Review of Cardiac Anesthesia with 2,100 MCQs (For all Examinations in Cardiac Anesthesia) Poonam Malhotra Kapoor
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1Review of Cardiac Anesthesia With 2,100 MCQs
3Review of Cardiac Anesthesia With 2,100 MCQs
For All Examinations in Cardiac Anesthesia
DM FNB FIACTA and Perioperative TEE Fellowship Examinations
Poonam Malhotra Kapoor MD DNB MNAMS FIACTA FTEE FISCU Additional Professor Cardiac Anesthesia, CN Center All India Institute of Medical Sciences, New Delhi, India Secretary, Society of Cardiac Anesthesia, Delhi and NCR Branch Coordinator, IACTA Education and Research Cell Co-editor, Annals of Cardiac Anesthesia Section EditorsYatin Mehta Deepak Tempe R Gopinath K Muralidhar Rajiv Juneja Naman Shastri ForewordNavin C Nanda
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This book has been published in good faith that the contents provided by the author contained herein are original, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the author specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the author. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
Review of Cardiac Anesthesia with 2,100 MCQs
First Edition: 2013
9789350906590
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2Section Editors
Yatin Mehta is the Chairman, Medanta Institute of Critical Care and Anesthesiology, Gurgaon, Haryana, and Founder President, Society of Cardiac Anesthesiology (SCA), Delhi and NCR Branch, India. He is also the Vice President, Indian Society of Critical Care Medicine (ISCCM), President, Critical Care Medicine (CCM), President, ISA, Gurgaon, Haryana, India, and first Editor of Annals of Cardiac Anesthesia.
Deepak Tempe is the Dean, Maulana Azad Medical College and Allied Hospitals, New Delhi; Chairman, Scientific Committee; Chairman, Annals of Cardiac Anesthesia, Society of Cardiac Anesthesiology, Delhi and NCR Branch; and Director and Head, Department of Anesthesiology, GB Pant Hospital, New Delhi, India.
R Gopinath is the Professor and Head, Department of Anesthesiology, Nizam Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India, and Chairman, IACTA Education and Research Cell (IERC).
K Muralidhar is the Director, Anesthesia, Narayana Hrudayalaya Hospitals, Bengaluru, Karnataka, India, and Course Director, Transesophageal Echocardiogram Workshop.
Rajiv Juneja is the Director, Medanta Institute of Critical Care and Anesthesiology Gurgaon, Haryana, and Founder Vice President, Society of Cardiac Anesthesiology, Delhi and NCR Branch, India.
Naman Shastri is the Head, Department of Cardiac Anesthesia SAL Hospital, Ahmedabad, Gujarat, India.
5Dedicated to
My father and family
Dr KK Malhotra (4.7.1929–4.1.2011)
My mentor, guide and inspiration in life
An extraordinary physician and human being with boundless affection, witty, hardworking and godly qualities
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7Foreword
It gives me an immense pleasure to write a foreword of Review of Cardiac Anesthesia with 2,100 MCQs written by Dr Poonam Malhotra Kapoor of All India Institute of Medical Sciences, New Delhi, India.
It is also pleasing to see an MCQ book entirely devoted to in-depth coverage of all aspects of cardiac anesthesia with traditional topics on drugs for cardiovascular diseases to congenital heart disease, embryology and rheumatic problems of valves pertinent to the Indian subpopulation. The book also has MCQs on rapidly developing areas like extracorporeal membrane oxygenation (ECMO), critical care and echocardiography which placed good coverage in this book. Explanations to the MCQs also add value to the book.
Setting MCQs for an examination is not an easy task. The author has done a good job to make them topic-wise, relevant and realistic for examination purpose. It shall be very useful to the students especially for those preparing for various competitive examinations. I feel Dr Malhotra's long stint at AIIMS, has honed her expression as an author and skills as a teacher, helping to prepare candidates for examinations in the superspecialty field of cardiac anesthesia. With her academic and research experience, she has added the freshness of a young teacher to the perspective of the book which has also been benefited tremendously by a very experienced faculty of cardiac anesthetists in India as section editors like Dr Yatin Mehta, Dr Deepak Tempe, Dr K Muralidhar, Dr R Gopinath, Dr Rajeev Juneja and Dr Naman Shastri. These globally renowned teachers have enriched the flavor of this objective mode of assessment in examinations. The ‘MCQ Pattern’ added great value to the book. Medical students in India are traditionally depended upon Western books for knowledge and information. The situation is changing now with many Indian authors coming up in all subjects but this is the first book of its kind in cardiac anesthesia and all concerned are masters on the subject. I myself have been an active onlooker of the Society of Cardiac Anesthesia, Delhi and NCR Branch (in the last two years), under whose ‘aegis’ this book is being promoted. It is a young and vibrant academic society and it is inspiring to see senior and founder members of the association, come together and fill a void in MCQ assessment by writing the book.
