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CHD2 Flashcards

1
Q
  1. At what gestational age do most major cardiovascular structures develop, making it the critical period for congenital heart defects? A. 1-2 weeks B. 3-8 weeks C. 9-12 weeks D. 13-16 weeks
A

B. 3-8 weeks

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2
Q
  1. Which of the following congenital heart defects may not present with symptoms immediately at birth but can manifest later in life? A. Transposition of the Great Arteries (TGA) B. Tetralogy of Fallot C. Ventricular Septal Defect (VSD) D. Patent Ductus Arteriosus (PDA)
A

C. Ventricular Septal Defect (VSD)

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3
Q
  1. Congenital heart disease accounts for approximately what percentage of perinatal deaths, especially in cyanotic heart diseases? A. 10% B. 20% C. 30% D. 40%
A

D. 40%

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4
Q
  1. Which of the following congenital heart conditions is ideally corrected surgically within the first two weeks of life? A. Ventricular Septal Defect B. Tetralogy of Fallot C. Transposition of the Great Arteries (TGA) D. Coarctation of the Aorta
A

C. Transposition of the Great Arteries (TGA)

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5
Q
  1. What is the current mortality risk for surgical correction of congenital heart disease due to advancements in surgical techniques? A. 1% B. 5% C. 10% D. 30%
A

B. 5%

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6
Q
  1. Which of the following is TRUE regarding the treatment of congenital heart disease? A. All congenital heart defects require immediate corrective surgery after birth. B. Some defects may close spontaneously without the need for surgery. C. All defects are fatal within the first year of life if untreated. D. Medications are never used in the treatment of congenital heart defects.
A

B. Some defects may close spontaneously without the need for surgery.

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7
Q
  1. What is the common treatment approach for severe cases like Tetralogy of Fallot or severe pulmonary stenosis? A. Medication only B. Palliative treatment C. Immediate corrective surgery D. Observation only
A

B. Palliative treatment

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8
Q
  1. Which of the following is NOT a common characteristic of congenital heart disease? A. Can be detected at birth B. May lead to cyanosis and perinatal death C. Always presents with symptoms immediately after birth D. Can result from faulty embryogenesis during weeks 3-8 of gestation
A

C. Always presents with symptoms immediately after birth

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9
Q
  1. What is the incidence of congenital heart disease in live births? A. 1-2% B. 7-8 per 1000 live births C. 5-6% D. 10-12 per 1000 live births
A

B. 7-8 per 1000 live births

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10
Q
  1. What percentage of congenital heart disease cases are diagnosed by 1 year of age? A. 50% B. 60% C. 88% D. 99%
A

C. 88%

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11
Q
  1. Which of the following congenital heart defects is more commonly seen in males than in females? A. Atrial Septal Defect (ASD) B. Ventricular Septal Defect (VSD) C. Transposition of the Great Arteries (TGA) D. Patent Ductus Arteriosus (PDA)
A

C. Transposition of the Great Arteries (TGA)

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12
Q
  1. Patent Ductus Arteriosus (PDA) of prematurity is NOT considered a congenital heart defect because: A. It does not cause any clinical symptoms. B. It resolves on its own without treatment. C. It can be treated medically with NSAIDs. D. It only occurs in term infants.
A

C. It can be treated medically with NSAIDs.

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13
Q
  1. What is the incidence of congenital heart disease in stillbirths? A. 1% B. 3-4% C. 10-25% D. 50%
A

B. 3-4%

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14
Q
  1. Which congenital heart defect is more common in females than in males? A. Coarctation of the aorta B. Pulmonary stenosis C. Mitral atresia D. Hypoplastic left heart syndrome
A

B. Pulmonary stenosis

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15
Q
  1. By what age should all congenital heart defects be diagnosed? A. 1 year B. 2 years C. 4 years D. 5 years
A

C. 4 years

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16
Q
  1. Which of the following left-sided congenital heart defects is more common in males? A. Coarctation of the aorta B. Atrial septal defect C. Pulmonary stenosis D. Ventricular septal defect
A

A. Coarctation of the aorta

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17
Q
  1. What is the incidence of congenital heart disease in premature infants, excluding PDA of prematurity? A. 1% B. 2% C. 3-4% D. 5-6%
A

B. 2%

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18
Q
  1. What percentage of congenital heart disease (CHD) cases have no identifiable cause? A. 50% B. 70% C. 90% D. 100%
A

C. 90%

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19
Q
  1. Which genetic syndrome is most commonly associated with Atrioventricular (AV) Septal Defect or Endocardial Cushion Defect? A. Marfan Syndrome B. Trisomy 21 (Down Syndrome) C. Noonan Syndrome D. Trisomy 13 (Patau Syndrome)
A

B. Trisomy 21 (Down Syndrome)

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20
Q
  1. Ventricular Septal Defect (VSD) or Tetralogy of Fallot (TOF) is present in over 90% of individuals with which of the following chromosomal abnormalities? A. Trisomy 18 B. Trisomy 21 C. Trisomy 15 D. Trisomy 13
A

A. Trisomy 18

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21
Q
  1. Which congenital heart defect is commonly associated with Noonan Syndrome? A. Aortic Dilatation B. Pulmonary Stenosis C. Coarctation of the Aorta D. Atrioventricular Septal Defect
A

B. Pulmonary Stenosis

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22
Q
  1. Marfan Syndrome is associated with which of the following cardiovascular abnormalities? A. Pulmonary Stenosis B. Aortic Dilatation C. Ventricular Septal Defect D. Patent Ductus Arteriosus
A

