Ire, !

**:*flinqn&r

A. Physiologic
Evat!ation
of Congenital
HeartDisease
I Rel.tlive
\vl. ,.r''r,.tt.r lgInlt,rlrletrne
hle,
A cannot sustarn fetalsurvival
js p.;m,lJyduelo decreased putmonary
,, bloodflow
q__lB Caused byIntracdrdiac Shuntat thefO.amen Ovale
Q is,tnetormalstate of rnIauterine
crrculatton
2 A favored hght-to'e[,lpA.to;oha)shuntjng of.blood
acrossth{dr.ctus
,r,rc,,nr,,J,,
".'' " du.
A v..tsodrl.'r,tl^ndalhrllrlmolar/vasclrtnr h,rrj " ,o,
Jl ql\\t i rr. y cr,rtlprrance
(9/'oir sysrcnrc
').r' vascutai res,5hngs. ,( L
D.htghlenattalpressure

::W,filHHrtitr,:Hffi
##::Wr-
, U t h ep ta (ertd ,sn o l ap a rlo fth ec{culaton
clrfo//
"<lrr-,
..nt,,
/
. u rtt5a ClcLl,rt.olr inse eS I
"*mlflillilll,l'l; '1"'*
i:lll;;" ,,.,t
ii,'ltilllrrll'1r';.
t ! I r r r i, t ,r.1 l | \/ v l l l | | t{ .
C rrr(.rentic
l aorltc
pressure
D growth rissue- (f- n*",.-{l:.-, t
0tarr.t septat
5 Intransitronatc d\:.,,_,.^_t
rcuat()n.whrch
0fthefolk changes
A.inciea;e occur atbidh;
infrrinonaryutoou
Ro*'*.'Sltt0dynamic
rnc r.irc rf oryrtenaion
wtthlhc ltrslcry*-
f
, u torn

r ol thcpulnonary
aderioles 0yi ,
canbearrested
oxra
snr ir llshllrlh,riron
).rlIdlo5rs
. noneoftheabove
'n 1"'
7.Theumbitical
bloodvesseis:
A carrywell-orygenated
bloodviatheumbilical
arleries
B.theumbiticat
anery
crriesbloodtromlheplacentaio
thetetalheart
dre2unrbrhcal
vernsandi umbiticalartery
Athere
rne
.. _" (7 umo'r,cat
vern
contains
thehrghest
oxygen-saturated
btood
o. Inecbsure olductus
artenosus:
Aconrpleteanatornic
ctosure
at10-1shours
afterbirth
-
(j,,mrlatcosure
rsbymedidsmoolhmuscleconstiction
_C.oxygen reverses
theproc8ss
0. prostagtandrn
E2facilitabs
ductclosure
- ^uuciatsnboth
v. muscleresponseh oxygeo isrnost
dependent
onthe;
A lac\ofsn"oo'rrnrscle
developntenl
(Blgesta0onal
aqeoflhenewbofir
C.presencerlothpr
car0tarles0ns
O hinhwciqlrl
 ptrrmonarv
'' "llll::ii:i:f][ffl.ll:;"y-* '"'cased brood there
is;
ru,tr,.,o'r
(V/Ol
'iow
@(,rtrl,'tu"' n,,snlatch.
* v" "l vgc'-'
i fiiJliJ'"'-'""''''"
11.Whrch
ofll.e rol'owrng iirjot€ oartolclinicaltools
lord,agnos,s,r
pedrahiccardrotogy?
A. historyand pE -* +-_r_
8.chest
X-ray _, \ _ ,'r t/l
-_-.
p2oecr'o.ara,cr.am '(') M,u,|,r:",rf f0el*.
(,y-^l^.fior.u (:G) ,
l2 lhcnr)j;r ',,\n.xr.ll =--\
rrh"r'l
'irrrncar
(rrqnosrs
inanacyanorrc
nrnnr
wrrrr
ur.rr r:.{
r(,ir,ri,, .r,;iil)r
----:- r-r:r'1'r'#.."r':1r
r(lhl !ur'r-
vcnk
cural
"'*Tnl,3;ulJlfi,l":H.'."0,",00,.,,1 ,
B pnA{r.l,rtt,tuctljs,lrterrcsus)
/i-,PS(pr,tmonrc stenosrst
. . ^f(9ASn l;rrr atse|ral defect)
. LJ Lrmcat dr,rqrx):;rs
r .rey.rnotrc
0eonatewithIncreased
pulnolary
bkrcrt
llow(pBF)
byfoes!,{riland
I btventrrcular ofrhy (BVfl)by
hvpenr ECG.
Ir i r ,t .,,,.t,,,.,tr!,,,t x.rlrr,.rt
.r, f t rk _ , j
,*
r {F,t r r r rri
lr" A rl,'r 1r:.(r',
I IA)
t t,ft ,tr tLr.' ,t l,rrr.rtolrs l.rnnlundy vplr\r\ re1,1rl
D lt'r (ler rr, o .lflot)
14.oxyge\ chal 'v
engetest;
A V.lolehy_4gruurg orygen lromtheneonate
/,
( ycan s[€r-.1
c altf,
d,agnose theetiology
Ofneona(al
cya|osriz.
-:C,candrfl4.e1lrilecentralfrompenpheral
cyafl0st6_
L
0. r always
Oone atttrOcathlab .
lti,. .. t5. Pulmonaq/edema InCHOwitfiIcGs;d pBFrsparivdueto.,
,td| 1.0!4!t!o'l,:,n'rl .
'f,;
ryhy,rr,i,tniiil-iiirft,ro ;j{ l{ +
ghtatrial(RA)presure l -
.- qy U r\
. Arncreased *
.{ltncreasedpuhonayarterial
1pA) pressrJre
^/l .
U.oDstruction
0flhepulmonic
valle
l. ConC[tiveH.rrt Friluro
l. Totljlliphera,resstance
rsequrvalenl
to;
$#HT;5l:t','
stroke
volume
.C. -

