View source for WBR0992

{{WBRQuestion
|QuestionAuthor={{MM}}
|ExamType=USMLE Step 3
|MainCategory=Emergency Room
|SubCategory=Cardiovascular
|MainCategory=Emergency Room
|SubCategory=Cardiovascular
|MainCategory=Emergency Room
|SubCategory=Cardiovascular
|MainCategory=Emergency Room
|MainCategory=Emergency Room
|SubCategory=Cardiovascular
|MainCategory=Emergency Room
|SubCategory=Cardiovascular
|MainCategory=Emergency Room
|SubCategory=Cardiovascular
|MainCategory=Emergency Room
|SubCategory=Cardiovascular
|MainCategory=Emergency Room
|MainCategory=Emergency Room
|SubCategory=Cardiovascular
|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?
|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.
|AnswerA=Internal mammary artery grafts remain open for 10 years
|AnswerAExp=Correct
Internal mammary artery grafts remain open for 10 years
|AnswerB=Saphenous vein grafts remain open for 10 years
|AnswerBExp=Incorrect
Vein grafts started to be occluded after 5 years
|AnswerC=Heparin is necessary for vein grafts
|AnswerCExp=Incorrect
There is no difference in the medication needs between saphenous vein grafts and internal mammary artery grafts.
|AnswerD=Anticoagulants is necessary with saphenous vein grafts
|AnswerDExp=Incorrect
There is no difference in the medication needs between saphenous vein grafts and internal mammary artery grafts.
|AnswerE=Anti-platelets  is less needed with Internal mammary grafts
|AnswerEExp=Incorrect
There is no difference in the medication needs between saphenous vein grafts and internal mammary artery grafts.
|RightAnswer=A
|WBRKeyword=[[CABG]]
|Approved=No
}}