B. Aortic Dilatation

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23
Q
  1. In which of the following environmental conditions is there a higher incidence of Patent Ductus Arteriosus (PDA)? A. Low altitude B. High altitude C. Coastal regions D. Temperate climates
A

B. High altitude

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24
Q
  1. Which of the following chromosomal abnormalities is associated with a high incidence of Ventricular Septal Defect (VSD) or Tetralogy of Fallot (TOF)? A. Trisomy 21 B. Trisomy 18 C. Trisomy 13 D. All of the above
A

D. All of the above

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25
Q
  1. Which genetic condition is associated with connective tissue disorders and is linked to aortic dilatation? A. Down Syndrome B. Marfan Syndrome C. Noonan Syndrome D. Edwards Syndrome
A

B. Marfan Syndrome

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26
Q
  1. Which of the following congenital heart defects is caused by abnormal migration of ectomesenchymal tissue? A. Ventricular Septal Defect (VSD) B. Hypoplastic Left Heart Syndrome C. Total Anomalous Pulmonary Venous Return (TAPVR) D. Ebstein Anomaly
A

A. Ventricular Septal Defect (VSD)

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27
Q
  1. Abnormalities in the migration of neural crest cells can result in which of the following heart defects? A. Endocardial Cushion Defect (ECD) B. Tetralogy of Fallot (TOF) C. Hypoplastic Left Ventricle D. Ebstein Anomaly
A

B. Tetralogy of Fallot (TOF)

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28
Q
  1. Abnormal intracardiac blood flow leading to reduced ventricular development can cause which of the following congenital heart defects? A. Double Outlet Right Ventricle (DORV) B. Hypoplastic Right Ventricle C. Aorto-Pulmonary Window D. Endocardial Cushion Defect
A

B. Hypoplastic Right Ventricle

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29
Q
  1. Which congenital heart defect is associated with abnormal cellular death, specifically the resorption of ventricular myocardium? A. Muscular Ventricular Septal Defect (VSD) B. Transposition of the Great Arteries (TGA) C. Total Anomalous Pulmonary Venous Return (TAPVR) D. Double Outlet Right Ventricle (DORV)
A

A. Muscular Ventricular Septal Defect (VSD)

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30
Q
  1. Endocardial Cushion Defect (ECD), also known as Atrioventricular Septal Defect, is caused by failure in the fusion of which heart structures? A. Pulmonary veins B. Endocardial cushions C. Ventricular myocardium D. Ectomesenchymal tissue
A

B. Endocardial cushions

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31
Q
  1. Failure in the absorption of pulmonary veins into the left atrium can lead to which congenital heart defect? A. Aorto-Pulmonary Window B. Total Anomalous Pulmonary Venous Return (TAPVR) C. Ebstein Anomaly D. Double Outlet Right Ventricle (DORV)
A

B. Total Anomalous Pulmonary Venous Return (TAPVR)

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32
Q
  1. Transposition of the Great Arteries (TGA) occurs due to which of the following embryological processes? A. Failure in neural crest migration B. Abnormal rightward bending of the heart tube C. Abnormal leftward bending of the heart tube D. Abnormal resorption of ventricular myocardium
A

C. Abnormal leftward bending of the heart tube

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33
Q
  1. Which congenital heart defect is commonly seen in patients with Down Syndrome due to abnormalities in the extracellular matrix and endocardial cushion fusion? A. Hypoplastic Left Heart Syndrome B. Atrioventricular Septal Defect (AVSD) C. Transposition of the Great Arteries (TGA) D. Muscular Ventricular Septal Defect (VSD)
A

B. Atrioventricular Septal Defect (AVSD)

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34
Q
  1. Newborns with cyanotic congenital heart disease typically present with: A. Central cyanosis B. Bradycardia C. Tachypnea without cyanosis D. Normal skin perfusion
A

A. Central cyanosis

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35
Q
  1. Respiratory distress in newborns with congenital heart disease is commonly due to: A. Decreased pulmonary blood flow B. Increased pulmonary blood flow and congestion C. Systemic hypoperfusion D. Left ventricular hypertrophy
A

B. Increased pulmonary blood flow and congestion

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36
Q
  1. A newborn with poor skin perfusion, pulmonary edema, and tachycardia is most likely presenting with which of the following? A. Central cyanosis B. Congestive heart failure C. Supraventricular tachycardia D. Cardiac murmur
A

B. Congestive heart failure

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37
Q
  1. Which of the following is TRUE regarding cardiac murmurs in congenital heart disease? A. Absence of a murmur rules out congenital heart disease. B. A systolic murmur in the left precordial area may indicate pulmonary stenosis. C. All cases of congenital heart disease present with a murmur. D. A murmur always indicates a ventricular septal defect.
A

B. A systolic murmur in the left precordial area may indicate pulmonary stenosis.

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38
Q
  1. A newborn with Patent Ductus Arteriosus (PDA) may present with: A. A diastolic murmur at birth B. A murmur at birth C. Absence of respiratory symptoms D. Bradycardia and normal oxygen saturation
A

B. A murmur at birth

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39
Q
  1. Congenital heart disease with signs of pulmonary edema, tachycardia, and frequent respiratory infections is most likely to be associated with: A. Central cyanosis B. Increased pulmonary blood flow C. Hypoplastic left heart syndrome D. Right-sided heart failure
A

B. Increased pulmonary blood flow

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40
Q
  1. Which of the following arrhythmias is commonly associated with congenital heart disease? A. Ventricular fibrillation B. Supraventricular tachycardia C. Atrial flutter D. Atrial fibrillation
A

