Iraqi Board Thoracic & Cardiovascular Surgery flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

CABG conduit of choice

The left internal thoracic artery to left anterior descending artery is the reference conduit because arterial grafts have higher long-term patency than saphenous vein grafts.

Aortic stenosis intervention trigger

Symptomatic severe aortic stenosis or asymptomatic disease with left ventricular ejection fraction below 50% is a class I indication for valve replacement.

Cardiac tamponade signs

Hypotension, elevated jugular venous pressure, muffled heart sounds, pulsus paradoxus, and diastolic chamber collapse on echocardiography indicate tamponade requiring urgent drainage.

Type A aortic dissection

Involves the ascending aorta and is a surgical emergency; repair replaces the ascending aorta and resuspends the aortic valve when leaflets are normal.

Lobectomy standard

Lobectomy with systematic nodal dissection is the standard resection for resectable non-small cell lung cancer; sublobar resection is reserved for limited reserve or small peripheral lesions.

Lung segment count

The right lung has 10 bronchopulmonary segments and the left has 8 to 10, depending on whether the subsuperior segment is counted separately.

Empyema stages

The American Thoracic Society stages empyema as exudative, fibrinopurulent, and organizing; the organizing stage may require decortication.

Malignant pleural effusion management

Indwelling pleural catheter or talc pleurodesis is used when lung re-expansion is adequate; trapped lung favors an indwelling catheter.

Tetralogy of Fallot components

Tetralogy of Fallot comprises ventricular septal defect, overriding aorta, right ventricular outflow obstruction, and right ventricular hypertrophy.

Prostaglandin E1 indication

Ductus-dependent congenital lesions such as critical coarctation, pulmonary atresia, and interrupted aortic arch require prostaglandin E1 infusion to preserve blood flow.

Fontan physiology

A total cavopulmonary connection diverts systemic venous return to the pulmonary arteries without a ventricular pump; it requires low pulmonary vascular resistance.

Arterial switch operation

The arterial switch operation corrects transposition of the great arteries in the first weeks of life by translocating the great vessels and reimplanting the coronary arteries.

Abdominal aortic aneurysm threshold

Elective repair is indicated at a diameter of 5.5 cm or more in men, 5.0 cm or more in women, growth over 1 cm per year, or symptoms.

Carotid endarterectomy indication

Carotid endarterectomy is indicated for symptomatic 70–99% stenosis, ideally within two weeks of the index event, and for selected moderate stenosis.

Endoleak types

Endoleaks after endovascular aneurysm repair are classified I–V; type I and III endoleaks require reintervention because of continued sac pressurization.

Thymoma association

Thymoma is associated with myasthenia gravis in about one third of patients, and complete thymectomy is the mainstay of treatment.

Esophageal cancer types

Adenocarcinoma arises in Barrett esophagus and the distal esophagus, while squamous cell carcinoma predominates in the upper and middle esophagus.

Mediastinal compartments

Mediastinal masses are divided into anterior, middle, and posterior compartments; anterior masses include thymoma, teratoma, thyroid, and lymphoma.

Berlin ARDS criteria

Acute respiratory distress syndrome is defined by onset within one week, bilateral infiltrates, no cardiac cause, and PaO2/FiO2 below 300.

KDIGO acute kidney injury

Acute kidney injury is staged by the KDIGO criteria using serum creatinine rise and urine output thresholds.

ECMO modes

Venovenous ECMO supports oxygenation, while venoarterial ECMO supports both cardiac and pulmonary function.

LVAD thrombosis signs

Pump thrombosis presents with hemolysis, elevated lactate dehydrogenase, and pump power spikes; it requires anticoagulation assessment and possible pump exchange.

Intra-aortic balloon pump effect

Counterpulsation augments diastolic coronary perfusion and reduces afterload; severe aortic regurgitation and aortic dissection are contraindications.

CT pulmonary angiography

Computed tomography pulmonary angiography is the first-line imaging test for suspected pulmonary embolism in hemodynamically stable patients.

Fractional flow reserve threshold

A fractional flow reserve of 0.80 or less identifies hemodynamically significant coronary stenosis and supports revascularization.

Primary PCI timing

ST-elevation myocardial infarction requires primary percutaneous coronary intervention within 90 minutes of first medical contact when feasible.

Coronary dominance

Coronary dominance is defined by which artery supplies the posterior descending artery; the right coronary artery is dominant in about 85% of people.

Oxygen delivery formula

Oxygen delivery equals cardiac output multiplied by arterial oxygen content, where content equals 1.34 times hemoglobin times saturation plus dissolved oxygen.

Phrenic nerve roots

The phrenic nerve arises from cervical roots C3 to C5 and supplies the diaphragm; injury causes diaphragmatic paralysis and respiratory compromise.

Bentall procedure

A composite graft replaces the aortic valve and ascending aorta with reimplantation of the coronary arteries in a single operation.

Surgical antibiotic prophylaxis

Prophylaxis is administered within 60 minutes before incision, with agent choice based on procedure and local resistance patterns.

Number needed to treat

Number needed to treat is the reciprocal of the absolute risk reduction and expresses how many patients must be treated for one additional benefit.