Question 1

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

Accepted Answer

Congenital heart defects are the most common cardiovascular disease in children. Acquired heart diseases, such as rheumatic heart disease, are much less common.

Question 2

What is the function of a patent opening between the left and right atria in a fetus?
A) It allows right-to-left shunt.
B) It allows left-to-right shunt
C) It allows blood to flow from the umbilical cord.
D) It allows blood to flow to the lungs for oxygenation.

Accepted Answer

In a fetus, the patent opening between the left and right atria, known as the foramen ovale, allows blood to bypass the non-functioning fetal lungs by shunting blood from the right atrium to the left atrium (right-to-left shunt).

Question 3

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

Accepted Answer

Fetal heart contractions typically begin around day 22-23, and can be detected by ultrasound by week 5-6 of gestation.

Question 4

Closure of the ductus arteriosus normally occurs immediately after birth.

Accepted Answer

The closure of the ductus arteriosus typically occurs within the first few days after birth, not immediately.

Question 5

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

Accepted Answer

In response to chronic hypoxemia, polycythemia may occur as the body generates additional red blood cells to increase the oxygen-carrying capacity of the blood.

Question 6

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

Accepted Answer

Patent foramen ovale (PFO) is a normal opening between the right and left atria of the heart that typically closes shortly after birth. However, in some cases, PFO may persist into adulthood due to conditions such as pulmonary hypertension, right ventricular failure, and tricuspid atresia.

Question 7

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

Accepted Answer

Lesions that increase pulmonary blood flow are left-to-right shunts, which allow oxygen-rich blood to flow from the left side of the heart back to the lungs instead of being distributed to the rest of the body. Right-to-left shunts, on the other hand, allow deoxygenated blood to bypass the lungs and enter the systemic circulation, resulting in cyanosis (a bluish discoloration of the skin, lips, and nails due to low oxygen levels). Examples of right-to-left shunts include tetralogy of Fallot and transposition of the great arteries.

Question 8

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

Accepted Answer

Most cardiovascular development occurs between the fourth and seventh weeks of gestation. This includes the formation of the heart tube, the development of the major vessels, and the formation of the atria and ventricles.

Question 9

Which of the following statements is true?
A) At birth,both systemic resistance and pulmonary resistance fall.
B) At birth,there is a shift in gas exchange from the placenta to the lung.
C) At birth,systemic resistance falls and pulmonary resistance rises.
D) At birth,both systemic resistance and pulmonary resistance rise.

Accepted Answer

At birth, there is a sudden increase in oxygen levels due to the separation of the infant from the placenta, leading to a shift in gas exchange from the placenta to the lung. This is accompanied by a decrease in pulmonary resistance and an increase in systemic resistance.

Question 10

In general,the pathophysiologic mechanisms of congestive heart failure are very different in children than in adults.

Accepted Answer

The pathophysiologic mechanisms of congestive heart failure are generally similar in children and adults, involving impaired cardiac function and compensatory mechanisms, though the causes may differ.

Question 11

Kawasaki disease is a self-limiting systemic vasculitis.

Accepted Answer

Kawasaki disease is a self-limiting systemic vasculitis that mainly affects children under the age of 5. It is characterized by unexplained prolonged fever, rash, conjunctivitis, swollen lymph nodes, and redness and swelling of the hands and feet. While the exact cause of Kawasaki disease is unknown, it is thought to be an autoimmune disorder. Early diagnosis and treatment are important to prevent complications such as coronary artery aneurysms.

Question 12

In some cases of total anomalous pulmonary venous return,pulmonary veins drain into the vena cava.

Accepted Answer

In total anomalous pulmonary venous return, the pulmonary veins do not connect to the left atrium as they should. Instead, the pulmonary veins drain into a systemic vein, such as the superior vena cava or inferior vena cava.

Question 13

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.

Accepted Answer

Left-to-right shunts allow blood to flow from the higher pressure left side of the heart to the lower pressure right side, leading to increased volume in the pulmonary circulation and eventually causing congestive heart failure.

Question 14

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

Accepted Answer

Primary hypertension often has no symptoms and is usually detected through routine blood pressure checks. As a result, diagnosis can be challenging in children as they may not present any visible signs or symptoms of elevated blood pressure.

Question 15

Common clinical manifestations of right ventricular failure in children include failure to thrive and periorbital edema.

Accepted Answer

This is true. Other common manifestations of right ventricular failure in children include hepatomegaly, ascites, and jugular venous distension.

Question 16

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

Accepted Answer

Systemic vascular resistance begins to rise once the placenta is removed from circulation, as the infant's lungs begin to function and systemic circulation is established. Before birth, the fetus receives oxygen and nutrients from the placenta, and the lungs are not involved in gas exchange. During labor and after birth, there may be fluctuations in vascular resistance, but the sustained increase occurs after placental circulation ceases.

Question 17

All hypertension in children is considered primary hypertension.

Accepted Answer

While primary hypertension is the most common type of hypertension in children, there are other potential causes, such as underlying medical conditions or medications. Therefore, not all hypertension in children is considered primary hypertension.

Question 18

Most cardiovascular development occurs between the fourth and seventh weeks of gestation.

Accepted Answer

This statement is true. During this time, the heart begins to form and the major blood vessels are established.

Question 19

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

Accepted Answer

Transposition of the great arteries (TGA) refers to a condition in which the aorta arises from the right ventricle and the pulmonary artery from the left ventricle. The result is two separate, parallel circuits in which unoxygenated blood circulates continuously through the systemic circulation and oxygenated blood circulates repeatedly through the pulmonary circulation. This condition is incompatible with extrauterine life unless a communication exists between the two circuits to provide the necessary oxygen to the body.

Question 20

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

Accepted Answer

The foramen ovale is a hole in the septum between the two atria of the fetal heart. It allows oxygenated blood to bypass the non-functional fetal lungs and enter the systemic circulation, which is necessary for fetal survival. After birth, the foramen ovale typically closes, redirecting blood to flow through the lungs for oxygenation.

Quiz 30: Alterations of Cardiovascular Function in Children