DNB CTVS Questions- December 2011

DECEMBER 2011    

PAPER 1
1. Describe surgical anatomy of tracheo-bronchial tree. 10
2. a. Enumerate constituents and various types of cardioplegic solutions.        b. Functions of those constituents  c. Advantages and disadvantages of blood Vs crystalloidcardioplegic solution 5+2+3
3. a. Embryology of transposition of great arteries. b. Coronary arterial anomalies 5+5
4. Briefly discuss diaphragmatic rupture under the following headings:            a. Clinical presentation and signs   b. Investigations    c. Treatment 3+4+3
5. Discuss in brief solitary pulmonary nodule under the following headings:    a. Differential diagnosis       b. lnvestigations      c. Management algorithms (flowchart)3+3+4
6. Hemolysis during cardiopulmonary bypass: Causes, Systemic effects, management and recent advances 3+3+2+2
7. Discuss in brief cardiac tissue engineering under the following headings:     a. Donor cell types        b. Delivery routes, advantages and disadvantages       c. Clinical applications 3+4+3
8. 64 slice MDCT angiography: a. Comparison with conventional angiography   b. Preoperative planning of primary and re-operative surgeries                      c. Role in congenital heart diseases           d. Role in coronary artery disease 2+2+3+3
9. Describe the causes, risk assessment and neuroprotective strategies of cerebral injury during CPB. 3+3+4
10. Briefly discuss the role of nitric oxide (NO) in cardiac surgery under the following headings:   a. Physiological basis of use of NO       b. Indications for its use      c. Modes of administration with dosing         d. Precautions, safety issues related to its use’in ICU 3+2+2+3

DECEMBER 2011 PAPER. II
1. Discuss briefly the spinal cord protection during thoracic aortic surgery under the following headings:  a. Blood supply and collateral circulation.     b. Methods of ischemia detection.      c. Preventive strategies for spinal cord protection.3+3+4
2. Benign thymic tumours: Classification, role of thymectomy in myasthenia gravis, and effects/complications after thymectomy. 3+4+3
3. a. Causes and types of post-operative cardiac dysarrhythmias.                       b. Univentricular Vs biventricular pading.          c. Post-operative heart blocks and roles of temporary atrialor A-V sequential pacing. 3+3+4
4. a. Treatment for pectus excavatum        b. Physiological effects of pectus excavatum           c. Treatment for pectus carinatum           d. Physiological effects of pectus carinatum. 3+2+3+2
5. a. Briefly discuss techniques of total chordal preservation;   and                     b. Advantages of chordal preservation and long term effects on reverse left ventricular remodeling. 6+4
6. Double outlet right ventricle: Anatomic definition, classification, investigations, management (surgical) and results. 1+3+2+3+1
7. Tricuspid valve anomalies: Types of congenital / acquired anomalies, indications of surgery and types of repair. 3+2+5
8. Discuss briefly your reasons for choice of valve prosthesis and /or procedure:      a. In a patient with end stage renal disease (ESRD)                   b. In a pediatric patient (less than or equal to 12 years)                                    c. In a lady in child bearing age .   d. Non rheumatic mitral valve disease in adult in 30’s.                                       e. Rheumatic mitral and aortic valve disease in an adult (less than or equal to 45years). 2+2+2+2+2
9. Enumerate types of congenital arch anomalies. Discuss in brief their presentation, investigations, management and results. 2+2+2+2+2
10. a. Hydatid cyst of lung: Diagnosis and management  2+3      b. Pericardial cysts: Diagnosis and management 2+3

DECEMBER 2011 PAPER III
1. Describe current status of extra-corporeal membrane oxygenation (ECMO) under the following headings:   a. Indications of use     b. Physiological basis    c. Equipment required for setting up                              d. Method of weaning                     e. Complications  2+2+2+2+2
2. Discuss TNM classification for lung carcinoma in relation to:     a. Recent recommendations in TNM criteria         b. Choice of treatment based on TNM staging            c. Results of treatments in various TNM stages. 3+3+4
3. a. CHOUSSATS’ criteria for single ventricle         b. Modified Fontan criteria  c. Physiological basis of Fontan’s circulation           d. Advantages of one and half ventricle repair 3+2+3+2
4. a. Design of SYNTAX trial                             b. Outcomes of SYNTAX trial                                c. lmpact of SYNTAX scoring system on current practice of coronary bypass surgery. 5+3+2
5. Discuss cardiopulmonary bypass strategies in a patient of  Heparin Induced Thrombocytopenia (HlT) in terms of:        a. Platelet pretreatment  b. Platelet inhibition              c. Alternate drugs for anticoagulation 3+3+4
6. Bosentan: Mechanism of action, pharmacokinetics, indications, side effects and current status of its use. 2+2+2+2+2
7. Percutaneous Left Ventricular Assist Devices (P-LVADs):  a. Types of             P-LVADs available,                      b. lt’s role in bridge to transplantations                        c. Systemic deleterious effects on various organ systems. 4+4+3
8. Discuss in brief methods to stop anastomotic leaks from a vascular anastomosis under the following headings:               a. Names of various devises/substances  b. Advantages and disadvantages of their uses              c. Use of Gel-plugs; mechanism of action and contraindication of its usage. 3+3+4
9. Modified Vs conventional ultrafiltration: Difference between them, indications and advantages/disadvantages 3+3+4
10. Discuss transannular patch in Tetralogy of Fallots under the following heads:       a. Indications and contraindications           b. Advantages and disadvantages       c. Surgical technique               d. Role of homografts Vs heterografts as replacement to   transannular patch  3+3+1+3

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