DNB CTVS Question- December 2012

DECEMBER 2012    

PAPER I
1. Discuss Jones criteria for diagnosis of rheumatic fever and current rheumatic fever prophylaxis guidelines.  4+6
2. Illustrate the surgical anatomy of the aortic root. Briefly describe patient- prosthesis mismatch. Draw labeled diagrams to show methods of aortic root enlargement. 3+2+5
3. Define renovascular hypertension. Describe its pathophysiology and treatment modalities. 2+(4+4)
4. Draw a labeled diagram to show fetal circulation. What are the immediate changes that occur soon after birth and why do they occur? 5+5
5. Discuss the roles of trans-thoracic and transesophageal echo in heart surgeries. 5+5
6. Discuss empyema thoraciswith respect to definition, etiology and management. 1+4+5
7. Mention the grades of pulmonary arterial hypertension. What are the methods of accessing the severity and reversibility of pulmonary arterial hypertension in children with congenital heart disease? 2+(5+3)
8. Discuss development of diaphragm, its surgical anatomy and management of hernia of Bochdalek.  4+3+3
9. Discuss in brief stem cell therapy in peripheral and myocardial angiogenesis with reference to     (a) source of stem cells         (b)methods of delivery with advantage and disadvantageof each method. 4+(3+3)
10. Can Tetralogy of Fallot (T.O.F) be called a monology? Justify your answer. Describe with diagram(s) the development of interventricular septumand right-ventricular outflow tract and describe what happens in T.O.F.  3+7
DECEMBER 2012     PAPER  II
1. Describe the concept and relevance of intracoronary shunts and stabilizers used in OPCAB. 4+3+3
2. Explain physiology of Fontan’s principle. Briefly describe the evaluation of Fontan’s operation and its current indications. 2+(4+4)
3. Describe the surgical anatomy of coronary arterial circulation.3
Discuss the rationale, advantages and limitations of retrograde coronary cardioplegia. 1+3+3
4. Describe the pathophysiology of ischemic mitral regurgitation. Discuss in brief the medical, surgical and percutaneous approaches to the disease. 4+(1+3+2)
5. Enumerate the drugs used, their role and results in thrombolytic treatment in prosthetic valve thrombosis. 2+4+4
6. Discuss the etiopathogenesis and management of acquired bronchopleural fistula. 3+7
7. Discuss the etiopathology and investigations for chronic constrictive pericarditis. What is post pericardiotomy syndrome? Briefly describe its management. 4+4+2
8. Classify and illustrate the lymph node stations in relation to the bronchogenic carcinoma. 10
9. Describe the risk factors for developing paraplegia during coarctation of aorta repair and management to prevent it. 5+5
10. Discuss the pathophysiology and  importance of pulmonary veins and left atrial enlargement in the genesis of atrial fibrillation in valvular heart disease and role of surgical intervention. 10

DECEMBER 2012     PAPER III
1. Discuss TAVI with regards to : a) indications and valves used               b) approach routes and              c) complications 3+4+3
2. Define and  classify heart failure. Discuss current status of destination therapy in surgical management of chronic heart failure. (2+2)+6
3. Briefly describe the concept of “Tissue engineered heart valves” and the current status of heart valve banking and heart valve institutes in India. 4+3+3
4. Define “ Internet and Communication Technology (I.C.T)” and comment on the impact of I.C.T in remote patient monitoring and health outcomes in cardiac surgical patients. 10
5. Define acute coronary syndrome. Discuss in brief indications of CABG in acute coronary syndrome and pathophysiology of “no-reflow phenomenon” 2+(3+5)
6. What are enabling devices? Briefly describe the role of enabling devices in cardiac surgery. 3+7
7. Define “counter-pulsation”. Describe physiological basis of IABP. What are its indications and complications? 2+3+(3+2)
8. Describe the concept of heart team. How do you think it will impact the future of CABG in India? 2+8
9. When is myocardial viability tests indicated? Discuss in brief the current modalities available for this test. 2+8
10. Discuss syntax trial under the following headings:
a) Design of the trial       b) outcome of the trial
c) Impact on current practice of stenting and CABG  4+4+2

DNB CTVS Question- December 2013

DECEMBER 2013  

PAPER II
1. a. Enumerate causes of pleural effusion. b. mention the criteria to label an effusion as a transudate or exudates. c. Management of malignant pleural effusion.3+3+ 4
2. a. Enumerate names of 6 trials comparing CABG with PCI.    b. What is MACE?   c. What are the recent outcomes from the syntax trial? 3+2+ 5
3. a. Describe the blood supply of the spinal cord.   b. Classify thoraco-abdominal aneurysms with diagram(s).   c. Describe landing zone criteria.4+3+ 3
4. a. What are modified Duke’s criteria for diagnosing native valve  endocarditis (NVE)?    b. Enumerate the organisms responsible for NVE.    c. What is the guideline for surgery in NVE? 4+2+4
5. a. Enumerate the congenital coronary artery anomalies.    b. What are the different options available for treating ALCAPA?5+ 5
6. a. What are the Choussat’s criteria for single ventricle repair? b. Describe the concept of one and a half ventricle repair? Where is it  indicated?  c. Enumerate complications of single ventricle repair.4+3+ 3
7. a. Enumerate complications of MI.  b. Briefly describe the surgical management of post MI VSD. 5+5
8. a. What do you mean by [i] bridge to transplant                                                  [ii]destination therapy       [iii] bridge to recovery? 6
b. What are the different types of long term mechanical circulatory support         devices? Briefly discuss its follow up. 4
9. a. What is post-operative renal dysfunction?  b. Mention its etiology and     diagnosis.  c. Briefly describe management of this disorder.2+(2+2)+ 4
10. a. Enumerate the PDA dependent circulation. b. How will you maintain patency of the PDA in such a case and mention complications of such therapy?     c. What is differential  cyanosis and mention its causes? 2+5+3

DECEMBER 2013  PAPER III
1. a. Describe the applied anatomy of mitral valve. b. What are the surgical methods to tackle ischemic mitral regurgitation? [5+5]
2. Discuss lung transplant under the following headings:
a. Indications [4]
b. Post operative complications [4]
c. Results [2]
3. a. What is PET? [1]
b. What is its role in SOL of lung? [4]
c. What is its role in ischaemic myocardium and ischaemic    cardiomyopathy? [5]
4. A) what is lung volume reduction Surgery (LVRS)
B)mention inclusion and exclusion criterion
C) Mention surgical techniques 1+3+3+1
5. A) state the materials used in making bio-valves and outline the treatment procedures available
B) Discuss the current status of bioprosthetic valve uses  5+5
6. A) what is patient prosthetic mismatch (PPM)
B) classify PPM
C) how do you investigate a patient suspected to have severe PPM  3+2+5
7. A) What is cardiac MRI
B) explain its relevance in defining anatomy , physiology, and function of heart with examples 2+3+3+2
8. A) Discuss intraoperative graft patency assessment during CABG
B) Discuss briefly background and current status of TMR ( TRANS MYOCARDIAL REVASCULARIZATION). 5+5
9. Describe the pathogenesis , causes and management of pulmonary hypertensive crisis. 3+2+5
10. A) Discuss the immunopathology of myasthania gravis
B) Discuss the biological markers in carcinoma lung. 5+5