Nokea
Obstructed total anomalous pulmonary venous return (TAPVR) is a pediatric surgical emergency because
- A. therapy is usually not effective
- B. severe pulmonary congestion
- C. left atrium may be small
- D. left ventricle may be small
Correct Answer: B
Rationale: Obstructed TAPVR requires immediate surgical intervention due to severe pulmonary congestion.
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Paroxysmal hypercyanotic attacks (hypoxic, blue, or tet spells) are a particular problem during the lst 2 yr of life. They are characterized by
- A. early evening occurrence
- B. an increase in intensity of the systolic murmur
- C. unpredictable onset
- D. metabolic alkalosis
Correct Answer: A
Rationale: Unpredictable onset and metabolic alkalosis are common features of tet spells.
Which among the following beta-blockers is not potent than propranolol (considering propranolol = 1)?
- A. Carvedilol
- B. Metoprolol
- C. Bisoprolol
- D. Labetalol
Correct Answer: D
Rationale: Labetalol has a lower beta-blocking potency compared to propranolol, especially considering it also has alpha-blocking activity.
A 12-month-old child who had repair of a congenital heart defect at 8 months of age has a normal exam and is not taking any medications. The nurse practitioner will contact the child's cardiologist to discuss whether the child needs which medication?
- A. Amoxicillin
- B. Capoten
- C. Digoxin
- D. Furosemide
Correct Answer: A
Rationale: Children who have had complete repair of congenital heart defect (CHD) should have subacute bacterial endocarditis (SBE) prophylaxis with amoxicillin for 6 months after the procedure.
The most likely diagnosis in the patient is
- A. patent ductus arteriosus
- B. critical aortic stenosis
- C. critical pulmonic stenosis
- D. tetralogy of Fallot
Correct Answer: D
Rationale: Tetralogy of Fallot involves right ventricular hypertrophy, a VSD, overriding aorta, and pulmonary stenosis, consistent with the findings.
Mental retardation is found in all the following:
- A. Trisomy 21
- B. Morquio syndrome
- C. Homocystinuria
- D. Ehlers-Danlos syndrome
Correct Answer: A
Rationale: Trisomy 21 (Down syndrome) is a well-known cause of mental retardation. Morquio syndrome, Homocystinuria, and Ehlers-Danlos syndrome are not typically associated with mental retardation.