Pediatric Cardiology Fellowship Practice Test

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• Bidirectional VT is defined by beat-to-beat alternation of which ECG feature?
• Which expression represents the Flamm equation for estimating systemic venous admixture?
• Orthodeoxia is best described as desaturation that occurs when standing.
• In DORV w/ subpulmonic VSD (TGA-like), which best describes the conus and the great-artery position?
• Which intervention increases MVO2 by increasing oxygen delivery?
• Which description best defines oxygen carrying capacity?
• In hypoventilation, what happens to PAO2 and PaO2?
• Which of the following is a recognized left axis deviation differential diagnosis on ECG?
• In Lev classification, DORV w/ subaortic VSD (TOF-like) is characterized by which feature?
• Precedex (dexmedetomidine) bolus dose for pediatric sedation is?
• A prominent PVa wave on pulmonary vein Doppler is most associated with which findings?
• Which of the following is a fenofibrate brand name?
• For every 1 mmHg PaO2, how much O2 is dissolved in blood?
• Which finding is a canonical cause of cannon A waves on right atrial pressure tracing?
• What's the solubility constant for O2 at 37 degrees C?
• Indirect Gerbode defect is a VSD with a hole in which structure?
• In constrictive pericarditis, what is the relation of E' lateral to E' septal?
• Which statement defines inappropriate sinus tachycardia in pediatrics?
• What is the recommended induction dose range for rocuronium in pediatric patients?
• Which PV Doppler finding is typical in mild to moderate MR with high LA pressure?
• Which CPO threshold best predicted in-hospital mortality in the referenced study?
• Basel Algorithm: which criteria indicate VT?
• In double outlet right ventricle (DORV) with subaortic VSD (TOF-like), which statement about the conus distribution is true?
• Which of the following is not a common post-truncal repair complication?
• G6PD deficiency results in hemolytic anemia due to oxidative stress when exposed to certain triggers. Which of the following is NOT a known trigger?
• Which statement describes the Haldane effect?
• Dexmedetomidine intermittent boluses range in mcg/kg?
• What does a concealed pathway mean in WPW context?
• Another name for DORV subpulmonic VSD?
• Which of the following is listed as a differential diagnosis for right axis deviation on ECG?
• In normal pulmonary vein Doppler patterns, which relation between S and D is observed?
• According to AHA criteria for coronary dilation, dilation only is defined as?
• In patients taking NPH, which medication has an increased hypersensitivity risk?
• In the cyanotic lesion differential, Tri Atresia with restrictive VSD is an example of which category?
• Which of the following is NOT listed as an extracardiac acyanotic left-to-right lesion?
• What are the normal septal and lateral e' velocity thresholds?
• At 100% saturation, approximately how many milliliters of O2 are bound per gram of Hb?
• Maneuver to increase Still's murmur?
• In congenital lateralities, which statement defines dextroversion?
• Which statement about vecuronium pharmacokinetics is correct regarding onset to peak and duration?
• What proportion of monomorphic VT is associated with structural heart disease such as CHD or MI?
• Lower PaO2 is associated with which change in systemic vasculature?
• What is the most common congenital heart disease diagnosed in adulthood?
• Which of the following is NOT listed as an etiology of severe hypertriglyceridemia in pediatric patients?
• In hypertriglyceridemia–induced pancreatitis, which therapy increases clearance of chylomicrons by activating lipoprotein lipase?
• RA/pulmonary artery wedge pressure ratio can help distinguish CP types. Which statement is supported by data?
• Which statement best defines Mobitz II?
• Name a contraindication to ketamine use in pediatric anesthesia.
• What is the best MVO2 representative when there is no left-to-right shunt?
• Which mode is asynchronous pacing and why is it used in surgery?
• Type B WPW Syndrome is characterized by which description?
• In hemodynamics with multiple pulmonary blood flow sites, what is the issue with calculating Qp?
• Which two forms of congenital heart disease would you not expect a patent ductus arteriosus at birth?
• According to ACC/AHA 2017 guidelines, prophylaxis for prosthetic material or devices after complete repair is recommended for how long?
• Early systolic reversal on PV Doppler is classically seen with which rhythm?
• What is the initial defibrillation energy dose for pediatric resuscitation?
• Turner associations commonly include which two conditions?
• Which defect occurs in about 50% of DORV associated defects?
• What is the typical presenting sign of truncus arteriosus?
• Which statement about dexmedetomidine is true?
• Which statement correctly describes a nondepolarizing blocker among the listed options?
• Why is systemic arterial saturation typically 1-3% lower than pulmonary venous saturation?
• Which of the following ECG findings is characteristic of ALCAPA (anomalous left coronary artery from the pulmonary artery)?
• During normal atrial septation, which event closes the foramen ovale?
• What is the first-line treatment for Belhassen VT?
• Which statement about the Basel Algorithm RWPT thresholds?
• What is the normal diastolic E/A ratio?
• Which of the following is an indication for infective endocarditis prophylaxis before dental procedures?
• Which induction dose is correctly matched to its drug for pediatric rapid sequence induction?
• Which arrhythmia is most common in Fontan patients?