B. Supraventricular tachycardia

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41
Q
  1. Absence of a cardiac murmur in a newborn: A. Excludes congenital heart disease B. Suggests the need for immediate surgery C. Does not rule out congenital heart disease D. Indicates a normal heart
A

C. Does not rule out congenital heart disease

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42
Q
  1. What is the recurrence rate of congenital heart disease (CHD) if there is one affected child in the family? A. 1% B. 3% C. 10% D. 20%
A

B. 3%

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43
Q
  1. A mother with diabetes mellitus (DM) is more likely to have a child with which congenital heart defects? A. Atrial Septal Defect (ASD) and Coarctation of the Aorta B. Ventricular Septal Defect (VSD) and Asymmetric Septal Hypertrophy C. Transposition of the Great Arteries (TGA) and Tetralogy of Fallot (TOF) D. Patent Ductus Arteriosus (PDA) and Tricuspid Atresia
A

B. Ventricular Septal Defect (VSD) and Asymmetric Septal Hypertrophy

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44
Q
  1. Maternal exposure to rubella in the first trimester is most commonly associated with which of the following congenital heart defects? A. Ventricular Septal Defect (VSD) B. Patent Ductus Arteriosus (PDA) and Peripheral Pulmonary Stenosis (PS) C. Atrial Septal Defect (ASD) D. Hypoplastic Left Heart Syndrome
A

B. Patent Ductus Arteriosus (PDA) and Peripheral Pulmonary Stenosis (PS)

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45
Q
  1. Maternal systemic lupus erythematosus (SLE) is associated with which congenital heart condition in the newborn? A. Ebstein’s Anomaly B. Heart Block C. Pulmonary Stenosis D. Aortic Stenosis
A

B. Heart Block

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46
Q
  1. What is the risk of congenital heart disease (CHD) if two first-degree relatives are affected? A. 2-6% B. 10-15% C. 20-30% D. 40-50%
A

C. 20-30%

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47
Q
  1. Maternal use of lithium during pregnancy is associated with which congenital heart defect? A. Atrial Septal Defect (ASD) B. Ebstein’s Anomaly C. Tetralogy of Fallot (TOF) D. Coarctation of the Aorta
A

B. Ebstein’s Anomaly

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48
Q
  1. Which maternal medical condition is associated with an increased risk of heart block in the newborn? A. Diabetes Mellitus B. Phenylketonuria (PKU) C. Systemic Lupus Erythematosus (SLE) D. Rubella exposure
A

C. Systemic Lupus Erythematosus (SLE)

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49
Q
  1. Maternal residence at high altitude is associated with an increased risk of which congenital heart defect? A. Ventricular Septal Defect (VSD) B. Patent Ductus Arteriosus (PDA) C. Aortic Stenosis D. Pulmonary Atresia
A

B. Patent Ductus Arteriosus (PDA)

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50
Q
  1. Anticonvulsant use during pregnancy is associated with an increased risk of which congenital heart defect? A. Ventricular Septal Defect (VSD) B. Atrial Septal Defect (ASD) C. Coarctation of the Aorta D. Transposition of the Great Arteries (TGA)
A

A. Ventricular Septal Defect (VSD)

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51
Q
  1. Which of the following is the most important vital sign to assess cyanosis in an infant with suspected congenital heart disease? A. Blood pressure B. Pulse rate C. Pulse oximetry D. Respiratory rate
A

C. Pulse oximetry

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52
Q
  1. A chest X-ray is useful in evaluating congenital heart disease by assessing which of the following? A. Electrolyte imbalances B. Heart murmurs C. Pulmonary vascular markings and heart enlargement D. Cardiac arrhythmias
A

C. Pulmonary vascular markings and heart enlargement

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53
Q
  1. In evaluating an infant with suspected congenital heart disease, an electrocardiogram (ECG) is primarily used to identify: A. Heart murmurs B. Cyanosis C. Ventricular enlargement D. Pulmonary vascular resistance
A

C. Ventricular enlargement

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54
Q
  1. What is the primary diagnostic tool used to evaluate congenital heart disease in infants? A. Cardiac catheterization B. Electrocardiogram (ECG) C. 2D-Echocardiography D. Chest X-ray
A

C. 2D-Echocardiography

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55
Q
  1. Cardiac catheterization or angiography is most often used in congenital heart disease to: A. Replace echocardiography as the first-line diagnostic test B. Evaluate complex congenital cyanotic heart defects C. Diagnose arrhythmias D. Measure blood pressure in the pulmonary arteries
A

B. Evaluate complex congenital cyanotic heart defects

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56
Q
  1. When is a treadmill exercise stress test indicated in patients with congenital heart disease? A. To assess cyanosis B. To evaluate premature ventricular contractions (PVCs) C. To diagnose heart murmurs D. To identify biventricular hypertrophy
A

B. To evaluate premature ventricular contractions (PVCs)

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57
Q
  1. Fetal echocardiography is particularly useful for: A. Detecting arrhythmias in newborns B. Early detection of fetal cardiac anomalies C. Identifying cyanosis in neonates D. Measuring pulmonary vascular resistance
A

B. Early detection of fetal cardiac anomalies

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58
Q
  1. Auscultation in the evaluation of congenital heart disease focuses on: A. Detecting cyanosis B. Evaluating heart sounds and murmurs C. Assessing pulse rate D. Measuring blood oxygen saturation
A

