CongHeartDis.doc Андрій Миколайович Лобода 2015
Зміст 3 Зміст
Зміст 4 A child with tetralogy of Fallot is most likely to exhibit: -Increased pulmonary blood flow -Increased pressure in the right ventricle -Increased pulse pressure -Normal pressure gradient across the pulmonary valve -Normal oxygen tension (PaO2) in the left ventricle Early signs to be useful for diagnosis of heart failure in infant include all the following EXCEPT: -Tachypnea -Hepatomegalia -Brain edema -Sweating -Tachycardia All the following are signs of heart failure ECXEPT: -Edema -Gallop rhytm -Cardiomegalia -Suprasternal and intercostal recessions -Splenomegalia Anti-failure drugs are all EXCEPT: -Epinephrine -Hydralazine -Spironolacton -Furosemide -Digoxine The following are used in heart failure ECXEPT: -Hydralazine -Co-trimoxazol -Spironolacton -Furosemide -Digoxine In tetralogy of Fallot the following statements are true ECXEPT: -Overriding aorta -Ventricular septal defect -Left ventricular hypertrophy -Pulmonary stenosis -Right ventricular hypertrophy Diagnosis of tetralogy of Fallot supported by EXCEPT: -Cyanosis at birth -Right ventricle hypertrophy on ECG -Episodes of squatting -Pulmonary pletora on chest X-ray -A murmur loudest at the lower left sternal edge A 15-year-old girl with short stature, neck webbing, and sexual infantilism is found to have coarctation of the aorta. A chromosomal analysis would demonstrate: -Mutation at chromosome 15 -Trisomy 21 -XO karyotype -Defect at chromosome 4p16 -Normal chromosome analysis The doctors in maternity hospital made a newborn boy the following diagnosis: congenital heart disease (interventricular septal defect). At the age of 2 months the boy has got a dyspnea. Objectively: BR- up to 60/min, tachycardia up to 170/min, liver is 3 cm below the costal margin. What medicines must be immediately prescribed? -Nonsteroidal antiinflammatory drugs -b-adrenoceptor blockers -Potassium preparations -Glucocorticoids -Cardiac glycosides In atrial septal defect all true, EXCEPT: -Continuous systolic and diastolic murmur in the second left interspace -Systolic murmur in the 2nd-3rd left interspace near the sternum -Accentuated 2nd tone over the pulmonary artery -Septum primum is associated with apex systolic murmur
Зміст 5 -Right bundle-branch block on ECG The systolic murmur in atrial septal defect is caused by: -Left to right flow through the septal defect -Increase flow through the pulmonary valve -Right to left flow through the septal defect -Increase flow through the mitral valve -Increase flow through the tricuspid valve In tetralogy of Fallot all present EXCEPT: -Pulmonary stenosis -Aortic stenosis -Right ventricular hypertrophy -Dextraposed aorta -Ventricular septal defect In ventricular septal defect all present EXCEPT: -Associated with harsh pansystolic murmur at left sternal border -Cyanosis is not usual -It is asymptomatic -90% of all ventricular septal defects are located the membranous part -Cardiac humpback A 2 month old child has feeding difficulty, bilateral crepitation, and systolic murmur in the 3rd-5th left interspaces near the sternum, diastolic murmur in apex. Heart rate is 70; liver is 5 cm below the costal margin. The most likely diagnosis is: -Atrial septal defect -Tetralogy of Fallot -Ventricular septal defect with congestive heart failure -Hypoplastic of left ventricle -Transposition of great vessels In congenital heart disease which is false: -Innocent murmur is always systolic, change with position -Hum venous -Bruit heart in sternal notch characterised aortic or pulmonary stenosis -Intensity of murmur correlates with size of defect -Fourth heart sound heard at end of diastole In tetralogy of Fallot the following complications are true ECXEPT: -Congestive heart failure -Brain abscess -Thrombosis -Polycythemia -Anaemia In tetralogy of Fallot only one of the following statements is correct: -Hypertrophy of both ventricle -Pulmonary oligomia -Pulmonary plethora -Aortic stenosis -Left to right flow through the septal defect In transposition of the great vessels all are true EXCEPT: -Cyanosis present within first hour of life -Murmur in the majority of cases are heard -Prostaglandins is given for survival or to keep patent ductus arteriosus -Predominant in boy full term baby -Ballon atrial septectomy would be most useful Ballon atrial septectomy would be most useful in infant within: -A large ventricular septal defects -Anomalous pulmonary venous drainage -Patent ductus arteriosus -Transposition of the great vessels -Endocardial fibroelastosis What is the most common congenital heart defect with a left to right shunt causing congestive heart failure in the paediatric age group? -Atrial septal defect -Atrioventricular canal -Ventricular septal defect -Patent ductus arteriosus
Зміст 6 -Aortopulmonary window What is the most likely age an infant with a large ventricular septal defect will begin manifesting symptoms of congestive heart failure? -1 day -1 week -1 month -6 months -1 year What is the dominant mechanism with which infants and young children increase their cardiac output? -By increasing ventricular contractility -By increasing heart rate -By increasing ventricular end-diastolic volume -By decreasing heart rate -By increasing respiratory rate The earliest sign of congestive heart failure on a chest X-ray is: -Increased heart size -Enlargement of liver -Central pulmonary vascular congestion -Pulmonary edema -Pleural effusion A 2 year old infant is noted to have mild cyanosis who assumes a squatting position during long walking. He is noted to have increasing fussiness followed by increasing cyanosis, limpness and unresponsiveness. The most likely underlying lesion is: -Hypoplastic left heart -Transposition of the great vessels -Anomalous pulmonary venous return -Tetralogy of Fallot -Aspiration with obstruction to air passages