Question 1

A 1-month-old infant was diagnosed with truncus arteriosus with a ventricular septal defect. Which of the following would also be expected?&#10;A) Hypertrophy of the aorta and major arteries&#10;B) Transposition of the aorta and the pulmonary trunk&#10;C) The aorta returning blood to the right atrium&#10;D) Blood from both ventricles mixing in a common vessel

Accepted Answer

Truncus arteriosus with a ventricular septal defect results in blood from both ventricles mixing in a common vessel, as the truncus arteriosus fails to divide into the aorta and pulmonary trunk, leading to a single vessel that receives blood from both ventricles. Hypertrophy of the aorta and major arteries may occur in response to increased blood flow, but it is not necessary. Transposition of the aorta and pulmonary trunk or the aorta returning blood to the right atrium are not expected with this condition.

Question 2

A newborn experiences frequent periods of cyanosis, usually occurring during crying or after feeding. Which of the following is the most likely diagnosis?&#10;A) Atrioventricular canal defect&#10;B) Ventricular septal defect&#10;C) Tetralogy of Fallot&#10;D) Atrial septal defect

Accepted Answer

Tetralogy of Fallot is a congenital heart defect that consists of four abnormalities: pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy, and overriding aorta. These abnormalities lead to decreased blood flow to the lungs and decreased oxygenation of the blood, which causes cyanosis. The cyanotic spells are often triggered by crying, feeding, or agitation because these activities increase the body's oxygen demand. Atrioventricular canal defect, ventricular septal defect, and atrial septal defect can also cause cyanosis, but they usually do not have a clear trigger like the cyanotic spells seen in tetralogy of Fallot.

Question 3

A newborn child experiences hypoxia and cyanosis. The most likely diagnosis is a congenital heart defect causing a(n) _____ shunt.&#10;A) right-to-left&#10;B) left-to-right&#10;C) ductus venosus&#10;D) umbilical

Accepted Answer

Hypoxia and cyanosis suggest inadequate oxygenation of the blood. A right-to-left shunt would allow deoxygenated blood to bypass the lungs and enter the systemic circulation, causing hypoxia and cyanosis. Left-to-right shunts, on the other hand, allow oxygenated blood to bypass the pulmonary circulation and return to the lungs, which does not cause hypoxia and cyanosis. The ductus venosus and umbilical shunts are important in fetal circulation but are not relevant to the diagnosis of a congenital heart defect in a newborn.

Question 4

Which of the following statements best describes total anomalous pulmonary venous connection?&#10;A) The foramen ovale closes after birth.&#10;B) Pulmonary venous return is to the right atrium.&#10;C) Pulmonary venous return is to the left atrium.&#10;D) The foramen ovale does not close.

Accepted Answer

In total anomalous pulmonary venous connection, the pulmonary veins do not connect normally to the left atrium but instead drain into the right atrium or systemic venous circulation, leading to mixing of oxygenated and deoxygenated blood.

Question 5

The patent opening between the aorta and pulmonary artery in a fetus is called the:&#10;A) foramen ovale.&#10;B) ductus venosus.&#10;C) ductus arteriosus.&#10;D) foramen magnum.

Accepted Answer

The patent opening between the aorta and pulmonary artery in a fetus is called the ductus arteriosus. The foramen ovale is a different opening between the right and left atria, while the ductus venosus is an opening between the umbilical vein and the inferior vena cava. The foramen magnum is a large opening at the base of the skull.

Question 6

A newborn child has a murmur and cyanosis. An echocardiogram reveals that the tricuspid valve failed to develop and no blood flows between the right atrium and ventricle. This condition is referred to as tricuspid:

A) regurgitation.
B) stenosis.
C) atresia.
D) transposition.

Accepted Answer

The condition described is tricuspid atresia, which occurs when the tricuspid valve fails to develop, leading to an absence of blood flow between the right atrium and ventricle. Tricuspid regurgitation refers to a leaky tricuspid valve, tricuspid stenosis refers to a narrowed tricuspid valve, and transposition refers to a condition where the positions of the pulmonary artery and aorta are switched.

