Cardiology

Collected by [Link] Eid from pediatric board study guide book

53 Cases

[Link] of diabetic mother presents with cyanosis of fingers and hands, and
normal color of the lower extremities

TGA (most likely)

[Link] common cause of cyanotic heart disease presents a few days after birth

Complete (d) TGA

[Link] presents with cyanosis in the lower extremities, tachycardia,

respiratory distress, and loud single S2 sound

Persistent pulmonary HTN

[Link] with cyanosis, pulse oximetry changed from 60 % to 64 % only on

100 % oxygen

Cardiac (most likely)

[Link] with cyanosis, pulse oximetry changed from 60 % to 88 % on 100 %

O2

Pulmonary (most likely)

[Link] the first 48 hours of life a newborn rapidly develop cyanosis, tachypnea,
respiratory distress, pallor, lethargy, metabolic acidosis, oliguria, weak pulses in
all extremities, hepatosplenomegaly and no murmur

Hypoplastic left heart

7.A 2-week-old boy develops congestive heart failure, severe metabolic acidosis,
and poor perfusion of the lower extremities
Coarctation of Aorta

8.A 12-year-old presents with hypertension, occasional headache and leg

cramps, weak and delayed femoral pulse, and blood pressure in the upper
limb is higher than the lower limb, chest X-ray (CXR) shows rib notching,
irregularities and scalloping on the undersurface of posterior ribs

Coarctation of Aorta

[Link] presents with shock, the echocardiogram showed coarctation of

aorta. What is the drug of choice?

Prostaglandin E1

10.A girl with Turner syndrome presents with hypertension, weak and delayed
femoral pulse

Coarctation of Aorta

[Link] presents with cyanosis, mother was on a medicine for severe bipolar
disorder, CXR shows cardiomegaly and right atrial enlargement

Ebstein Anomaly

[Link] presents with severe cyanosis, systolic ejection murmur, and a

single second heart sound

Severe Pulmonary Stenosis

[Link] baby presents with a soft, harsh systolic ejection murmur, best
heard at the axillae, and precordium and no symptoms

Peripheral pulmonary stenosis (PPS)

[Link] common cardiac lesion associated with Down syndrome

Endocardial cushion
[Link] common cardiac lesion associated with Turner syndrome

Bicuspid aortic valve

[Link] common cardiac lesion associated with Williams syndrome

Supravalvar aortic stenosis

[Link] common cardiac lesion associated with Alagille syndrome

Pulmonary stenosis

[Link] common cardiac lesion associated with Noonan syndrome

Pulmonary stenosis

[Link] common cardiac lesion associated with DiGeorge syndrome

Tetralogy of fallot

[Link] common cardiac lesion associated with Holt–Oram syndrome

ASD

[Link] common cardiac lesion associated with TAR syndrome

Tetralogy of fallot

[Link] common cardiac lesion associated with lithium teratogen

Ebstein Anomaly

23. Most common cardiac lesion associated with supraventricular tachycardia

Ebstein anomaly
24. Most common cardiac lesion associated with trisomy 18 (Edward $)

VSD

25. Most common cardiac lesion associated with infant of diabetic mother

Hypertrophic cardiomyopathy with outflow tract obstruction

26. Most common cardiac lesion associated with tuberous sclerosis

Cardiac rhabdomyoma

27. Most common valvular lesion associated with acute rheumatic fever

Mitral regurge

28. The most common cardiac lesion associated with Marfan syndrome

Aortic dissection

29. Syndrome that is associated with true interrupted aortic arch

DiGeorge syndrome

30. Adolescent routine physical exam, apical mid-systolic non ejection click and
late systolic murmur, the murmur is louder when goes from a supine to a
standing position, and the murmur become softer when squatting

Mitral valve prolapse

31. A child routine physical exam, ejection systolic murmur with a vibratory
character, best heard in the lower sternal border towards the apex

Still’s murmur
32. A 6-year-old with systolic-diastolic murmur, low-pitched sound, best heard in
the infraclavicular region, disappears when supine and with gentle pressure on
the jugular vein

Venous hum

33. Aortic stenosis, hypertrophic cardiomyopathy, mitral regurgitation, and

hypertension are associated with which extra-heart sound in children? S3 or S4?

S4 (S4 is always abnormal in children)

[Link] brushing teeth, a 15-year-old girl develops cold sweats, pallor, and
palpitations and loses consciousness for 10 s

Vasovagal Syncope

35. A 15-year-old girl faints while running and has a positive family history of
deafness and sudden death

Long QT syndrome

[Link] fails hearing screen, electrocardiogram (EKG) shows a very

prolonged QT interval

Jervell and Lange-Nielsen syndrome

37. A 5-year-old, heart rate is 230 beats/min, chest discomfort, the heart rate
decreases to 80 beats/min after ice is applied to the face

SVT

38. What is the definitive treatment for SVT?

Radiofrequency ablation
39. A child presents with a history of intermittent tachycardia, EKG shows short
PR interval, slurred and slow rise of the initial upstroke of QRS (delta wave),
widened QRS complex

Wolff–Parkinson–White syndrome (WPW)

40. A child presents with chest pain, fever, friction rub, EKG shows diffuse ST
segment elevation, had URI 10 days before

Pericarditis

41. Adolescent diagnosed with influenza presents with fever, tachycardia,

edema, and gallop, CXR shows pulmonary edema, cardiomegaly, low-voltage
EKG

Myocarditis

42. An athlete presents with dyspnea while playing, systolic ejection crescendo
decrescendo murmur best heard at the apex and left sternal border, and radiates
to the suprasternal notch, murmur is louder while standing and with Valsalva
maneuver

Hypertrophic cardiomyopathy

42. EKG in 12-day-old shows negative T wave in V6

Left ventricular hypertrophy

43. A 15-year-old boy with history of recurrent chest pain during exercise faints
and dies while playing basketball, hypertrophic cardiomyopathy ruled out as a
cause of death

Anomalous of left coronary artery is most likely

44. Had repaired VSD with synthetic patch 3 months ago and going in for dental
work
Antibiotic prophylaxis

45. Had repaired ASD with synthetic patch 7 months ago and going in for dental
work

No antibiotic prophylaxis

46. A child with prosthetic mitral valve going for surgery

Antibiotic prophylaxis

47. A child with mitral regurgitation, and VSD and going in for dental work

No antibiotic prophylaxis

SBE Prophylaxis in VSD is not recommended, except within the first 6 months
of closure or if there is a residual left to right shunt following closure.

48.A child with tetralogy of fallot and going in for dental work

Antibiotic prophylaxis

49.A child with previous history of endocarditis

Antibiotic prophylaxis

[Link], peaked T waves in precordial leads indicates

Hyperkalemia

51. An infant of diabetic mother presents few hours after birth with jitteriness,
hypoglycemia, cyanosis, EKG shows prolonged QT interval

Hypocalcemia
[Link] shows sinus tachycardia, widened QRS complex with interval greater
than 100 ms, in a child who presents with altered mental status after accidentally
ingested the grandmother’s medication

Tricyclic antidepressants (TCAs) toxicity

52. EKG shows normal PR intervals and periodic drop in QRS

Mobitz II or Type II second degree AV block

53. EKG shows progressive prolongation of PR interval followed by a drop in

QRS

Mobitz I or Type I second degree AV block