B. Evaluating heart sounds and murmurs

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59
Q
  1. What is the primary use of a chest X-ray in ruling out congenital heart disease (CHD)? A. Detecting cardiac murmurs B. Ruling out pulmonary parenchymal disease C. Evaluating arrhythmias D. Measuring blood pressure in the heart
A

B. Ruling out pulmonary parenchymal disease

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60
Q
  1. Decreased pulmonary blood flow seen on a chest X-ray is often associated with which congenital heart defect? A. Ventricular septal defect (VSD) B. Pulmonary stenosis or atresia C. Patent ductus arteriosus (PDA) D. Atrial septal defect (ASD)
A

B. Pulmonary stenosis or atresia

61
Q
  1. A Cardiothoracic (CT) ratio greater than what percentage is consistent with cardiomegaly on a chest X-ray? A. 50% B. 55% C. 60% D. 65%
A

D. 65%

62
Q
  1. Which of the following conditions is characterized by the cardiac apex being positioned on the right side of the chest? A. Dextrocardia B. Situs solitus C. Situs ambiguous D. Normal cardiac anatomy
A

A. Dextrocardia

63
Q
  1. On a chest X-ray, situs inversus is identified by which of the following findings? A. Cardiac apex on the left, stomach on the left, liver on the right B. Cardiac apex on the right, stomach on the right, liver on the left C. Cardiac apex on the left, liver on the left, stomach on the right D. Cardiac apex on the right, liver on the right, stomach on the left
A

B. Cardiac apex on the right, stomach on the right, liver on the left

64
Q
  1. In a child with CHD, the chest X-ray shows oligemic lungs. This finding suggests which of the following conditions? A. Increased pulmonary blood flow B. Pulmonary edema C. Decreased pulmonary blood flow D. Cardiomegaly
A

C. Decreased pulmonary blood flow

65
Q
  1. Which of the following is NOT typically evaluated using a chest X-ray in congenital heart disease? A. Pulmonary blood flow B. Ventricular enlargement C. Heart murmurs D. Cardiac position
A

C. Heart murmurs

66
Q
  1. On chest X-ray, left ventricular enlargement is suggestive of which condition? A. Pulmonary stenosis B. Patent ductus arteriosus (PDA) C. Pulmonary atresia D. Hypoplastic left heart syndrome
A

B. Patent ductus arteriosus (PDA)

67
Q
  1. Which of the following is a typical chest X-ray finding in congenital heart disease with increased pulmonary blood flow? A. Oligemic lungs B. Enlarged hilar vessels C. Decreased pulmonary vessels in the hilum D. Boot-shaped heart
A

B. Enlarged hilar vessels

68
Q
  1. In which of the following congenital heart defects would you expect to see increased vascularity on chest X-ray? A. Tetralogy of Fallot (TOF) B. Atrial Septal Defect (ASD) C. Pulmonary Stenosis D. Pulmonary Atresia
A

B. Atrial Septal Defect (ASD)

69
Q
  1. A chest X-ray shows a boot-shaped heart. This finding is most commonly associated with which congenital heart disease? A. Ventricular Septal Defect (VSD) B. Atrial Septal Defect (ASD) C. Tetralogy of Fallot (TOF) D. Patent Ductus Arteriosus (PDA)
A

C. Tetralogy of Fallot (TOF)

70
Q
  1. Which of the following is a characteristic chest X-ray finding in cases with decreased pulmonary blood flow? A. Enlarged vessels in the outer 1/3 of the lungs B. Dark-appearing lungs due to reduced vascularity C. Enlarged hilar vessels D. Normal pulmonary vascular markings
A

B. Dark-appearing lungs due to reduced vascularity

71
Q
  1. Which congenital heart disease is associated with increased vascularity on chest X-ray but is acyanotic? A. Tetralogy of Fallot (TOF) B. Pulmonary Atresia C. Ventricular Septal Defect (VSD) D. Pulmonary Stenosis
A

C. Ventricular Septal Defect (VSD)

72
Q
  1. What is the normal cardiothoracic (CT) ratio value on chest X-ray? A. 0.3 (30%) B. 0.5 (50%) C. 0.6 (60%) D. 0.65 (65%)
A

B. 0.5 (50%)

73
Q
  1. A chest X-ray shows an apex of the heart positioned on the right side. This finding is known as: A. Situs inversus B. Cardiomegaly C. Dextrocardia D. Pulmonary atresia
A

C. Dextrocardia

74
Q
  1. Which of the following is NOT a feature seen in Tetralogy of Fallot (TOF)? A. Pulmonary stenosis B. Right ventricular hypertrophy C. Atrial septal defect D. Large aorta overriding the VSD
A

C. Atrial septal defect

75
Q
  1. At what arterial oxygen saturation level does cyanosis typically become apparent in congenital heart disease (CHD)? A. 90%-92% B. 85%-88% C. 95%-97% D. 80%-82%
A

B. 85%-88%

76
Q
  1. Which of the following conditions is associated with central cyanosis and persistent pulmonary hypertension of the newborn? A. Meconium Aspiration Pneumonia B. Ventricular Septal Defect (VSD) C. Tetralogy of Fallot (TOF) D. Transposition of the Great Arteries (TGA)
A

A. Meconium Aspiration Pneumonia

77
Q
  1. In an infant with cyanosis, an oxygen challenge test (hyperoxia test) shows no improvement in oxygen saturation after administering oxygen. This finding suggests: A. A pulmonary cause of cyanosis B. A cardiac cause of cyanosis C. A neurologic cause of cyanosis D. A metabolic cause of cyanosis
A