D.myocardiat
contractjlilv
3.Congenital
hearlfailure
is:
t i. d

"*"ilil,XHili",;iffin'-r+o''e; ry..&til
t B.ventlcular
septatdefect
NSO)
A patenr
ductus (pDA)
arteriosus
. (lfpulmonrc
stenosis
(pS)
to6^l':ilL1:j;,.,sep.iina,viumprair*e
-,
; ft-lnl .
{ l . r o l rsrrcc n o s r s - ,. r /- I .
C fightventrcular (RV)ralnre* ,( .(nl r t . (t-) - /.A"c;(aX ^,"-
u { -L'q<l (,/
D.coarclatron
u coarctation oftheaorta
ofthe ao{a 0
U ", L,
*"i:ilH:[i"evorume ovetroadins
; F+e* ^ fu l^"1
I r,
'^
B.letratoqy
otfa'tot{ToF) ffJ1lt^
. G\rythrobtastosis
fetals
D hypopta.r,, -
tettheartsyndrome
(HLHS)
/ Incse.Ir'(tln'(trJ\.dr,,rl lesronsrn lheneonate elcept:
A.aorltc atrosril
B severe Loarctatron ottheaorta I I a\t .\) 1
C Interl,trr.d ,rr)rrrc t I -f
,nch
i Apulmornc slcnosis
L True ofthehemodvnamrc ciangesin CHF;
A Increased heart(ie is alwaysbenefcial
B-r'r.:red
c,l leart alecalncreaGltteventlrcular fr rngr,nrl
,.L.tn.tn.t'.{
rl vonlrrlaren{i-dtlslolicvolltme incren,,n1, lho{.]rrit,rc
olrlrlrl
(x[x|ari;theearliest
0. brp0rl,rl signU0l1f
L Frank;*art'ng mecnilnrsm of theheartestablishedthat;
. (f,.byincreasrng thepreload, LVejection
alSO Increases
I llrcronsc InIly r:.ir(1,,dory0endomnnd --
ls benclic,,rl
L. nlyocaro,at waltstessdoesnotIncrease oxygen demand
0 noneoflhestatemenl is fne
10.ln con0estive heitdfaiture {CHF), chestXray
tsneeded ;
A.roassess lheheartstze
evaluate 0uimonary vascul*marxtngs
,,.Rlo-
{gD 0t rneabove
u. none0ttheabove

