Module 11 - Cardiovascular Flashcards
What cardiac defect can be found in females with primary amenorrhea without secondary sex characteristics but a present uterus?
A. Tetralogy of Fallot
B. Ventricular septal defect
C. Pulmonary valve stenosis
D. Coarctation of the aorta
D. Coarctation of the aorta
- Turner syndrome presents as primary amenorrhea without secondary sex characteristics, but patients have a uterus.
- Turner syndrome is frequently complicated by coarctation of the aorta
A 3-year-old male child is brought to the outpatient department to evaluate shortness of breath for the past month. The parents report that the child frequently stops while playing, then squats, and refuses to walk further. Which of the following findings would be most likely evident on the examination?
A. A loud systolic murmur, a history of fainting, and clubbing of the fingers
B. Bradycardia, a faint systolic murmur, weak pulses
C. A faint systolic murmur, tachycardia, and a history of fainting
D. Bradycardia, weak or absent pulses, and clubbing of the fingers
A. A loud systolic murmur, a history of fainting, and clubbing of the fingers
TOF
A 3-month-old infant presents to the clinic for a well-child visit. On examination, the child had a bluish discoloration of the skin and the mucous membranes and also had poor weight gain since his last visit. Which of the following could be the most likely diagnosis?
A. Patent ductus arteriosus
B. Coarctation of aorta
C. Patent foramen ovale
D. Tetralogy of Fallot
D. Tetralogy of Fallot
A 26-year-old primigravida gives birth at 39 weeks of gestation. The neonate has an APGAR score of 7 at 1 minute and 10 at 5 minutes of life. On examination, there is the presence of a harsh holosystolic murmur heard at the left sternal border. If the patient’s condition is left untreated, what is the likely complication to occur?
A. High-output cardiac failure due to collaterals
B. Eisenmenger syndrome
C. Infective endocarditis
D. Paradoxical embolus
B. Eisenmenger syndrome
- When the pressure in the pulmonary circulation exceeds the pressure in the systemic circulation, the shunt direction reverses and becomes a right-to-left shunt. This is known as Eisenmenger syndrome.
Reyes syndrome, risks
Giving Asa
Causes encephalopathy
followed by fatty degenerative liver failure
A 1-month-old is brought by his parents with shortness of breath, failure to thrive, and a mild fever. The baby was born at 34 weeks of gestation after a cesarean section. On heart auscultation, a machine-like murmur below the clavicle radiating to the back is heard. There is tachycardia. The infant is now noted to have a hoarse cry. Which of the following drugs should be prescribed for this patient’s underlying pathology?
Propranolol Latanoprost Alprostadil Indomethacin
Indomethacin
PDA
MACHINE MURMUR
INFRACLAVICULAR
A newborn infant delivered at term is being examined following delivery. The mother reports an uncomplicated pregnancy. On physical exam, auscultation reveals a continuous, machine-like murmur heard best at the left infraclavicular area. No evidence of any other cardiac defect is found. What is the most appropriate treatment for this infant?
Acetaminophen Indomethacin Ibuprofen Surgical correction
Indomethacin
PDA
MACHINE MURMUR
INFRACLAVICULAR
A 1-month-old premature female was brought to the clinic with the complaint of persistent shortness of breath and poor weight gain. A diagnosis of patent ductus arteriosus was made. Which of the following is true regarding this condition?
a. It is cyanotic heart disease.
b. It is acyanotic heart disease.
c. It always requires surgical repair.
d. It is a connection between the right and left ventricles.
b. It is acyanotic heart disease.
An 8-year-old female child presented for routine evaluation. On physical examination, the patient was found to have a pan-systolic murmur at the lower end of the left sternum. The patient has no significant history of syncope or hemodynamic instability during childhood. Her developmental milestones are in the normal range. The rest of the physical examination is unremarkable. What advice should be given to the patient and parents regarding her participation in sports activity?
The child should avoid isometric exercises
The child can be involved in any sport without concern
The child should avoid swimming due to the risk of syncope
The child should avoid competitive running but other sports are acceptable
The child can be involved in any sport without concern
VSD
PAN/HOLO SYSTOLIC MURMUR
LOWER END OF STERNUM
A newborn baby is evaluated in the newborn nursery immediately post-birth. The baby appears well, with APGAR scores of 9 and 9 at one and five minutes, respectively. On cardiac auscultation, there is a grade II/VI holo-systolic murmur heard best in the left lower sternal border. It is later found on echocardiogram that the baby has a large ventricular septal defect. In what direction will the blood flow through this aberrant opening initially?
Right ventricle to left ventricle
Left ventricle to right ventricle
Right atria to right ventricle
Right atria to left atria
VSD
LEFT TO RIGHT VENTRICLE
A 6-year-old female presents to establish care. She is asymptomatic, meeting all of her milestones, and is up-to-date on her vaccines. Upon physical examination, a holosystolic murmur is auscultated at the left lower sternal border. What cardiac defect does she most likely have?
Atrial septal defect
Ventricular septal defect
Tetrology of Fallot
Patent ductus arteriosus
VSD
VSD SHUNT FLOW DIRECTION
LEFT TO RIGHT VENTRICLE
A 4-year-old boy is brought to the clinic for episodes of “fainting” per the parents. The patient has recently immigrated to the country. According to the parental history, this patient has had episodes where he turns “blue,” but the “fainting” has begun the past several weeks. On further investigation, the patient has also had a history of bluish discoloration when he becomes upset and has developed a method of squatting until the episode has improved. On auscultation, there is a III/VI systolic ejection murmur, and the patient’s nails are clubbed. On pulse oximetry, the patient’s oxygen saturation is 85% on room air. A chest radiograph shows oligemic lung fields and a cardiac silhouette that looks like a boot. Which of the following sets of defects is most likely to be present in this patient?
A. Hypoplastic tricuspid valve, right ventricular hypoplasia, atrial septal defect, hypoplastic pulmonary valve
B. Mitral valve stenosis, aortic valve stenosis, mild left ventricular hypoplasia, discrete coarctation of aorta
C. Right ventricular hypertrophy, overriding aorta, right ventricular outflow tract obstruction, ventricular septal defect
D. Aortic valve stenosis, aortic hypoplasia, mitral valve hypoplasia, left ventricular hypoplasia
C. Right ventricular hypertrophy, overriding aorta, right ventricular outflow tract obstruction, ventricular septal defect
TOF
BOOT
SQUAT
A male neonate is noted to be profoundly cyanotic shortly after delivery. An echocardiogram reveals that the patient has transposition of the great arteries. Prostaglandin E (PGE) is started. However, the patient continues to have oxygen saturations in the 50’s and is intubated without improvement. Which of the following is the next best step in the management of this patient?
A. Administration of inhaled nitric oxide
B. Balloon atrial septostomy
C. Emergent repair of great arteries
D. Stopping PGE
B. Balloon atrial septostomy
A 6-month-old child is brought to the outpatient department with complaints of poor weight gain. The child has a palpable thrill and a prominent anterior chest on examination. What is the most likely diagnosis in this child?
A. Atrial septal defect
B. Ventricular septal defect
C. Aortic stenosis
D. Pulmonic stenosis
B. Ventricular septal defect
