FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
DECEMBER 2016

POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
CARDIOTHORACIC SURGERY
PAPER I
CTH/D/16/04/I
Time 3 hours
Max. Marks 100
Important instructions:
• Attempt all questions in order.
• Each question carries 10 marks.
• Read the question carefully and answer to the point neatly and legibly.
• Do not leave any blank pages between two answers.
• Indicate the question number correctly for the answer in the margin space.
• Answer all the parts of a single question together.
• Start the answer to a question on a fresh page or leave adequate space between two answers.
• Draw table/diagrams/flowcharts wherever appropriate.
Write short notes on:
1. Anatomy of the mitral valve under the following headings:
Structure.
Importance of subvalvular apparatus.
Carpenter's classification of mitral regurgitation.
Structural changes in ischemic MR.

2. Estimation of ejection fraction under the following headings:
By echocardiography.
By imaging techniques.
Limitations.
Clinical significance of the assessment.

3. Cardiomyopathy under the following headings:
Aetiopathogenesis.
Dilated cardiomyopathy.
Restrictive cardiomyopathy.

4. Thrombolysis in acute myocardial infarction:
Drugs used.
Importance of the window period.
Contraindications.
Results.
Complications.

5. Total Circulatory Arrest under the following headings:
Indications.
Conduct.
Strategies to reduce risk to the CNS.
Long term sequelae.

6. Interventricular Septum:
Embryology.
Pathological classification of VSDs.
5+5
7. Ventricular afterload:
Definition.
Vasopressor agents.
Methods of reduction of ventricular afterload.

8. Effect of diabetes on the CVS:
Pathology.
Assessment of target organ damage.
Relationship between atherosclerosis and diabetes.
Effect on wound healing.

9. Use of heparin in cardiopulmonary bypass:
Dose and mechanism of actions.
Heparin resistance.
Heparin substitutes.
Monitoring of level of anticoagulations.
Heparin reversal.

10. Effects of cardiopulmonary bypass on the lung under the following
headings:
Pathological changes.
Role of WBC.
Pump lung.
Strategies to reduce the deleterious effects on the lung.