Nokea
List FOUR differential diagnoses aside from aortic coarctation for a two-week old infant presenting with tachypnea and poor femoral pulses.
- A. Tachycardia induced cardiomyopathy
- B. Critical aortic stenosis
- C. Dilated cardiomyopathy
- D. Myocarditis
Correct Answer: A
Rationale: Differential diagnoses in such cases can include non-structural heart conditions like tachycardia induced cardiomyopathy, which affects the heart's ability to pump effectively.
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All of the following are true about a small VSD EXCEPT
- A. spontaneous closure is more common in muscular vs. membranous defects
- B. closure usually occurs in the first 2 years of life
- C. there is no risk of endocarditis
- D. pulmonary pressures are normal
Correct Answer: C
Rationale: Even small VSDs carry a risk of endocarditis until they close.
The reason that the hematocrit is so high is
- A. chronic hypoxia
- B. it was taken in a low cardiac output state
- C. it was a peripheral finger stick
- D. embolic stroke
Correct Answer: A
Rationale: Chronic hypoxia leads to secondary polycythemia as a compensatory mechanism.
Mechanisms of dyspnea in left heart disease include all, except
- A. PVH and decreased lung compliance
- B. Respiratory muscle fatigue
- C. Elevated LV End diastolic pressure leads to decreased antegrade coronary blood flow
- D. Reverse 'Bernheim' effect
Correct Answer: C
Rationale: Elevated LV end-diastolic pressure does not typically lead to decreased antegrade coronary blood flow.
What is one of the most frequent causes of hypovolemic shock in children?
- A. Sepsis
- B. Blood loss
- C. Anaphylaxis
- D. Congenital heart disease
Correct Answer: B
Rationale: Blood loss is the most frequent cause of hypovolemic shock in children. Sepsis causes septic shock, which is overwhelming sepsis and circulating bacterial toxins. Anaphylactic shock results from extreme allergy or hypersensitivity to a foreign substance. Congenital heart disease contributes to hypervolemia, not hypovolemia.
Nystagmus can be a presenting sign in:
- A. Partial albinism
- B. Retinopathy of prematurity
- C. Acute vestibulitis
- D. Medulloblastoma
Correct Answer: D
Rationale: Medulloblastoma, a type of brain tumor, can present with nystagmus due to its impact on the cerebellum and brainstem.