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The Correct Answer is C!

Knowledge to Practice, in collaboration with Mayo Clinic, offers online board review and lifelong learning products in Cardiovascular Medicine. With a full pre-assessment, you can identify the topics you’ve mastered and focus your time on topics where you need it the most. Our products are proven to increase knowledge 75% more than traditional methods in less time.

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Question:

A 44 year-old woman with complex tricuspid atresia underwent a Fontan procedure 5 years ago. In the past year, she has developed severe edema, ascites, and pleural effusions. She was found to have a serum albumin of 2.2 g/dL and total protein of 4.5 g/dL.

What is the next step in management?

  1. Bone marrow biopsy
  2. Paracentesis sent for cells and culture
  3. Alpha 1 antitrypsin level in stool
  4. Right and left heart catheterization with fluid loading

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