C.Hirtory.nd physicelEramin ion

'!.A mall(ratviratIntectron
fhatcauses pDA,andcataract
deafness. intheneonate,
ll|ube a
B.CMV
C.heryos
D,coxsackie
Bvirus
2.onlyoneoftheffisnolleratoqenic
;
A.;d((rhol
$)aracelannl
C.amphetantires
D,valprotc
acid
i
l
 ;cttctol rrr,rl{)r,r.r
LrliLrS
It r nconatc:
A cild|(nIyop,tlhy
A sh unttes on
heart blocl
^Glomplete
n rrrr',\,r/Ll,lr"
4 Oy,llosrs
|r .l cllrktrsr ostltkely
duetoCHDif itisassociated
wilh,
A.crying
[BFlubbins
C coughing
D.limping
5.Squatting
l
A commoninshunt
lesions
(9)h;ttlmartFosture ofcya4o$c heanpafunts
C Increa:cs tl'r,putrnolayarlery{pA)pressure
U rowertI.n syt.lefltavascular resislance
6.A signof lefl-srded
headfailure,
A puffyface/eyelids - if < u FltO"ts c t:N6f<T/o)
L hepatomeaaly
q brpedatedenra
{9lachyoI
7.Frequent respiratoryiraclinfection
is associaled
with;
A (',r,ri,(1
(1r\ l, ln]orrxry
bl(rxlllow
lJ.lIIll{lt(nt(n1\}t
0 liliclislillr:l
(C-)rrrqc
hlt lo.right
shrntesiond I IBF
D.obstructrveiypeol hearesion
I
8.Wh€€zing, crackl€s anO,nterruptedteeding
areallsunsol
,v"' A,qt heartfailure
B.Ryfaiture
]&puJmonary anerialhypertension(pAH)
(u,.,syslemrc
venous conoestion
9.A so|lmurmu, fewhour5 afteriirth
ismostlikelydueto.except.
A.slenoliclesron
B.innocent murmur.
C.smallshunt
D.large
10.A cardiac
VSD
chestpainisdescribed asi
I
A.shaF
Atocahzed
(l;.,neevy pressui
e
ifi
D.tender onpalpation
11.Chest parnwrt'rsyocopeorpatpitation
isrnore
tketydu€to:. il
i\ A. lorlicstel]osrs
B costochondntis
C.trauma
i
D pulmonary Datholoov
iII
12A neurotogrc reaiilikely
syrnptorn ofcardraongrn, I
A.slroke l1
B choretc
(gl [cs
movemeots I

E
 U t le < i (J ,x i l tl
13 Whchol thed cdr0aclrlness
rarelypfesent
n'**"
i liilil;llll,,n"'"
w h sy4cope,

C lolgQT5yn(1qrns 'oi'n'
.. ^ mrlalvatve
pfotapse
(MVp)
'" *'11iT:l'il"''l'li3jtl{of svndrome
-0.
)w fr$s
_,,,,,l
l*ril
ogaon,c'nsumcie,iciiert
pulmonic
U,loysptastrc valve