B. A cardiac cause of cyanosis

78
Q
  1. Peripheral cyanosis is typically associated with: A. Arterial desaturation B. Normal oxygen saturation C. High cardiac output D. Severe metabolic acidosis
A

B. Normal oxygen saturation

79
Q
  1. A boot-shaped heart on chest X-ray is characteristic of which congenital heart disease? A. Transposition of the Great Arteries (TGA) B. Tetralogy of Fallot (TOF) C. Total Anomalous Pulmonary Venous Return (TAPVR) D. Atrial Septal Defect (ASD)
A

B. Tetralogy of Fallot (TOF)

80
Q
  1. Which of the following cyanotic congenital heart diseases presents with a ‘snowman heart’ appearance on chest X-ray? A. Tetralogy of Fallot (TOF) B. Total Anomalous Pulmonary Venous Return (TAPVR) - Supracardiac type C. Transposition of the Great Arteries (TGA) D. Patent Ductus Arteriosus (PDA)
A

B. Total Anomalous Pulmonary Venous Return (TAPVR) - Supracardiac type

81
Q
  1. The ‘egg on a string’ appearance on chest X-ray is associated with which congenital heart defect? A. Ventricular Septal Defect (VSD) B. Tetralogy of Fallot (TOF) C. Transposition of the Great Arteries (TGA) D. Total Anomalous Pulmonary Venous Return (TAPVR)
A

C. Transposition of the Great Arteries (TGA)

82
Q
  1. Which of the following statements is TRUE regarding central cyanosis? A. It is also known as acrocyanosis. B. It is caused by arterial desaturation. C. It results in cool extremities and bluish discoloration of the fingers. D. It has no association with congenital heart disease.
A

B. It is caused by arterial desaturation.

83
Q

Case 1: A 2-year-old boy is brought to the ER due to difficulty breathing and cyanosis. His respiratory rate is 45 breaths/min. On physical exam, he has increased work of breathing, but his heart size appears normal on the chest X-ray. An O₂ challenge test shows that his PO₂ improves to 160 mmHg. What is the most likely cause of this patient’s cyanosis? A) Cardiac cyanosis B) Pulmonary cyanosis C) Cyanotic congenital heart disease D) Non-cyanotic congenital heart disease

A

B) Pulmonary cyanosis

84
Q

Case 2: A 3-year-old child presents with cyanosis, a respiratory rate of 50 breaths/min, and mild difficulty breathing. The chest X-ray shows an abnormal heart shape and pulmonary edema. An O₂ challenge test results in PO₂ remaining < 150 mmHg. Which of the following is the most likely diagnosis? A) Bronchiolitis B) Congenital heart disease (cyanotic) C) Asthma exacerbation D) Cystic fibrosis

A

B) Congenital heart disease (cyanotic)

85
Q

Case 3: A 4-year-old child presents with cyanosis, tachypnea, and mild difficulty breathing. Blood gas analysis shows an elevated PCO₂ with signs of respiratory acidosis. The chest X-ray shows asymmetric infiltrates. An O₂ challenge test shows PO₂ > 150 mmHg. What is the primary physiological derangement in this child? A) Metabolic acidosis B) Respiratory acidosis C) Normal acid-base balance D) Metabolic alkalosis

A

B) Respiratory acidosis

86
Q

Case 4: A 6-year-old boy presents with cyanosis, minimal work of breathing, and tachypnea. Blood gas reveals low PCO₂ and metabolic acidosis. The chest X-ray shows an enlarged heart with increased pulmonary vascular markings. The PO₂ after the O₂ challenge test is < 150 mmHg. What is the most likely underlying cause of this patient’s cyanosis? A) Pulmonary infection B) Congenital heart disease (cyanotic) C) Acute asthma D) Bronchiolitis

A

B) Congenital heart disease (cyanotic)

87
Q
  1. The purpose of the hyperoxic test (oxygen challenge test) is to confirm which type of cyanosis? A. Peripheral cyanosis B. Metabolic cyanosis C. Central cyanosis D. Neurologic cyanosis
A

C. Central cyanosis

88
Q
  1. During the hyperoxic test, 100% oxygen is administered for how many minutes? A. 5 minutes B. 10 minutes C. 15 minutes D. 20 minutes
A

B. 10 minutes

89
Q
  1. In a patient with pulmonary disease, how does arterial PaO₂ typically respond during the hyperoxic test? A. Decreases to below 50 mmHg B. Remains unchanged C. Rises to >150 mmHg D. Rises to between 50-100 mmHg
A

C. Rises to >150 mmHg

90
Q
  1. In a patient with an intracardiac right-to-left shunt, what is the expected change in arterial PaO₂ during the hyperoxic test? A. PaO₂ exceeds 150 mmHg B. PaO₂ increases by 50 mmHg or more C. PaO₂ increases only by 10-30 mmHg or less D. PaO₂ remains unchanged
A

C. PaO₂ increases only by 10-30 mmHg or less

91
Q
  1. Which of the following findings during the hyperoxic test suggests a cardiac cause for cyanosis? A. Arterial PaO₂ rises significantly above 150 mmHg B. Arterial PaO₂ increases by 50-100 mmHg C. Arterial PaO₂ does not exceed 150 mmHg D. Arterial PaO₂ decreases below 50 mmHg
A

C. Arterial PaO₂ does not exceed 150 mmHg

92
Q
  1. What does an increase in arterial PaO₂ of less than 30 mmHg during the hyperoxic test indicate? A. Pulmonary disease B. Intracardiac right-to-left shunt C. Peripheral cyanosis D. Neurologic cause of cyanosis
A