• Left posterior fascicular block is typically associated with which axis deviation?
• In the pulmonary circulation, what is the response to decreased PAO2?
• Potts shunt connects which vessels?
• Which neonatal finding is a tip off for tricuspid atresia?
• In DORV with subpulmonic VSD (TGA-like), which statement is true regarding conus distribution?
• What is the downside of VVI pacing in a patient with normal sinus rhythm?
• Definition of polycythemia in this context?
• Which venous structure has the lowest oxygen saturation entering the right atrium?
• Which statement about fentanyl is true?
• What does co-oximetry measure that standard pulse oximetry does not?
• What is the recommended dose of midazolam (Versed) for pediatric sedation?
• What is a recommended initial management step for inappropriate sinus tachycardia?
• What is the correct cardiac power formula?
• What is the recommended intravenous ketamine induction dose in pediatric anesthesia?
• What daily dose of omega-3 fatty acids is recommended for hospitalized patients with hypertriglyceridemia?
• Which veins stream toward the right heart, and which has the lowest oxygen saturation?
• In Zone 2 of the lung, what is the typical pressure order?
• G6PD deficiency is inherited in which pattern?
• In shunt assessment, which statement is correct regarding SVC sat relative to PA sat?
• Rocuronium duration is increased with which organ failure?
• In Sgarbossa criteria for diagnosing MI in the setting of LBBB, what total score indicates high specificity?
• Which statement about acidosis and vecuronium blockade is true?
• What PV Doppler finding is typical in severe mitral regurgitation?
• After triglycerides fall below 500 mg/dL, what dietary plan is recommended?
• What is the induction dose of vecuronium in pediatric patients?
• What is the abnormal threshold for TAPSE per ASE?
• What is the abnormal S' wave velocity threshold per ASE?
• What does the a wave on right atrial pressure tracing represent?
• What is the etomidate dose for rapid sequence intubation in pediatric patients?
• Which adverse effect is associated with dexmedetomidine?
• Delta waves on ECG indicate what?
• Which statement best describes the Haldane effect?
• Williams syndrome associations with which congenital heart disease findings?
• Pulmonary atresia with or without other lesions is categorized as which pulmonary blood flow pattern?
• Pathophys of DORV-TOF type: path of blood
• Which statement about histamine release with vecuronium is true?
• Which drug is known to cause methemoglobinemia?
• In the Van Praagh classification, which variant corresponds to truncus arteriosus without a ventricular septal defect?
• Which description describes Taussing Bing anomaly?
• According to RSV Synagis criteria, which scenario qualifies as hemodynamically significant congenital heart disease during RSV season?
• In the four-letter code, what does the fourth letter represent?
• Which finding supports Belhassen VT over SVT with RBBB and left anterior fascicular block?
• In older children with a narrow and regular tachycardia, the energy used for synchronized cardioversion is typically:
• Idiopathic fascicular left ventricular tachycardia is also known as which of the following?
• Which type of idiopathic fascicular monomorphic VT is defined by posterior fascicle with RBBB and LAD?
• Which intervention would decrease metabolic oxygen consumption (MVO2)?
• Vecuronium duration is increased in which conditions?
• If a patient has a narrow and irregular tachycardia, what energy is recommended for synchronized cardioversion?
• In TGA, how is O2 increased if you use PGE1 infusion?
• In Zone 1 of the lung, which statement is true?
• In diastology, which statement best describes the E/e' ratio?
• If the initial synchronized cardioversion fails in a child with a narrow, regular tachycardia, what energy is recommended for the second attempt?
• Which mechanism explains a wide, fixed splitting of S2?
• Most common DORV subtype?
• Pulmonary vein Doppler: which wave corresponds to atrial kick?
• Which statement about rocuronium onset times is correct?
• Which statement is true about wide fixed splitting of S2?
• In high-degree AV block, the P:QRS ratio is typically
• MAPCA stands for which anatomical structure?
• What is the formula for the pulmonary artery pulsatility index (PAPi)?
• What is the meaning of the a wave on the atrial pressure tracing?
• Which condition is commonly included in the differential diagnosis for left bundle branch block (LBBB) on ECG?
• In semiquantitative MR evaluation, which item is used as one of the three core criteria?
• Which statement about rocuronium's renal failure status is true?
• In HTG-induced pancreatitis, what is the recommended initial fluid resuscitation bolus?
• CXR finding in supracardiac TAPVR?
• In adults with ASD-associated PAH, when should medical therapy be considered and ASD closure discussed?
• Where is the VSD usually located in DORV?
• What happens to P2 when pulmonic stenosis worsens?
• In truncus arteriosus, the typical number of truncal valve leaflets is?
• Methemoglobinemia involves iron in hemoglobin being oxidized from Fe2+ to Fe3+. Which statement describes its effect on oxygen binding?
• Sinoatrial node is derived from which embryologic tissue?
• Which statement is true regarding saturations in shunt evaluation?
• Tri Atresia with restrictive VSD is listed under which pulmonary blood flow category?
• Lown-Ganong-Levine syndrome is characterized by which ECG finding?