Question 7

A 1-month-old infant visits his physician for a well-baby check. Physical exam reveals decreased cardiac output, hypotension, tachycardia, and a loud murmur suggestive of aortic stenosis. Which of the following would be expected with this diagnosis?

A) Ventricular dilation
B) Ventricular hypertrophy
C) Atrial rigidity
D) Decreased contractility

Accepted Answer

Aortic stenosis leads to increased resistance to blood flow from the left ventricle to the aorta. This results in increased pressure within the left ventricle, causing the muscle to hypertrophy in order to pump blood past the narrowed valve.

Question 8

A newborn is suspected of having coarctation of the aorta. Which of the following assessments would aid in diagnosis?&#10;A) Cyanosis&#10;B) Bounding pedal pulses&#10;C) Cool arms&#10;D) Weak or absent femoral pulses

Accepted Answer

Weak or absent femoral pulses are a classic sign of coarctation of the aorta in newborns. This occurs because the narrowed portion of the aorta is located near the insertion of the ductus arteriosus, which connects the pulmonary artery to the descending aorta. If the coarctation is severe enough, blood flow to the lower body may be compromised, leading to weak or absent femoral pulses. Cyanosis, bounding pedal pulses, and cool arms are not specific findings for coarctation of the aorta.

Question 9

A newborn baby is severely cyanotic. An echocardiogram reveals transposition of the great arteries. Which of the following occurs with this defect?&#10;A) The pulmonary artery leaves the right ventricle&#10;B) The aorta leaves the right ventricle&#10;C) Ventricular septal defect&#10;D) Atrial septal defect

Accepted Answer

Transposition of the great arteries occurs when the aorta leaves the right ventricle and the pulmonary artery leaves the left ventricle, leading to a lack of oxygenated blood reaching the body. This is incompatible with life unless there is an associated defect that allows for mixing of oxygenated and deoxygenated blood, such as a ventricular septal defect or atrial septal defect.

Question 10

A 2-week-old infant presents with poor feeding, fatigue, dyspnea, and a murmur. She is diagnosed with a patent ductus arteriosus. This condition results in a(n):&#10;A) decreased pulmonary blood flow.&#10;B) right-to-left shunt.&#10;C) left-to-right shunt.&#10;D) increased systemic blood flow.

Accepted Answer

Patent ductus arteriosus (PDA) is a condition where the ductus arteriosus, a fetal blood vessel that normally closes shortly after birth, remains open. This results in a left-to-right shunt of blood from the aorta to the pulmonary artery, leading to increased pulmonary blood flow, which can cause symptoms such as dyspnea, poor feeding, and fatigue. The murmur is caused by increased blood flow through the PDA. The shunt does not cause a right-to-left or decreased pulmonary blood flow, nor does it directly increase systemic blood flow.

Question 11

A newborn is diagnosed with pulmonary stenosis. Which of the following intrauterine factors could have caused this defect?&#10;A) Diabetes&#10;B) Alcohol exposure&#10;C) Infection&#10;D) Dextroamphetamine

Accepted Answer

The answer of A newborn is diagnosed with pulmonary stenosis....

Question 12

A newborn develops a murmur and cyanosis shortly after birth. She is diagnosed with pulmonary stenosis after an echocardiogram revealed narrowing of the:&#10;A) mitral valve.&#10;B) pulmonary artery.&#10;C) pulmonary valve orifice.&#10;D) pulmonary vein.

Accepted Answer

The answer of A newborn develops a murmur and cyanosis...

Question 13

An infant undergoes an echocardiogram for a suspected heart defect. Tests reveal an opening in the middle of the atrial septum. This defect is referred to as:&#10;A) ostium primum atrial septal defect.&#10;B) ostium secundum atrial septal defect.&#10;C) sinus venosus atrial septal defect.&#10;D) Eisenmenger syndrome.

Accepted Answer

The answer of An infant undergoes an echocardiogram for a...

