WBR0992

Author	[[PageAuthor::Mohamed Moubarak, M.D. [1]]]
Exam Type	ExamType::USMLE Step 3
Main Category	MainCategory::Emergency Room
Sub Category	SubCategory::Cardiovascular
Prompt	[[Prompt::A 50 year- old male comes to ED complaining of a dull pain started 15 min ago all over his chest that radiates to the left shoulder and arm. EKG is normal. After the resolve of his attack, you ordered a stress test, which turn abnormal and show a reversible ischemia. The patient was indicated for angiography which shows >70% stenosis in the left main coronary artery, and the patient indicated for CABG. Which of the following is the main difference between saphenous vein grafts and internal mammary artery grafts?]]
Answer A	AnswerA::Internal mammary artery grafts remain open for 10 years
Answer A Explanation	[[AnswerAExp::Correct Internal mammary artery grafts remain open for 10 years]]
Answer B	AnswerB::Saphenous vein grafts remain open for 10 years
Answer B Explanation	[[AnswerBExp::Incorrect Vein grafts started to be occluded after 5 years]]
Answer C	AnswerC::Heparin is necessary for vein grafts
Answer C Explanation	[[AnswerCExp::Incorrect There is no difference in the medication needs between saphenous vein grafts and internal mammary artery grafts.]]
Answer D	AnswerD::Anticoagulants is necessary with saphenous vein grafts
Answer D Explanation	[[AnswerDExp::Incorrect There is no difference in the medication needs between saphenous vein grafts and internal mammary artery grafts.]]
Answer E	AnswerE::Anti-platelets is less needed with Internal mammary grafts
Answer E Explanation	[[AnswerEExp::Incorrect There is no difference in the medication needs between saphenous vein grafts and internal mammary artery grafts.]]
Right Answer	RightAnswer::A
Explanation	[[Explanation::The main difference between Internal mammary artery grafts and saphenous vein grafts is in the occlusion period. Vein grafts started to be occluded after 5 years, while internal mammary aretry grafts are often patent at 10 years. There is no difference in the medication needs between them. Educational Objective: References: ]]
Approved	Approved::No
Keyword	[[WBRKeyword::CABG]]
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::