Saturday, March 17, 2012

Saturday, March 10, 2012

Quiz #7: Barium Swallow study

Question 1: Describe the finding in PA view.
Question 2: Describe the finding in Lateral view.
Question 3: What is the diagnosis?

Link to the answer















Monday, March 5, 2012

Quiz #6: Barium Swallow Study

Esophagogram:
1) Describe the finding.
2) What is the diagnosis?

Additional "bonus" questions:
3) What tracheal anomaly is associated with this condition?
4) What is the common cardiac defect associated with this condition?

Link to the answer

Saturday, February 25, 2012

Quiz #5: EKG (12-lead)

Sinus rhythm EKG from a 17-year old patient:
1) What is the diagnosis? (Answer is obvious, of course!)
2) Where is the accessory pathway located?
(Click on the image to see a larger image)

Link to the answers

Monday, February 20, 2012

Quiz #4: EKG - Pacemaker

4 month old, s/p VSD repair. Postoperative day #3. Temporary pacemaker is on, for complete AV block. Set to DDD mode. What is wrong?

Click on the image to see a larger image.

Link to the answer

Friday, February 10, 2012

Quiz #3: Surgical anatomy - Arrangement of Atrial Appendages

In figure 1, the arrows point to atrial appendages. What is the name for this arrangement of atrial appendages? What lesions are associated with this atrial arrangement?

Link to the answer









Saturday, February 4, 2012

Quiz #2: Abdominal Aortogram

1 year old boy, referred for heart murmur evaluation. History of recurrent pneumonia (2 episodes in past 3 months) involving right lower lobe. After initial evaluation, underwent this abdominal angiogram. (There is a video below. Make sure, you watch until the contrast completely clears. In case the video does not play, you will have to satisfy with the still frame!)


1) What is the diagnosis?
2) What is the characteristic sign in Chest X-ray you would expect?
3) A cath intervention was performed after this angiogram. What intervention was it?

Link to the answer

















Monday, January 30, 2012

Quiz #1: What is the surgery(surgeries) shown in this image?

Front cover of January 2012 issue:
1) What surgery (surgeries are shown in this image?
2) Name the components of the surgery(surgeries) shown in the image.

Please leave your answers in comments section. Answer will be posted in approx. 7-10 days.

Link to the answer