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Pediatric Cardiology MCQ's
1. What is the most common congenital heart defect with a left to right shunt causing congestive heart failure in the pediatric age group?
a. Atrial septal defect
b. Atrioventricular canal
c. Ventricular septal defect VSD
d. Patent ductus arteriosus
e. Aortopulmonary window

2-All true regarding ASD Exept:
a. Atrial septal defect is the second most common congenital heart defect in children and adults.
b. Patients with atrial septal defects may have an embolic stroke as the initial presentation.
c. Most children with atrial septal defects are asymptomatic.
d. The most common yet least serious type of atrial septal defect is an ostium secundum defect.
e. The most common yet least serious type of atrial septal defect is ostium primum defect.

3. What is the most likely age an infant with a large ventricular septal defect will begin manifesting symptoms of congestive heart failure?
a. 1 day
b. 1 week
c. 1 month
d. 6 months
e. 1 year

4. What is the dominant mechanism with which infants and young children increase their cardiac output?
a. By increasing ventricular contractility
b. By increasing heart rate
c. By increasing ventricular end-diastolic volume
d. By decreasing heart rate
e. By increasing respiratory rate

5. The earliest sign of congestive heart failure on a chest X-ray is:
a. Increased heart size.
b. Kerley B lines.
c. Central pulmonary vascular congestion.
d. Pulmonary edema.
e. Pleural effusion.

6. A two day old cyanotic infant with a grade 3/6 ejection systolic murmur is noted to have decreased pulmonary vascular markings on
chest x-ray and left axis deviation on EKG. The most likely diagnosis is:
a. Tetralogy of Fallot
b. Transposition of Great Vessels
c. Truncus Arteriosus
d. Tricuspid Atresia.

7. 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:
a. Hypoplastic left heart
b. Transposition of the Great Vessels
c. Anomalous Pulmonary Venous Return
d. Tetralogy of Fallot
e. Aspiration with obstruction to air passages

8. An infant with a marked cyanotic congenital heart defect with decreased pulmonary vascularity should be treated with:
a. Digoxin
b. Indomethacin
c. Prostaglandin E1
d. Epinephrine

9. Cyanosis is produced by the presence of deoxygenated hemoglobin of at least:
a. 1-2 gm/dL
b. 3-5 gm/dL
c. 6-8 gm/dL
d. 9-10 gm/Dl

10. A "tet spell" or "blue" spell of tetralogy of Fallot is treated with all of the following except:
a. oxygen
b. knee chest position
c. morphine
d. digoxin
e. propranolol
f. phenylephrine
g. sodium bicarbonate

11. Pulmonary vascularity is increased in all of the following except:
b. Tricuspid atresia
c. TGV
d. Hypoplastic left heart

12. Pulmonary vascularity is decreased in all of the following except:
a. Tetralogy of Fallot
b. Pulmonary atresia
d. Tricuspid atresia

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