Cardio & Pulm

Question 1

MC congenital heart disease

Answer 1

VSD

Question 2

what direction of shunt leads to cyanosis

Answer 2

Right to Left

Question 3

Describe the murmur of VSD

Answer 3

smaller defect = louder murmur

holo pansystolic palpable thrill

Question 4

In young patients with embolic stroke and fixed split S2

Answer 4

ASD

Question 5

machine like grinding murmur

Answer 5

PDA

Question 6

Tx for PDA in neonates

Answer 6

indomethacin

sx if no response

Question 7

ToF consists of

Answer 7

VSD
overriding aorta
pulm stenosis
RVH

Question 8

treatment of ToF

Answer 8

surgery always indicated

Question 9

4 y/o male with five days of fever, and 3 days of bilat painless conjuncitivity, stomatitis, and cervical LAN. A rash that affects the hands and feet

Answer 9

Kawasaki Disease

IVIG and ASA

Question 10

main complication of untreated Kawasaki Disease

Answer 10

coronary aneurysm

Question 11

Coarctation of Aorta commonly associated with other syndrome?

Answer 11

Turner Syndrome

+ bicuspid aortic valve

Question 12

Infant with delayed femoral pulses

Answer 12

Coarctation of the aorta

Question 13

Tx for Coarctation of aorta

Answer 13

simple uncomplicated- balloon angioplasty

or surgical resection

Question 14

MCC sudden cardiac death in young/athletes

Answer 14

Hypertrophic cardiomyopathy

Question 15

patho of hypertrophic cardiomyopathy

Answer 15

thickened but non-dilated LV

familial component

Question 16

Rheumatic fever sxs

Answer 16

J: joints
O: carditis
N: nodules subq
E: erythema marginatum
S: Sydenham chorea

Question 17

tx rheumatic fever

Answer 17

benzathing PCN G IM, PCN qmonth until 21

symptomatic ASA use

Question 18

MCC acute pericarditis

Answer 18

viral- esp coxsackie and echoviruses

Question 19

pleuritic CP relieved when sitting forward

friction rub

Answer 19

acute pericarditis

Question 20

classic EKG changes of acute pericarditis

Answer 20

diffuse ST segment elevation
low QRS amplitude
PR depression
electrical alternans

Question 21

respiratory distress in neonate born at 28 weeks
decreased air movement, bilat atelectasis on CXR
dx
tx

Answer 21

hyaline membrane disease

early intubation, 02, surfactant admin (Survanta)

Question 22

15 y/o otherwise healthy male with insidious onset of cough, myalgias, and low grade fevers
CXR shows interstitial infiltrates

Answer 22

atypical PNA- mycoplasma

tx erythromycin

Question 23

MCC bronchiolitis

Answer 23

RSV

Question 24

URI sxs and gradual onset of resp distress with wheeze, cough, and dyspnea
prolonged expiratory phase
dx
tx

Answer 24

Bronchiolitis

tx generally supportive, cool humidified O2

Question 25

RSV bronchiolitis associated with increased risk of what

Answer 25

asthma later in life

Question 26

Prevention of RSV

Answer 26

Palivizumab in high risk infants:

<6m born 32-35wk with day care attendance, etc

Question 27

barking cough + stridor

Answer 27

croup

Question 28

MCC croup

Answer 28

parainfluenza

Question 29

Tx for croup

Answer 29

symptomatic

1 dose of decadron

Question 30

bursts of harsh cough followed by inspiratory high pitched “whoop”

Answer 30

Pertussis

Question 31

Tx for pertussis

Answer 31

Zpack or Erythromycin

Question 32

Dx CF

Answer 32

pilocarpine iontophoresis sweat test >60
-2 tests on different days

genotyping