Nokea
Dome and dart P wave in lead V1 in electrocardiogram is suggestive of which of the following?
- A. Dextrocardia
- B. Left atrial ectopic rhythm
- C. Biatrial enlargement
- D. Mitral stenosis
Correct Answer: C
Rationale: The dome and dart P wave morphology is characteristic of biatrial enlargement, often seen in conditions like mitral stenosis and atrial fibrillation.
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Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test.
- B. It is necessary to be completely “asleep†during the test.
- C. The test is short, usually taking less than 1 hour.
- D. When the procedure is done, you will have to keep your leg straight for at least 4 hours.
Correct Answer: D
Rationale: The child’s leg will have to be maintained in a straight position for approximately 4 hours. Younger children can be held in the parent’s lap with the leg maintained in the correct position. Postural drainage will not be performed unless the child has corresponding pulmonary problems. The child should be sedated to lie still, but being completely asleep is not necessary. The test will vary in length of time from start to finish.
During a well baby examination of a 6-week-old infant, poor weight gain, acrocyanosis of the hands and feet, and a respiratory rate of 60 breaths per minute are noted. Oxygen saturation on room air is 93%. What is the correct action?
- A. Follow-up in 1 week to assess the infant's weight.
- B. Order a chest radiograph and an electrocardiogram.
- C. Reassure the parents that the exam is within normal limits.
- D. Refer the infant to a pediatric cardiologist.
Correct Answer: D
Rationale: Infants with oxygen saturation less than 95% and those with poor feeding should be referred emergently to a cardiologist.
All of the following reduces intensity of first heart sound (S1) except
- A. Mechanical ventilation
- B. Calcific mitral stenosis
- C. Short PR interval
- D. LV dysfunction
Correct Answer: B
Rationale: Calcific mitral stenosis typically increases the intensity of the first heart sound (S1).
Of the following, the cyanotic cardiac lesion with decreased pulmonary blood flow is
- A. transposition of the great vessels
- B. single ventricle
- C. truncus arteriosus
- D. tricuspid atresia
Correct Answer: D
Rationale: Tricuspid atresia results in decreased pulmonary blood flow due to lack of right ventricular input.
What are THREE classes of medication used to treat giant coronary artery aneurysms in Kawasaki Disease?
- A. ACE inhibitor
- B. Beta blocker
- C. Statin
- D. All of the above
Correct Answer: D
Rationale: These medications are typically used in the management of giant coronary artery aneurysms to manage cardiovascular risks.