Deck 33: Alterations of Cardiovascular Function in Children

Question 1

Which compensatory mechanism is spontaneously used by children diagnosed with tetralogy of Fallot to relieve hypoxic spells?

A) Lying on their left side
B) Performing the Valsalva maneuver
C) Squatting
D) Hyperventilating

Answer 1

Squatting

Question 2

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 (COA)
B) Pulmonary stenosis (PS)
C) Aortic stenosis
D) Hypoplastic left heart syndrome

Answer 2

Pulmonary stenosis (PS)

Question 3

What is the initial manifestation of aortic coarctation observed in a neonate?

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

Answer 3

Congestive heart failure (CHF)

Question 4

An infant diagnosed with a small patent ductus arteriosus (PDA)would likely exhibit which symptom?

A) Intermittent murmur
B) Lack of symptoms
C) Need for surgical repair
D) Triad of congenital defects

Question 5

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

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

Question 6

An infant has a crescendo-decrescendo systolic ejection murmur located between the second and third intercostal spaces along the left sternal border.A wide fixed splitting of the second heart sound is also found.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 7

An infant has a continuous machine-type murmur best heard at the left upper sternal border throughout systole and diastole,as well as 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 8

Classic manifestations of a systolic ejection murmur heard at the left interscapular area,cool mottled skin on the lower extremities but hypertension noted in the upper extremities,and decreased or absent femoral pulse are indicative of an older child with which congenital defect?

A) Tetralogy of Fallot
B) Aortic stenosis
C) Ventricular septum defect (SD)
D) Coarctation of the aorta (OA)

Question 9

The function of the foramen ovale in a fetus allows what to occur?

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

Question 10

When does systemic vascular resistance in infants begin to increase?

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

Question 11

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

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

Question 12

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 13

Which scenario 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 14

Most cardiovascular developments occur between which weeks of gestation?

A) Fourth and seventh weeks
B) Eighth and tenth weeks
C) Twelfth and fourteenth weeks
D) Fifteenth and seventeenth weeks

Question 15

Where can coarctation of the aorta (COA)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 16

Older children with an unrepaired cardiac septal defect experience cyanosis because of which factor?

A) Right-to-left shunts
B) Left-to-right shunts
C) Obstructive lesions
D) Mixed lesions

Question 17

At birth,which statement is true?

A) Systemic resistance and pulmonary resistance fall.
B) Gas exchange shifts from the placenta to the lung.
C) Systemic resistance falls and pulmonary resistance rises.
D) Systemic resistance and pulmonary resistance rise.

Question 18

Which event triggers congenital heart defects that cause acyanotic congestive heart failure?

A) Right-to-left shunts
B) Left-to-right shunts
C) Obstructive lesions
D) Mixed lesions

Question 19

Which condition 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) An intermittent murmur is present.

Question 20

What is the most common cause of chronic sustained hypertension observed only in a newborn?

A) Renal parenchymal disease
B) Primary hypertension
C) Renal artery stenosis
D) Congenital renal malformation

Question 21

What congenital heart defects are associated with intrauterine exposure to rubella? (Select all that apply.)

A) Pulmonary stenosis (PS)
B) Cardiomegaly
C) Patent ductus arteriosus (PDA)
D) Coarctation of aorta (COA)
E) Ventricular septal defect (VSD)

Question 22

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)Abnormal communication between the atria
E)Allows right-to-left shunting

Question 23

Which statements related to the ambulatory blood pressure monitoring (ABPM)system with children are true? (Select all that apply.)

A) ABPM monitors blood pressure for a 24-hour period.
B) ABPM assists in identifying children with white coat hypertension.
C) ABPM is effective in identifying children at risk for target organ damage
D) ABPM assists in identifying children who demonstrate masked hypertension.
E) ABPM is effective in determining blood pressure load or hypertension for at least 48 hours.

Question 24

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)Abnormal communication between the atria
E)Allows right-to-left shunting

Question 25

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)Abnormal communication between the atria
E)Allows right-to-left shunting

Question 26

Match the phrases with the corresponding terms.
Atrial septal defect

A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Abnormal communication between the atria
E)Allows right-to-left shunting

Question 27

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 28

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)Abnormal communication between the atria
E)Allows right-to-left shunting

Question 29

Which symptoms meet the diagnostic criteria for Kawasaki disease in a child? (Select all that apply.)

A) Fever for 5 days or longer
B) "Strawberry tongue"
C) Peripheral edema
D) Inguinal lymphadenopathy
E) Bilateral conjunctival infection

Question 30

What is the suggested mean blood pressure for an 8- to 9-year-old child?

A) 104/55 mm Hg
B) 106/58 mm Hg
C) 112/62 mm Hg
D) 121/70 mm Hg