I congratulate the authors and hope that the book gains success, it deserves. I strongly recommend this student-friendly book to all examinees and examiners of cardiac anesthesia.
Navin C Nanda
Distinguished Professor, Medicine and Cardiovascular Disease
Section Head, Electrocardiography
Director, Clinical Echocardiography Fellowship Program
UAB School of Medicine, Birmingham, Alabama, USA
President, International Society of Cardiovascular Ultrasound (ISCU)
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9Preface
The book containing 2,100 MCQs in cardiac anesthesia is the first of its kind in the young subject of cardiac anesthesia. It is an important contribution about the study of the subject from the examination point of view. I am delighted with this interactive assessment book entitled Review of Cardiac Anesthesia with 2,100 MCQs. Examination on any subject is a must for progress. The backbone of any examination today is multiple choice questions. They guide the examinees toward the examination trends. The book is a powerful and most welcome statement about the place of examination trending in the evolving and ever-growing subject of cardiac anesthesia and the 3 sections have contributors as section editors from renowned names in cardiac anesthesia like Dr Yatin Mehta, Dr Deepak Tempe, Dr R Gopinath, Dr K Muralidhar, Dr Rajiv Juneja and Dr Naman Shastri. I shall always remain indebted to each of them for their contribution.
The book is a compilation of echocardiography information and transesophageal echocardiography (TEE) stills and videos from perioperative TEE and transthoracic echocardiography (TTE) with explanations in Section 2 and about 250 questions in Section 3 on upcoming topics like critical care and ECMO.
Competing technology, miniaturization, real time 3D TTE and TEE, extracorporeal membrane oxygenation (ECMO) (Perioperative and postoperative), critical care and infection control are modern tools of cardiac anesthesia, which have enhanced the position of a cardiac anesthetist from a mere giver of drugs to a perioperative physician performer doing activities like performing local, GA and hemodynamic monitoring, pain relief and patient outcome monitor measures in ICU—making him all incharge of the patient. Also, with the growing field has come a growth in examinations. The book aims at the latter with videos, tables and figures in a simplistic manner for each of the 37 chapters. Explanation in the echocardiography section, makes Section 2—easy and good reading. I hope you enjoy the basic book on Review of Cardiac Anesthesia with 2,100 MCQs which is informative and easy-to-use.
I am sure, the book will fully meet the requirements of students preparing for all examinations in cardiac anesthesia like DM, FNB, FIACTA and perioperative TEE examinations.
Poonam Malhotra Kapoor
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11Acknowledgments
I would like to thank my office staff at All India Institute of Medical Sciences, New Delhi, India, consisting of Sandeep Kumar, Pradeep Kumar, Sachin, Poonam and Manoj Mishra for their continuous, laborious arduous, day-to-day compilation of this manuscript. Without their ongoing enthusiastic efforts, this book would not have seen this day. I would especially like to thank Dr Yatin Mehta, Dr Naman Shastri, Dr Varun Kapoor and Pranav Kapoor who inspired me into putting the book together.
I would like to acknowledge the residents of Cardiac Anesthesia Department, All India Institute of Medical Sciences, New Delhi, India, and students of FIACTA and those seeking Fellowship examinations in TEE for providing the much-needed stimulus that animated my efforts.
My family whom, I take for granted every second and my senior and junior colleagues in Department of Cardiac Anesthesia, All India Institute of Medical Sciences, New Delhi, India, deserve a heartfelt ‘Thank you’. The SCA–Delhi and NCR is an ever-growing Banyan tree founded by Professor Nita Saxena and Dr Yatin Mehta, under whose aegis, academics and research will also flourish. Seniors like them, are rare. My good luck.
Finally, I would like to express my gratitude to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr Tarun Duneja (Director-Publishing) and staff of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for their guidance in making this book.