[MS] Cardiology

Question 1

What pathology is indicated with a persistent, widely split S2 heart sound?

Answer 1

ASD, RBBB, or pulmonic stenosis

Question 2

What pathology is indicated with a paradoxically split S2 heart sound?

Answer 2

Severe aortic stenosis or LBBB

Question 3

What heart sound is almost always abnormal?

Answer 3

S4

Question 4

What kinds of heart murmurs increase with the Valsalva maneuver?

Answer 4

Hypertrophic cardiomyopathy or obstructive left-sided heart lesions

Question 5

What is the calculation for heart rate from the ECG?

Answer 5

1500 / RR interval

Question 6

What syndrome is associated with a prolonged QT interval, syncope, and hearing loss?

Answer 6

Jervell and Lange-Nielsen syndrome

Question 7

What electrolyte abnormalities cause a prolonged QT interval?

Answer 7

Hypocalcemia
Hypomagnesemia
Hypokalemia

Question 8

What are the electrocardiographic findings associated with Brugada syndrome?

Answer 8

RV conduction delay

ST elevation in leads V1 to V3

Question 9

What electrolyte abnormality can cause a shortened QT interval?

Answer 9

Hypercalcemia

Question 10

What is the most common cause of pediatric cardiac chest pain?

Answer 10

Pericarditis

Question 11

What disease causes elevated ST segments in all ECG leads?

Answer 11

Pericarditis

Question 12

What is the normal duration of the QRS interval?

Answer 12

Less than 120ms

Question 13

What are the electrocardiographic findings associated with Mobitz I (Wenckebach phenomenon)?

Answer 13

Progressive prolonging of the PR interval until there is a drop in the QRS

Question 14

What is the classic ECG finding associated with a right bundle branch block?

Answer 14

“Rabbit ears” of lead V1

Question 15

What types of children typically develop sick sinus syndrome?

Answer 15

Those that underwent atrial surgery such as ASD closure or Fontan procedure

Question 16

What drug can precipitate heart failure in patients with atrial flutter?

Answer 16

Verapamil

Question 17

What is the treatment for patients with unstable supraventricular tachycardia?

Answer 17

DC Cardioversion

Question 18

What is the treatment for patients in atrial flutter/fibrillation who have known Wolff-Parkinson-White syndrome?

Answer 18

IV Procainamide

Question 19

What is the preferred treatment for stable patients with ventricular tachycardia?

Answer 19

Amiodarone

Question 20

What is a known side effect of Procainamide?

Answer 20

Drug-induced Lupus

Question 21

What electrolyte disturbances typically exacerbate Digoxin toxicities?

Answer 21

Low potassium

High calcium

Question 22

What is the most common congenital heart lesion?

Answer 22

VSD`

Question 23

What congenital heart lesion is associated with Lithium?

Answer 23

Ebstein’s anomaly

Question 24

What genetic diseases are classically associated with pulmonic stenosis?

Answer 24

Noonan syndrome, Alagille syndrome

Question 25

What genetic diseases are classically associated with a VSD?

Answer 25

Apert syndrome, Cri-du-chat syndrome, Trisomy 18, Trisomy 13

Question 26

What is a primary indication for closure of a VSD?

Answer 26

If shunts result in twice the normal amount of pulmonary blood flow

Question 27

What is an important sequelae of long-term, unrepaired atrial septal defects?

Answer 27

Eisenmenger syndrome

Question 28

What is the most common congenital heart lesion of Trisomy 21?

Answer 28

Endocardial cushion defect

Question 29

What is the most common cause of mitral regurgitation, both worldwide and in the US?

Answer 29

Worldwide - Rheumatic Fever | US - Mitral Valve Prolapse

Question 30

What medications act as cardiac afterload reducers?

Answer 30

ACE Inhibitors | Hydralazine

Question 31

What positions can increase the murmur heard with mitral valve prolapse?

Answer 31

Sitting or Standing

Question 32

What is the second most common of the congenital cardiac defects?

Answer 32

Pulmonic stenosis

Question 33

What is a critical indication to start PGE1 therapy in neonates?

Answer 33

Critical pulmonary stenosis

Question 34

What is the cause of the majority of cases of congenital aortic stenosis?

Answer 34

Bicuspid aortic valve

Question 35

What is the next step to perform if a child with known aortic stenosis presents with syncope?

Answer 35

Cardiac catheterization, balloon angioplasty, or surgery

Question 36

What happens to the murmur of aortic stenosis when children squat?

Answer 36

The sound with increase, which is opposite of what happens with hypertrophic cardiomyopathy

Question 37

What syndrome is associated with isolated supravalvular aortic stenosis?

Answer 37

Williams syndrome

Question 38

What syndrome is associated with true interruption of the aortic arch?

Answer 38

DiGeorge syndrome -- use FISH analysis to look for 22q11 mutation

Question 39

What are major complications that children with unrepaired Tetralogy of Fallot experience?

Answer 39

Brain abscesses Cerebral Thrombosis Infective Endocarditis

Question 40

What antenatal medication is typically used in infants with Tetralogy of Fallot?

Answer 40

Prostaglandin E1

Question 41

By what age should patient's with Tetralogy of Fallot receive correction?

Answer 41

6 to 12 months, if not earlier

Question 42

What congenital heart defects present with a left axis deviation?

Answer 42

Ostium Primum ASD Complete AV Canal Tricuspid Atresia

Question 43

What form of TAPVR is associated with more severe pulmonary edema and cyanosis?

Answer 43

Subdiaphragmatic form

Question 44

What congenital heart lesion is associated with a "figure 8" or a "snowman" on chest x-ray?

Answer 44

TAPVR

Question 45

What is Beck's triad and what is it associated with?

Answer 45

Increased jugular venous pressure with inspiration, dropping systolic blood pressures, and muffled heart sounds, all associated with Cardiac Tamponade

Question 46

What medications are inotropic agents?

Answer 46

Dopamine, Dobutamine, Epinephrine, Milrinone, and Digoxin

Question 47

What are the symptoms of acute digoxin toxicity?

Answer 47

Nausea, vomiting, diarrhea, color-vision change, confusion, vertigo, and arrhythmias

Question 48

What complication is associated with loop diuretic use in premature infants?

Answer 48

Nephrocalcinosis

Question 49

What is a rare side effect of Spironolactone use?

Answer 49

Gynecomastia

Question 50

What concerning diagnosis is associated with a sharp, "tearing" chest pain in patients with Marfan's or Ehlers-Danlos syndromes?

Answer 50

Aortic Dissection