Deck 31: Alterations of Cardiovascular Function in Children

Question 1

In general, the pathophysiologic mechanisms of congestive heart failure (CHF) are very different in infants and children than in adults.

Answer 1

False

Question 2

When does systemic vascular resistance in infants begin to rise?

A)One month before birth
B)During the beginning stage of labor
C)One hour after birth
D)Once the placenta is removed from circulation

Answer 2

Once the placenta is removed from circulation

Question 3

Whereas cardiogenesis begins at approximately 3 weeks' gestation, most cardiovascular development occurs between the fourth and seventh.

Answer 3

True

Question 4

Complete transposition of the great vessels is a congenital heart defect in which the left ventricle pumps blood to the pulmonary circulation.

Question 5

Common clinical manifestations of right ventricular failure in infants include unexplained weight gain and periorbital edema.

Question 6

When does most cardiovascular development occur?

A)By the twenty-eighth day of gestation
B)Between the fourth and seventh weeks of gestation
C)Between the eighth and tenth weeks of gestation
D)Between the twelfth and fourteenth weeks of gestation

Question 7

Conditions in which a patent foramen ovale may continue past the first month of life include pulmonary hypertension, right ventricular (RV) failure, and tricuspid atresia.

Question 8

Diagnosis of primary hypertension in children is difficult because the early stages are often asymptomatic.

Question 9

At birth which of the following statements is true?

A)Systemic resistance and pulmonary resistance fall.
B)There is a shift in gas exchange from the placenta to the lung.
C)Systemic resistance falls and pulmonary resistance rises.
D)Systemic resistance and pulmonary resistance rise.

Question 10

Congenital heart defects that cause hypoxemia, and therefore cyanosis, usually involve:

A)right-to-left shunts.
B)left-to-right shunts.
C)obstructive lesions.
D)mixed lesions.

Question 11

Closure of the patent ductus arteriosus (PDA) in a full-term infant normally occurs immediately after birth.

Question 12

In some cases of total anomalous pulmonary venous connection (TAPVC), pulmonary veins drain into the vena cava.

Question 13

Iron deficiency anemia may result from polycythemia that develops from chronic hypoxia.

Question 14

Congenital heart defects that cause acyanotic congestive heart failure usually involve:

A)right-to-left shunts.
B)left-to-right shunts.
C)obstructive lesions.
D)mixed lesions.

Question 15

Fetal heart contractions begin by approximately the twenty-eighth day of gestation.

Question 16

The purpose of the foramen ovale is to allow a right-to-left shunt necessary for fetal circulation.

Question 17

Kawasaki disease is a self-limiting systemic vasculitis.

Question 18

Acquired heart disease is the most common cardiovascular disease in children.

Question 19

The function of a patent opening between the left and right atria in a fetus is that it allows:

A)right-to-left blood shunting.
B)left-to-right blood shunting.
C)blood to flow from the umbilical cord.
D)blood to flow to the lungs.

Question 20

Lesions that increase the pulmonary blood flow are called right-to-left shunts.

Question 21

Classic manifestations of a systolic ejection murmur, cyanosis of the lower extremities, and decreased or absent femoral pulse are indicative of an older child with which of the following congenital defects?

A)Tetralogy of Fallot
B)Aortic stenosis
C)Ventricular septum defect
D)Postductal aortic coarctation

Question 22

Which of the following describes total anomalous pulmonary venous return?

A)The foramen ovale closes after birth.
B)Pulmonary venous return is to the right atrium.
C)Pulmonary venous return is to the left atrium.
D)The left atrium receives oxygenated blood.

Question 23

The infant diagnosed with a small patent ductus arteriosus (PDA) is likely to present:

A)an intermittent murmur.
B)asymptomatically.
C)a need for surgical repair.
D)with a triad of congenital defects.

Question 24

An infant has a crescendo-decrescendo systolic ejection murmur located between the second and third intercostal spaces along the left sternal border.There is also a wide fixed splitting of the second heart sound.These clinical findings are consistent with which congenital heart defect?

A)Atrial septal defect (ASD)
B)Ventricular septal defect (VSD)
C)Patent ductus arteriosus (PDA).
D)Atrioventricular canal (AVC) defect

Question 25

Children with tetralogy of Fallot compensate to relieve hypoxic spells by:

A)lying on their left side.
B)performing the Valsalva maneuver.
C)squatting.
D)hyperventilating.

Question 26

Which heart defect results in a single vessel arising from both ventricles providing blood to both the pulmonary and systemic circulations?

A)Coarctation of the aorta
B)Tetralogy of Fallot
C)Total anomalous pulmonary connection
D)Truncus arteriosus

Question 27

Which of the following is consistent with the cardiac defect of transposition of the great vessels?

A)The aorta arises from the right ventricle.
B)The pulmonary trunk arises from the right ventricle.
C)The right ventricle pumps blood to the lungs.
D)All of the above.

Question 28

Match the phrases with the corresponding terms.
Ostium primum

A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting

Question 29

An infant has a continuous-machine type of murmur best heard at the left upper sternal border throughout systole and diastole.The infant has a bounding pulse and a thrill on palpation.These clinical findings are consistent with which congenital heart defect?

A)Atrial septal defect (ASD)
B)Ventricular septal defect (VSD)
C)Patent ductus arteriosus (PDA)
D)Atrioventricular canal (AVC) defect

Question 30

Match the phrases with the corresponding terms.
Foramen ovale

A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting

Question 31

The foramen ovale is covered by a flap that creates a check valve allowing blood to flow unidirectionally from the _____ to the _____.

A)right atrium; right ventricle
B)right ventricle; left ventricle
C)right atrium; left atrium
D)left atrium; left ventricle

Question 32

Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome?

A)Coarctation of the aorta and pulmonary stenosis
B)Tetralogy of Fallot and persistent truncus arteriosus
C)Atrial septal defect and dextrocardia
D)Ventricular septal defect and patent ductus arteriosus

Question 33

An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck.These clinical findings are consistent with which congenital heart defect?

A)Atrial septal defect (ASD)
B)Ventricular septal defect (VSD)
C)Patent ductus arteriosus (PDA)
D)Atrioventricular canal (AVC) defect

Question 34

Coarctation of the aorta (COA) may be located:

A)exclusively on the aortic arch.
B)proximal to the brachiocephalic artery.
C)between the origin of the aortic arch and the bifurcation of the aorta in the lower abdomen.
D)between the origin of the aortic arch and the origin of the first intercostal artery.

Question 35

Match the phrases with the corresponding terms.
Bulbus cordis

A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting

Question 36

What is the most important clinical manifestation of aortic coarctation in the neonate?

A)Congestive heart failure (CHF)
B)Cor pulmonale
C)Pulmonary hypertension
D)Cerebral hypertension

Question 37

Which heart defect produces a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border with an occasional ejection click?

A)Coarctation of the aorta
B)Pulmonic stenosis
C)Aortic stenosis
D)Hypoplastic left heart syndrome

Question 38

Match the phrases with the corresponding terms.
Septum secundum

A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting

Question 39

Match the phrases with the corresponding terms.
Truncus arteriosus

A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting

Question 40

Which heart defect produces a systolic ejection click at the upper left sternal border with a thrill palpated at the upper left sternal border?

A)Coarctation of the aorta
B)Pulmonic stenosis (PS)
C)Aortic stenosis
D)Hypoplastic left heart syndrome