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Surgery

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Thyroid & Adrenal

Question
54 out of 99
 

Brain abscesses and paradoxical cerebral emboli are complications that occur with on increased frequency in patients who have.



A Aortic stenosis

B Tetralogy of Fallot

C A sinus venosus type of ASD

D Corrected transposition of the greats vessels with a VSD

Ans. B Tetralogy of Fallot (Ref: Schwartz :Principles of surgery 8th edition page no. 822-823)

a. Tetralogy of fallo(TOF) is congenital heart disese of cyanotic group.

b. The four pathological features of the disease are: 1. Obstruction of the outflow of the RV 2. VSD 3. Dextroposition of the aorta & 4.hypertrophy of the RV

c. Combination of the brain abscess and cerebral emboli are found in patients with TOF>

d. Anoxia occurs in patients with TOF.

e. Chronic anoxia produces compensatory polycythemia and clubbing of the fingers.

f. Cyanosis occurs and increases in first few years of the life.

g. Patients having cyanosis at birth are develop severe anoxia and do not survive infancy unless operation is performed.

h. Patients having cyanosis at first year of the age have minor course.

i. Severe cyanosis is visible only after polycythemia has developed.

j. The main threat to life in first few years are cerebral infarction and cyanotic spells.

k. Brain abscess is another serious and often lethal condition.

l. Cardiac anomalies that permit systemic venous blood and its content (eg Bacteria and thrombi) to pass directly into the systemic arterial circulation without being filtered by the lung are associated with an increased susceptibility to brain abscess and paradoxical cerebral emboli.

m. TOF is associated with a higher incidence of brain abscess than any other conditions involving a right to left shunt.

n. Cardiac failure is rare in TOF.

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