B. Intracardiac right-to-left shunt

93
Q
  1. What is the primary diagnostic use of the hyperoxic test in congenital heart disease? A. To measure heart rate B. To differentiate cardiac from pulmonary causes of cyanosis C. To determine pulmonary blood flow D. To assess ventricular function
A

B. To differentiate cardiac from pulmonary causes of cyanosis

94
Q
  1. During the physical examination of a newborn with suspected congenital heart disease, diminished lower extremity pulses may indicate which condition? A. Ventricular Septal Defect (VSD) B. Coarctation of the Aorta (CoA) C. Patent Ductus Arteriosus (PDA) D. Tetralogy of Fallot (TOF)
A

B. Coarctation of the Aorta (CoA)

95
Q
  1. Bounding pulses are commonly seen in which of the following conditions? A. Coarctation of the Aorta (CoA) B. Patent Ductus Arteriosus (PDA) C. Tetralogy of Fallot (TOF) D. Atrial Septal Defect (ASD)
A

B. Patent Ductus Arteriosus (PDA)

96
Q
  1. Hepatomegaly on palpation during a physical exam in an infant suggests: A. Coarctation of the Aorta B. Tetralogy of Fallot C. Cardiac failure D. Normal heart function
A

C. Cardiac failure

97
Q
  1. A systolic blood pressure difference of more than 20 mmHg between the upper and lower extremities during a four extremity blood pressure check is suggestive of: A. Aortic arch anomalies B. Patent Ductus Arteriosus C. Atrial Septal Defect D. Ventricular Septal Defect
A

A. Aortic arch anomalies

98
Q
  1. Which of the following physical exam findings is associated with Coarctation of the Aorta (CoA)? A. Bounding upper extremity pulses and diminished lower extremity pulses B. Normal upper and lower extremity pulses C. Absent pulse in the upper extremities D. Hypertension in both upper and lower extremities
A

A. Bounding upper extremity pulses and diminished lower extremity pulses

99
Q
  1. The presence of a heave or thrill on palpation suggests: A. Hyperactive precordium B. Respiratory distress C. Normal heart function D. Abnormal cardiac impulse
A

D. Abnormal cardiac impulse

100
Q
  1. A hyperactive precordium on inspection is commonly associated with which of the following conditions? A. Respiratory failure B. Congenital heart disease C. Normal cardiac function D. Neurologic abnormalities
A

B. Congenital heart disease

101
Q
  1. A single or loud S2 heart sound during auscultation suggests: A. Pulmonary hypertension or aortic valve disease B. Atrial Septal Defect C. Patent Ductus Arteriosus D. Normal heart sounds
A

A. Pulmonary hypertension or aortic valve disease

102
Q
  1. The presence of a systolic murmur right after birth may indicate: A. Valvular stenosis or tricuspid/mitral regurgitation B. Ventricular Septal Defect C. Atrial Septal Defect D. Coarctation of the Aorta
A

A. Valvular stenosis or tricuspid/mitral regurgitation

103
Q
  1. In the evaluation of congenital heart disease, auscultation should focus on which heart sound to assess semilunar valve function? A. S1 B. S2 C. S3 D. S4
A

B. S2

104
Q
  1. The absence of a split in the second heart sound (S2) is indicative of which congenital heart defect? A. Atrial Septal Defect (ASD) B. Pulmonary Valve Atresia C. Patent Ductus Arteriosus (PDA) D. Ventricular Septal Defect (VSD)
A

B. Pulmonary Valve Atresia

105
Q
  1. Which of the following heart conditions is associated with a ‘single S2’ due to a malfunctioning or absent semilunar valve? A. Truncus Arteriosus B. Ventricular Septal Defect (VSD) C. Atrial Septal Defect (ASD) D. Coarctation of the Aorta (CoA)
A

A. Truncus Arteriosus

106
Q
  1. In which congenital heart disease is a ‘loud P2’ heart sound commonly heard due to pulmonary hypertension? A. Pulmonary Stenosis B. Atrial Septal Defect (ASD) C. Tetralogy of Fallot (TOF) D. Transposition of the Great Arteries (TGA)
A

B. Atrial Septal Defect (ASD)

107
Q
  1. A fixed wide split of S2 is a hallmark of which congenital heart defect in acyanotic babies? A. Atrial Septal Defect (ASD) B. Tetralogy of Fallot (TOF) C. Pulmonary Valve Atresia D. Patent Ductus Arteriosus (PDA)
A

A. Atrial Septal Defect (ASD)

108
Q
  1. Which of the following congenital heart defects is associated with a ‘fixed wide split S2’ in cyanotic infants? A. Truncus Arteriosus B. Transposition of the Great Arteries (TGA) C. Total Anomalous Pulmonary Venous Return (TAPVR) D. Coarctation of the Aorta
A

C. Total Anomalous Pulmonary Venous Return (TAPVR)

109
Q
  1. In Transposition of the Great Arteries (TGA), why is the aortic valve typically the only semilunar valve heard on auscultation? A. The pulmonary artery is stenotic. B. The aorta is positioned anteriorly and to the left of the pulmonary artery. C. The pulmonary valve is absent. D. The aorta is posterior to the pulmonary artery, blocking the sound.
A

B. The aorta is positioned anteriorly and to the left of the pulmonary artery.

110
Q
  1. A single S2 heart sound in Tetralogy of Fallot (TOF) is caused by which of the following? A. Pulmonary hypertension B. Absent or severely stenotic pulmonary valve C. Overriding aorta D. Aortic regurgitation
A