Question 14

The most common type of congenital heart defect is:&#10;A) atrial septal defect.&#10;B) ventricular septal defect.&#10;C) tetralogy of Fallot.&#10;D) atrioventricular canal defect.

Accepted Answer

The answer of The most common type of congenital heart...

Question 15

An 8-week-old infant presents to his pediatrician for a well-baby checkup. Physical exam reveals a murmur and an echocardiogram confirms a ventricular septal defect. Which of the following genetic factors would most likely accompany this diagnosis?

A) Huntington disease
B) Color blindness
C) Down syndrome
D) Hemophilia

Accepted Answer

The answer of An 8-week-old infant presents to his pediatrician...

Question 16

An 8-week-old infant presents to her physician for a well-baby check. Physical exam reveals a murmur, and an echocardiogram shows a large ventricular septal defect. Left untreated, this defect will result in:

A) pulmonary hypertension.
B) cyanosis.
C) dysrhythmias.
D) valve damage.

Accepted Answer

The answer of An 8-week-old infant presents to her physician...

Question 17

A 40-year-old pregnant woman is concerned about the health of her unborn child. She has phenylketonuria (PKU) and recently had a viral infection. If the child is born with a congential heart defect, which of the following is the most likely based on the mother's history?

A) Coarctation of aorta
B) Pulmonic stenosis
C) Ventricular septal defect
D) Patent ductus arteriosus

Accepted Answer

The answer of A 40-year-old pregnant woman is concerned about...

Question 18

A newborn child is diagnosed with Trisomy 18. Which of the following congenital heart defects will she most likely have?&#10;A) Atrial septal defect&#10;B) Coarctation of the aorta&#10;C) Atrioventricular canal defect&#10;D) Ventricular septal defect

Accepted Answer

The answer of A newborn child is diagnosed with Trisomy...

Question 19

Coarctation of the aorta is the local narrowing of the aorta near the:&#10;A) aortic valve.&#10;B) ductus arteriosus.&#10;C) diaphragm.&#10;D) bifurcation into the common iliac arteries.

Accepted Answer

The answer of Coarctation of the aorta is the local...

Question 20

A 22-year-old pregnant woman presents to her OB/GYN for a prenatal checkup. The heartbeat sounds irregular, and a fetal echocardiogram reveals an atrioventricular canal defect. This defect is characterized by:

A) the failure of the ductus arteriosus to close.
B) fusion of the endocardial cushions.
C) blood flow between all four heart chambers.
D) right-to-left shunt.

Accepted Answer

The answer of A 22-year-old pregnant woman presents to her...

Question 21

A 5-year-old female is found to have hypertension during three separate visits to her physician. Lab tests reveal that the hypertension is secondary to:&#10;A) renal disease.&#10;B) brain tumor.&#10;C) hypocalcemia.&#10;D) hyponatremia.

Accepted Answer

The answer of A 5-year-old female is found to have...

Question 22

A 22-year-old pregnant female presents for a fetal echocardiogram. Tests reveal small left atrium and mitral valve and an absent left ventricle and aortic valve. This defect is:&#10;A) an indication for neonatal heart transplant.&#10;B) rarely fatal.&#10;C) easily repaired.&#10;D) asymptomatic.

Accepted Answer

The answer of A 22-year-old pregnant female presents for a...

Question 23

A 3-year-old Japanese male is diagnosed with Kawasaki disease. Which of the following is the most likely cause?&#10;A) A genetic defect causing left heart failure&#10;B) Autoimmune injury to the lymphatic vessels&#10;C) Infectious pericarditis&#10;D) Systemic vasculitis of unknown etiology

Accepted Answer

The answer of A 3-year-old Japanese male is diagnosed with...

Question 24

A 1-year-old female with a ventricular septal defect is experiencing congestive heart failure. Which of the following will most likely occur?&#10;A) Failure to thrive and periorbital edema&#10;B) Edema to the hands and feet&#10;C) Weight loss and jaundice&#10;D) Flat neck veins and increased urinary output

Accepted Answer

The answer of A 1-year-old female with a ventricular septal...

Deck 24: Alterations of Cardiovascular Function in Children