Pathology: Congenital disease Test 3

Question 1

What is the arrow pointing to and what is the name of this disease?

Answer 1

Atrial septal defect

Question 2

What is this picture showing? What disease is this associated with?

Answer 2

A hole in the atrial septal wall

ASD

Question 3

What is this picture showing? What disease is this associated with?

Answer 3

A hole in the atrial septal wall

ASD

Question 4

What is this picture showing? What is this called?

Answer 4

Paradoxical embolus

This occurs when an embolism formed in the venous system gets lodged within the setal defect

Note: if the embolism was smaller, it would affect the systemic circulation

Question 5

What is this picture showing? What disease is it associated with?

Answer 5

A hole in the ventricular septum

VSD

Question 6

What is this picture showing? What disease is it associated with?

Answer 6

A hole in the ventricular septum

VSD

Question 7

What is this picture showing? What disease is it associated with?

Answer 7

A hole in the ventricular septum

VSD

Question 8

What is this picture showing? What disease is it associated with?

Answer 8

A hole in the ventricular septum

VSD

Question 9

Surgical correction of VSDs in babies is often delayed beyond infancy. When would you NOT want to delay the surgery in an infant? And why?

Answer 9

If you have a really big VSD with L to R shunt, this can cause pulmonary hypertension, eventually leading to Eisenmenger’s Syndrome

Question 10

Which way is blood flowing through the Ductus Arteriosus in utero?
After birth?

Answer 10

In utero, blood flows from the pulmonary trunk to the aorts

At birth, blood flows from the aorta to the pulmonary trunk

Question 11

What is this image showing? (disease)

Answer 11

Patent ductus arteriosus

Question 12

Name the unidentified labels. What disease is this?

Answer 12

Patent Ductus Arteriosus

Question 13

What’s going on here?

Answer 13

Patent Ductus Arteriosus

Question 14

What is this? Are men or women more likely to get this? What other genetic disease can this occur in?

Answer 14

Aortic coarctation

Men are more likely to get the disease

Turner syndrome

Question 15

Aortic coarctation can be with a Patent Ductus Arteriosus (PDA). Would this patient present any differently than if did not have a PDA?

Answer 15

Right to left shunt to the body with cyanosis to lower limbs (left)

Without PDA all limbs will receive oxygenated blood

Question 16

What is thei CXR showing?

Answer 16

Tetralogy of Fallot

RV hypertrophy leads to a “boot-shaped heart”

Question 17

What is this picture showing?

Answer 17

Transposition of the great arteries

Question 18

What are the 5 Right to Left shunt diseases

Answer 18

• Tetralogy of Fallot
• Transposition of Great Arteries
• Tricuspid Atresia
• Persistent Truncus Arteriosus
• Total anomalous venous return

Question 19

A 2 year old girl has growth and developmental delay. She has had several past episodes when she would suddenly have trouble breathing, become blue, and assume a squatting position to catch her breath. Workup finds a defect in the ventricular wall septum, increased thickness of the right ventricular wall, and dextroposition of the aorta. Which of the following abnormalities is most likely to also be present?

A.Coarctation of the aorta

B.Incompetent mitral valve

C.Patent foramen ovale

D.Persistent AV canal

E.Stenosis of pulmonic valve

Answer 19

E.Stenosis of the pulmonic valve?

Question 20

A 2 year old asymptomatic girl is discovered to have a soft systolic murmur with a systolic thrill. No cyanosis is present and her peripheral pulses are normal. An ECG reveals slight left ventricular hypertrophy. Which is the most likely diagnosis?

A.Coarctation of the aorta

B.Patent Ductus Arteriosus

C.Persistent Truncus arteriosus

D.Tetralogy of Fallot

E.VSD

Answer 20

A.Coarctation of the aorta?

Question 21

Prior to surgery, which of the following is the best medical therapy for a newborn infant born with transposition of the pulmonary artery and aorta?

A.Give prostaglandin E2 to keep the ductus arteriosus open

B.Given prostaglandin F2 to keep the ductus arteriosus open

C.Given oxygen to keep the ductus arteriosus open

D.Given indomethacin to keep the ductus arteriosus open

E.Give indomethacin to close the ductus arteriosus

Answer 21

A.Give prostaglandin E2 to keep the ductus arteriosus open

Question 22

Which of the following statements correctly describes the flow of blood in a patient with an ASD that develops Eisenmenger syndrome?

A.Left atrium to right atrium to right ventricle to lungs to left atrium

B.Left ventricle to right ventricle to lungs to left atrium to right ventricle

C.Right atrium to left atrium to left ventricle to aorta to right atrium

D.Right ventricle to left ventricle to aorta to right atrium to right ventricle

Answer 22

A.Right atrium to left atrium to left ventricle to aorta to right atrium