B. Absent or severely stenotic pulmonary valve

111
Q
  1. A holosystolic (pansystolic) murmur begins and ends during which part of the cardiac cycle? A. Starts after S1 and ends before S2 B. Begins with S1 and continues through S2 C. Occurs only during diastole D. Occurs only during systole
A

B. Begins with S1 and continues through S2

112
Q
  1. A systolic ejection murmur associated with pulmonary stenosis is most likely to radiate to which area? A. The neck B. The back C. The left lower sternal border D. The axilla
A

B. The back

113
Q
  1. In a patient with aortic stenosis, where would the systolic ejection murmur be best heard? A. Left lower sternal border B. Right intercostal space (ICS), radiating to the neck C. Left upper sternal border D. Apex of the heart
A

B. Right intercostal space (ICS), radiating to the neck

114
Q
  1. A continuous murmur that is heard during both systole and diastole is typically associated with which congenital heart defect? A. Ventricular Septal Defect (VSD) B. Aortic Stenosis C. Patent Ductus Arteriosus (PDA) D. Pulmonary Stenosis
A

C. Patent Ductus Arteriosus (PDA)

115
Q
  1. Which type of murmur is described as a machinery-like sound? A. Holosystolic murmur B. Continuous murmur of Patent Ductus Arteriosus (PDA) C. Diastolic murmur of Mitral Stenosis D. Systolic ejection murmur of Aortic Stenosis
A

B. Continuous murmur of Patent Ductus Arteriosus (PDA)

116
Q
  1. A diastolic murmur with a rumbling sound is typically associated with which condition? A. Mitral Stenosis B. Aortic Insufficiency C. Pulmonary Stenosis D. Ventricular Septal Defect
A

A. Mitral Stenosis

117
Q
  1. A diastolic blowing murmur is characteristic of which condition? A. Aortic Insufficiency B. Aortic Stenosis C. Pulmonary Stenosis D. Patent Ductus Arteriosus (PDA)
A

A. Aortic Insufficiency

118
Q
  1. Which of the following murmurs is often associated with rheumatic heart disease? A. Continuous murmur B. Diastolic rumble of Mitral Stenosis C. Holosystolic murmur D. Systolic ejection murmur
A

B. Diastolic rumble of Mitral Stenosis

119
Q
  1. Which of the following is a characteristic feature of an innocent murmur in children? A. High intensity and continuous B. Diastolic component present C. Low intensity and short systolic ejection D. Associated with structural heart defects
A

C. Low intensity and short systolic ejection

120
Q
  1. Innocent murmurs are typically graded as less than what grade? A. Grade 1 B. Grade 2 C. Grade 3 D. Grade 4
A

C. Grade 3

121
Q
  1. Which of the following conditions can accentuate an innocent murmur in children? A. Normal resting state B. Fever and anemia C. Pulmonary stenosis D. Ventricular septal defect (VSD)
A

B. Fever and anemia

122
Q
  1. Which of the following is an example of an innocent murmur characterized by a low-pitched vibratory systolic ejection sound? A. Pulmonary flow murmur B. Still’s murmur C. Venous hum D. Aortic stenosis
A

B. Still’s murmur

123
Q
  1. Which of the following murmurs typically disappears when the child is in a supine position and can be eliminated with digital compression of the jugular vein? A. Still’s murmur B. Pulmonary flow murmur C. Venous hum D. Aortic regurgitation
A

C. Venous hum

124
Q
  1. Still’s murmur is best heard in which position? A. Sitting B. Supine C. Standing D. Lying on the side
A

B. Supine

125
Q
  1. Which innocent murmur can be heard in newborns due to the acute take-off of the pulmonary artery and is best heard in the supine position? A. Still’s murmur B. Pulmonary flow murmur C. Venous hum D. Mitral stenosis
A

B. Pulmonary flow murmur

126
Q
  1. Which of the following is a distinguishing characteristic of Still’s murmur? A. It increases with Valsalva maneuver B. It decreases in the supine position C. It increases in the supine position and can increase with fever D. It is a continuous murmur that increases in the supine position
A

C. It increases in the supine position and can increase with fever

127
Q
  1. A holosystolic (pansystolic) murmur heard from S1 to S2 with constant intensity is most commonly associated with which congenital heart defect? A. Ventricular Septal Defect (VSD) B. Patent Ductus Arteriosus (PDA) C. Pulmonary Stenosis D. Aortic Stenosis
A

A. Ventricular Septal Defect (VSD)

128
Q
  1. A systolic ejection murmur with a crescendo-decrescendo (diamond-shaped) pattern is typically associated with which of the following conditions? A. Ventricular Septal Defect (VSD) B. Aortic Stenosis C. Patent Ductus Arteriosus (PDA) D. Mitral Regurgitation
A

B. Aortic Stenosis

129
Q
  1. Which of the following describes the characteristic murmur of Patent Ductus Arteriosus (PDA)? A. Holosystolic murmur B. Continuous machinery-like murmur C. Crescendo-decrescendo systolic murmur D. Diastolic murmur
A

B. Continuous machinery-like murmur

130
Q
  1. Where does the murmur of aortic stenosis typically radiate? A. The back and neck B. The apex of the heart C. The lower left sternal border D. The axilla
A

A. The back and neck

131
Q
  1. A crescendo-decrescendo systolic murmur is commonly associated with which two congenital heart defects? A. Ventricular Septal Defect and Patent Ductus Arteriosus B. Aortic Stenosis and Pulmonary Stenosis C. Mitral Regurgitation and Tricuspid Regurgitation D. Atrial Septal Defect and Patent Foramen Ovale
A