', o"'0,1,il'ji'n'i?lT,n"'j|3lffil
A rl.ancl,flcatty
prcluo
; $)YS amtrsli']cardiacPf because
can,eptace ",,.rro'#ffiilitr's
theusefrrtne55
6fsus6ul!3tarl
l'] { c,rrl.t..:.c.i1
L. lhcI\({tphcral
vaSCUlAreststancg
u I CanInrttally piclupvascular
ror,r,e
.^ _
cent,ir
cya.oJ,;l;;::,fi::;i#:H[i]?ffi obr
lj\:,::1.,:.J;,."..
B.buccalmucousa.
lCtnoso
0. ninll)rxili
17.Pallordue
tocinctrovascular
illness
ininfants
isleastlilelyduelo
I
J
B.shocL
I ,Qanemra
,,onPf,,.x!',#iT?".,n
rff
1!
Aacub arterial
(ptrap,flary
",,
desaturaton
hyperlrophy
I 1".orgrtat
vascula congestion
I .^ u. alerctarhyp€rplasra
{v,^!v E ng0rdraphofesis
I Inthelorehead
i isa srgnof;
\psympathetjc overaclrvriy
D.pafasympathetlccompensaton
i u. decompensaled
D.
heart
i .. lernlnlsl,lge
^- AwEssalpathologrc
ljcarl,atlure
zu. heansound bypE;
li
'I L52

a3r
2t A cyYnotc
heandrsease,

6?3f
l
I

it
D,ASD
 signsofheart
/-Carl€st fallure
inchjldren:
A tachypnea
B.tachycardra
Oiott
u. ne(her
23.Bipedaledemacouldmean,
A.RVfailure
A end-stagefarlure
€iboth
D.neither
24.Normal
arterial
oxyOen saturation;

M
ff:fn,..l\4.
thDownb
s,ndrome;
miFifr i:TW;
oror -yterfifuMft,u/orceonr+
ed
| ..t Whrcholttru nr,,w r I s ont r prt ot ctrnrcattoots ,or dragnosisn pedrat.bcardiotogv?
A r ls ldv and nt
I chest x .ay
,C. 20 echocardroqt.m
r | ! \ 1' L\ , r it [ Ar an ( t CC)
Th. ntr l[.lt L dtr,r nrJnrrli'. h rn J.ynnotK mtantwdh rrrcase(t l,8t t]y d!'sl Xrry dn.j !ohl ventncutarhypertroptry
{RVr{) rn
EOG
A VSo (ventncurar septatdercct)- l"- ,
B p D A(p a l e odi u c tu as d e n osus) ,.,,
(_ ps (trlrtmonrsienosis)
, Or ASO{at,rats. et d.tRt)
3 oryqe..ha en-Qe lest
A rsdono try d6pivrng oxyo.n tiorn r€ n4o.al.
n dn 6fF Jrly ,rdqnce tn. et u.ogy ot nF,, ,.tr , ,d,a,\,\
r C, r n ,ir ttfl 'r'.o fi .tF r .n ttr t ft .m tFrrFh .t I ydn,,\tr
L, r , i$ r Yl n .tr ' . n ( th ..n th t.b
lol. t .' l rn 1. , r t { , r r r i + t r nv J r €rrt.
(' I ^) \ . y s r , i, ! r nqr od, r
,ysfurfL Dretodd

D t).r prtrrJ Derruskrr

5 wh{h or'r.. ' . j/ { ! : dJ , j J lr e. d, nl r he s r o h e v o i u r e
! 4. \ s nus r ny r hh
,6 D. er o. d
C afief oad
t) myocardiatcontr.ctitit,
6 A c6u3eolrntrdller ne vorrm. ov.ro.dhg
\ rjYd..rri( 3
ll nr r n, r ) y . ' lar r or( I of )
i
"r v 1t r , nn\ l! r r n i, t r t r h
|' I ' v t , ot.,s l' , . l, ll hea' ls y r r n o i i j F1 1 l l lL l , )
7 An rale ni.l! nl ir li' i hal. aG . s d. . hes s , Po A . f r l . J l a r a d D r h r r 'n , n .
IA r lbell.
B CMV
(i herpes
O cors.ckle B vtrus
L Crft.6 Ln.chrld I molt L*.ry due ro cHo il E rs6@Bred w(h
't
tfir l -t9. ni,oot,'g
t cotthlnt
C
D l,mping
t Efhclof ftal.mrl l! pu! in. n6onrl.
A ca.dromyop.thy
e $unl e.lon
.(c c ,,mp e te h ..n b to .l
o m y o c .rn tE
!0. Ody on. olltu ll Bnol l.f.log.nE
A rlaohol
,{9,. p.r.c.t.nbt
C amph.l!mh.!
o v.tprot acid
il. A.lgn ot r.n.ded h..n l.ilur.,
A putt t.c./.y.tidt
B hep.ton.g.ty
_C bp.dlt.d.rn.
.{O lachyo.
i2 Y\rh..ring.crr.itl. .nd lnt.r0tl.ri t..dtn0 .r. aI.r0n|l)t,
A l.lt h..rt t {on
,A R Vt [u r6
C puhon.ry.,t.rrirhyp.d...ton(pAH)
O iyrt.mr v.no6cffo.lrn
r I Ttr hEhllt oryg€n6aru.. on tFt.rrr blood-v.$.r
I A Ao.tt
t. rdnd ,n

