Nokea
Systolic murmur in which among the following conditions does not increase in intensity in the cardiac cycle after a premature ventricular contraction?
- A. Valvular aortic stenosis
- B. Hypertrophic obstructive cardiomyopathy
- C. Valvular pulmonic stenosis
- D. Mitral valve prolapse
Correct Answer: D
Rationale: Mitral valve prolapse does not typically increase in intensity after a premature ventricular contraction.
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Possible causes of upper airway obstruction are:
- A. Inhaled foreign body in the main bronchus on the right side
- B. Epiglottitis
- C. Retropharyngeal abscess
- D. Viral croup
Correct Answer: B
Rationale: Epiglottitis is a serious condition that can cause acute upper airway obstruction due to swelling of the epiglottis.
What is one reason why patients with CHD are more likely to have rejection post-transplant than those with cardiomyopathy?
- A. Sensitized recipients with panel reactive antibody (PRA)
- B. Absence of systemic disease
- C. History of good compliance
- D. None of the above
Correct Answer: A
Rationale: Patients with congenital heart disease (CHD) are often sensitized due to prior surgeries and blood transfusions, leading to a higher risk of rejection post-transplant.
Patients with a small PDA have the following criteria EXCEPT
- A. asymptomatic risk for endocarditis
- B. normal peripheral pulses
- C. normal pulmonary artery pressure
- D. normal life expectancy
Correct Answer: A
Rationale: Small PDAs typically have a low risk for endocarditis.
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.
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.