B. Aortic Stenosis and Pulmonary Stenosis

132
Q
  1. Which of the following murmurs is present throughout both systole and diastole? A. Holosystolic murmur B. Crescendo-decrescendo systolic murmur C. Continuous murmur D. Diastolic murmur
A

C. Continuous murmur

133
Q
  1. A pansystolic murmur that remains constant in intensity throughout systole is most characteristic of: A. Patent Ductus Arteriosus (PDA) B. Ventricular Septal Defect (VSD) C. Aortic Stenosis D. Pulmonary Stenosis
A

B. Ventricular Septal Defect (VSD)

134
Q
  1. In acyanotic congenital heart disease with a left-to-right shunt, blood flows from: A. Right side to left side B. Left side to right side C. Pulmonary circulation to systemic circulation D. Vena cava to the right ventricle
A

B. Left side to right side

135
Q
  1. Which of the following congenital heart defects results in a left-to-right shunt? A. Coarctation of the Aorta B. Pulmonary Stenosis C. Ventricular Septal Defect (VSD) D. Aortic Stenosis
A

C. Ventricular Septal Defect (VSD)

136
Q
  1. Left-to-right shunts in acyanotic congenital heart disease result in which of the following conditions? A. Volume overload of the right side B. Volume overload of the left side C. Pressure overload of the right side D. Pressure overload of the left side
A

A. Volume overload of the right side

137
Q
  1. Which of the following congenital heart defects is classified as acyanotic without a left-to-right shunt? A. Atrial Septal Defect (ASD) B. Patent Ductus Arteriosus (PDA) C. Pulmonary Stenosis D. Atrioventricular Septal Defect (AVSD)
A

C. Pulmonary Stenosis

138
Q
  1. In which of the following conditions is there a pressure overload in the heart due to an obstruction but no left-to-right shunt? A. Coarctation of the Aorta B. Atrial Septal Defect (ASD) C. Ventricular Septal Defect (VSD) D. Patent Ductus Arteriosus (PDA)
A

A. Coarctation of the Aorta

139
Q
  1. Which congenital heart defect results in volume overload due to a left-to-right shunt between the atria? A. Aortic Stenosis B. Atrial Septal Defect (ASD) C. Pulmonary Stenosis D. Coarctation of the Aorta
A

B. Atrial Septal Defect (ASD)

140
Q
  1. Obstructive lesions without a left-to-right shunt, such as aortic stenosis, result in: A. Volume overload B. Cyanosis C. Pressure overload D. Low pulmonary pressure
A

C. Pressure overload

141
Q
  1. Which of the following is NOT an example of a congenital heart defect causing a left-to-right shunt? A. Patent Ductus Arteriosus (PDA) B. Atrial Septal Defect (ASD) C. Aortic Stenosis D. Ventricular Septal Defect (VSD)
A

C. Aortic Stenosis

142
Q
  1. In acyanotic congenital heart disease, left-to-right shunts occur because of an abnormal communication between which two areas of the heart? A. Low-pressure left side and high-pressure right side B. High-pressure left side and low-pressure right side C. Low-pressure systemic circulation and high-pressure pulmonary circulation D. Right atrium and left ventricle
A

B. High-pressure left side and low-pressure right side

143
Q
  1. Chronic volume overload in left-to-right shunt congenital heart disease leads to which of the following consequences? A. Cyanosis B. Left or right chamber dilatation or hypertrophy C. Pressure overload D. Low pulmonary blood flow
A

B. Left or right chamber dilatation or hypertrophy

144
Q
  1. What type of murmur is typically heard in pediatric patients with a left-to-right shunt due to increased turbulence of blood flow? A. Diastolic murmur B. Pansystolic murmur C. Continuous machinery-like murmur D. Mid-systolic ejection murmur
A

B. Pansystolic murmur

145
Q
  1. Excessive blood flow to the lungs in patients with left-to-right shunt results in which of the following clinical symptoms? A. Cyanosis B. Tachypnea and shortness of breath C. Low pulmonary vascularity on chest X-ray D. Bradycardia
A

B. Tachypnea and shortness of breath

146
Q
  1. Increased pulmonary hypercirculation in acyanotic congenital heart disease often leads to which radiologic finding? A. Decreased pulmonary vascularity B. Normal chest X-ray C. Increased pulmonary vascularity D. Enlarged heart with absent lung markings
A

C. Increased pulmonary vascularity

147
Q
  1. In a patient with a ventricular septal defect (VSD), chronic volume overload typically results in which form of hypertrophy? A. Right ventricular hypertrophy (RVH) B. Left ventricular hypertrophy (LVH) C. Left atrial hypertrophy (LAH) D. Right atrial hypertrophy (RAH)
A

B. Left ventricular hypertrophy (LVH)

148
Q
  1. Atrial septal defects (ASD) in left-to-right shunt congenital heart disease typically result in which form of cardiac hypertrophy? A. Left ventricular hypertrophy (LVH) B. Left atrial hypertrophy (LAH) C. Right ventricular hypertrophy (RVH) D. Right atrial hypertrophy (RAH)
A

C. Right ventricular hypertrophy (RVH)

149
Q
  1. Which of the following is a typical symptom of pulmonary hypercirculation in left-to-right shunt CHD? A. Cyanosis B. Poor feeding and easy fatigability C. Bradycardia D. Peripheral edema
A

B. Poor feeding and easy fatigability

0 - PEDIA2 (5 decks)

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