A _puhon.ryldery
_fcl umbiticatvein
\{ Dktus6den6us
14 Tnr. ol ntaritern€rct.l shlnls
.A t |nt.acdrdhc 6nd2.rlr.c&dr!c shunts
B 2 rntracardrac and 1 enfacardiacshuds
c 1 ntraca.diac..dl sn.r!.rdr.c.huiir
) N .4 a n ra .l h o n ti
 ---.- |

,A Thesour.eottetaioxygenandnulrition
A. pt.c.nt.
I F.tattunqs
(, chorknl. vrltr
tj t ddlt iv r r
Itt lh.most.rDirur.ongq !r hed.l,rN.sse In down Syndrom€
. A. VSD
& POA
. j!- ,aso
1?r'"."'""!,"],"9rc':Ij3.*-"**
A
Diencoph.toru
,I
R a th t(e ,s p o u c n
C Nalrohypophylis
n tftrit.ry.t.tk
ln sihtrt|.( rytr.rt.n:rrr drl.hd.ehnrmocytoma ll dncto
A Aklostoon.
8 Co({hohmln.r
C Angiotonsn tl
D Rcnth
19. Squriingit a iypica|f€atur.ol
A AS O
B TOF
c vso
O POA
m RalllN€ hypoxenr. dLfng Inr.urllh. ti|! |
A cnnnotrGt.in t.t!tlurvivrl
I hpidr.r,tv du. tod.cr.!ie(t D tmn^lry r)ktodit,jw
I N !,nrrod bv trdc.rdlacahu.t et rhe trrnrr,n nr
rt,.
r r ". nr . n, , r , r t s t it . . t r h t r . t n r , n "( n c g f l r 4 l
21 Pimlrr ! { u' la' y f iO hr b. du€ t o
ri 'tD
.A- ru,ioB
B ..Qcnn.t.t
in.llr
c Hypoth.r.fttcdF ullclton
0 Endorglnralidrntio GH
?2 Ort!.n
Ctor.! th. a|rtor |.a.to||,.
^-
! Cdsd Frdroia.t iEdt o.d
. G. cl-t|l-.ttta
s m -th -b
rrra e --
A, Cdrhro||
l' Dl.t b
-a-t Y.r e6t t d*nath|ii
hyrold lhid I tc&d t|}h../

_-1"' "3 Jilff.

