Nokea
The following procedures may abort an attack of SVT EXCEPT
- A. placing of the face in ice water
- B. straining
- C. breath holding
- D. standing on head
Correct Answer: D
Rationale: Standing on the head is not a practical or effective method to terminate SVT.
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Down syndrome and VSD
- A. Doesn't close spontaneously as in children without downs
- B. Inaudible murmur is a characteristic feature / Murmur is not audible
- C. Pulmonary Hypertension is a late complication
- D. If no murmur, condition need not be investigated
Correct Answer: C
Rationale: Pulmonary hypertension is a known late complication in Down syndrome with VSD.
True statements about the use of the new Child Health Foundation growth charts include:
- A. Immediate referral is advised if the height of a child is on the second centile
- B. The midparental height of a child, whose parents are 176 and 160 cm tall, is 175 cm
- C. They can be used for all children including those with Down's syndrome
- D. The target centile range for a girl is midparental height ± 10 cm
Correct Answer: C
Rationale: The growth charts are designed to be inclusive and can be used for children with Down's syndrome, among others.
Can parents hold their child during an echocardiogram procedure?
- A. You will be able to hold your child during the procedure.
- B. Your child can be active during the procedure, but can’t sit in your lap.
- C. Your child must lie quietly; sometimes a mild sedative is administered before the procedure.
- D. The procedure is invasive so your child will be restrained during the echocardiogram.
Correct Answer: C
Rationale: Although an echocardiogram is noninvasive, painless, and associated with no known side effects, it can be stressful for children. The child must lie quietly in the standard echocardiographic positions; crying, nursing, or sitting up often leads to diagnostic errors or omissions. Therefore, infants and young children may need a mild sedative; older children benefit from psychological preparation for the test. The distraction of a video or movie is often helpful.
List THREE indications for intervention for aortopathy in Marfan’s syndrome in an older teenager.
- A. Aortic root or ascending aorta dilation >44-50mm
- B. Symptomatic (pain consistent with rupture)
- C. Growth of >0.5cm/y
- D. All of the above
Correct Answer: D
Rationale: These are significant indicators that require surgical intervention to prevent further complications, such as rupture or dissection.
Varying intensity of the first heart sound from a booming (bruit de canon) to virtual inaudibility is seen in which of the following?
- A. Mitral stenosis with atrial fibrillation
- B. Constant 2:1 AV block
- C. First-degree AV block
- D. Congenital complete heart block
Correct Answer: A
Rationale: In mitral stenosis with atrial fibrillation, the intensity of the first heart sound can vary depending on the dynamics of atrial contraction and ventricular filling.