a. Edttfiqt .lnL in hf.nci b con nonr'i
-\A. loMs
-b
-fr
r E.'r. nr,"6f ,n:i:ff:f.d 'nr'nh
A .t.chypn..
"g
B Tfrhycridt.
q. N.{ht
(]0- loln
cr.l'.lsm L rbo known!.
A Cong.nit.t Dw.rfi.rn
B qd!tr|litf HvD.rthk;-rffh
c Coh!.nitdHyporhyiordhn
u u,yplothyrotdF{n
2l UruDoFC l.tn n c^y.nokn..n d|i.!s. d.v.toF Go^d.ry
A r^d.rr. btoodflow ro
B Fr.qu6nttrruma
! fut.riord d lta on
.D C.p eryhyp.rtroohv
29 v.rpopedal
- spdsmseenh Hypoc6tc.nirf
A Chvostek irgF
a Mo6.O4
C Trcaeorc lbn
D SIc wag'.do;
 Aclle neonatarhvoocalcemia E doe lo
'A
Lowcaiciumcontenlin cd s milk
B Hiqh PhGPh3t. cMlenl in cMs mrlk
c r nqhc . l. lum PO 4r alio
L) t nw ( it ldlnr Po4 r lt r o
l1 lnlr.ltenne tel6lctr.(blrun rs descnbedas
A Crculalron n series
B T.ansitionalckcl]ralon
I C. Parall.l cncublion
o Neonalalcdcuhnon
Th. only anteno'prl!'la.y hormonewft specitictalgel oroan
A lirobcnn
I Crov!'thHormonc
c Ac Tr l
r) lx y r or ' f l) r r
d
3J A contrnuolstrrurtrir'!l rho .' rCS l lr5B is most lkelv duc lo
A PO A
B VSO
c A so
o loF
u hean sou.d is due lo lheciGure oI
f
,A Semilunaivalves
I Alrlov.nhcularvalves
C Thepesl.n v.lve
O Ellac hr . nv alle
35 Palp atd ynn d nos . qlr v s r ef llo a 9r . de 4 m ! . nr u 6
, B. rh t{.
I r ' tNla n
{) !rr'rl
36 Fln tionalclo.ure-olthe-loramln ov.l.li btougnltboll by
(a in6...i In LA Prtr'uf'
- a incre.sc in Lv volume
c hcr.t. i"onb F*!t'
O oro$lh ol llrr'l 3'Pl!l |txu'
occ r al bi'lh
97 rn tr.ns,r'oral cfcurslrJ; w\ch ol (h. tollN|og h'modyn'hE cF'ngE
A ncr..s. r. Puhontry blo'd flow
B , rncr.a3. ih orygen'tion $fih rht nr.t crl
. aC bdlh

Normrl$.tu.lNn or lh! Plrrn{r.rv nrl.r1016o'n lr"rr'nl'd bv'

JI
- / A, . hYPot r .
B .6.113nLinll6ion
C tlkrlG6
o non. ol th. rbo!.
!e. th. umbllE.l blood v6s.||i
A .,'ru dll-.r6.n.t.d Uood vh ln. umbllh'l
'n'tiostolhtLlrlh'ln
pl'c'nl!
A rrtr umo,rur'itrrv crnl' Uood fron lh'
c th€r! .r. 2 umb{Lrl v.lm.nd 1 uftbilhrl
-irri 'd'rv
vctnooalint ln! hl9h61oxvg'6'3ttu€l'd blo'd
16' umlircrt
()n Tb 016!r. ol duclusanelosus
lf) uurrir.r,'.u'. r. ovTtrd hurcl' con'klcilon
Y fiY!.n t.v.t!.. th. Poc6. 'mmlh
(0) floiltor.ndh E?l|cllr'l.r do'l 6l6ur'
 ('/\lll)l() j. -.
.1. i.\../ .r.Lt
. I lIi) .t'hi(.s L,\t(,i.
> j '" l ( s t rt('t.
; -'11 r'
. J. l. lr,,l,,lit( Sl
I . {.,t6 -th ri l l
5 . rtrtr'1 r..
ctc,.tr,rrr rrrrrr r r r r r r - ( r hrr r,,r
r r tr
r,
;
io. VI{S
1llli:;;';'".'",i",iil,l,l""', "'L'.,',,,r:,,i,,,,,,,,,,,,,
'.,r'crrtr
it rrl.rr(jCCtion, t.V r:r) t.;l,-,t..,.r\-,, .1 1
a. itA rtr'ik ttxcti,ul tt.l
l,ri tIt.\.lr;h.t.t,r[.,1
ru, r||tt,l', rlt,ti rlrrrrrl
- l.||nrrtctrrrr,rrle
r r. r^\\tr \\thtr,lla
i1 ;\\,Sl) rttu,ltcort

il ;;;l;'ili'lli,
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