• Which of the following are mortality risks after truncal repair?
• Which syndrome is often associated with truncus arteriosus?
• 2nd most common DORV subtype?
• Which agent listed is a nondepolarizing neuromuscular blocker?
• Which statement about rocuronium onset times is true?
• Which of the following is a standard parameter to assess right ventricular function?
• What is the lower reference value for normal RV FAC (%)?
• Which echocardiographic finding supports severe aortic regurgitation due to a large regurgitant orifice?
• In DORV nomenclature, Lev et al classification defines subtypes by what primary relationship?
• Dextroposition describes the heart being located where?
• Which ASD type is due to a defect in the septum primum?
• Which statement about rocuronium's cardiovascular effects is true?
• In pulmonary vein Doppler recording, which wave represents diastolic flow?
• Dextrocardia w/ mirror imaging is characterized by which arrangement?
• In truncus arteriosus, which associated finding ranks third in frequency?
• In severe cyanosis with a loud systolic murmur, think of?
• Which congenital lesion is classically associated with a wide fixed splitting of S2?
• In hepatopulmonary syndrome, how are V/Q ratio and A-a gradient affected?
• Noonan syndrome is associated with which of the following cardiac anomalies?
• Which features define Eisenmenger type VSD?
• Base excess on a blood gas reflects what concept?
• Which statement best defines a Mahaim pre-excitation pathway?
• What is the most common associated defect with DORV?
• For ketamine, what is the intramuscular induction dose range in pediatric patients (when IV access is not available)?
• Which statement is a true advantage of fentanyl compared with morphine?
• Mobitz II is also known as which block?
• What TAPSE value constitutes abnormal right ventricular systolic function in adults?
• What is a potential drawback of using heparin to stimulate lipoprotein lipase in HTG pancreatitis?
• Atrioventricular septal defect commonly presents with regurgitation across which valve?
• A single forward Doppler signal on PV Doppler is most commonly associated with which congenital lesion?
• Left anterior fascicular block is most characteristically associated with which axis deviation?
• What is the recommended amoxicillin dose for infective endocarditis prophylaxis in a child?
• What is the typical great-artery relationship in the most common DORV?
• On pulmonary vein Doppler, what change accompanies elevated left atrial pressure and mitral regurgitation in S2?
• In Mobitz II, the RR interval around the drop beat is
• Which pattern corresponds to Moderate diastolic dysfunction Grade II on pulmonary vein Doppler?
• Dexmedetomidine infusion dose (continuous) range in mcg/kg/hr?
• Which of the following is a left-sided obstruction lesion?
• As PS murmur intensity increases, which of the following is true?
• Procainamide dosing for SVT in children is IV over which duration?
• DTGA with VSD is listed as which type of mixing lesion with respect to pulmonary blood flow?
• According to ACC/AHA 2017 SBE prophylaxis guidelines, which condition warrants prophylaxis?
• Which of the following lists the four ASE diastolic parameters and their normal thresholds?
• Which statement about saturations is true in DORV with subpulmonic VSD?
• According to Collette & Edwards, Type IV pulmonary artery anatomy involves what?
• Why can't you use the RA for a mixed venous gas sample?
• V/Q = 0 occurs in which scenario?
• Which statement about morphine is true?
• In the Van Praagh anatomic classification of truncus arteriosus, which variant describes when only one pulmonary artery arises from the truncal root and the other is supplied by the patent ductus arteriosus or by a MAPCA?
• What is the most common congenital heart defect diagnosed in adulthood?
• A high velocity S and D wave on pulmonary venous Doppler is most suggestive of which diagnosis?
• Which induction agent is preferred for increasing systemic vascular resistance and reducing right-to-left shunting in certain conditions?
• If there is a left-to-right shunt, from which site should MVO2 be obtained?
• Left posterior fascicular block commonly shows which lead pattern: qR in which leads?
• In Zone 3, the pressure order is which?
• Left anterior fascicular block commonly shows which lead pattern: which lead shows a qR complex?
• In the four-letter pacemaker code, what does the third letter represent?
• Which factor tends to decrease the D wave on pulmonary vein Doppler?
• Which of the following is a Class IB antiarrhythmic?
• V/Q = infinity describes which scenario?
• Direct Gerbode defect is best described as a communication between which chambers?
• Great artery relationship in Taussing Bing?
• Prolonged D wave deceleration on PV Doppler suggests which condition?
• What is the threshold for abnormal RV 2D strain?
• Class IB antiarrhythmics have which effect on the QT interval?
• Why is methylene blue contraindicated in patients with G6PD deficiency?
• Which statement best describes the Smith-Modified Sgarbossa criteria?
• Indirect Gerbode defect is a VSD with a hole in which structure, resulting in shunt to the right atrium?
• After truncal repair, which finding is a common complication requiring catheter intervention?
• According to ASE 2015, what is the normal right ventricular wall thickness?
• If supplemental O2 is given in a hypoxemic patient, what happens to PAO2 and PaO2?
• In constrictive pericarditis, which statement about tissue Doppler E' is correct?
• At high altitude, PAO2 falls due to lower barometric pressure. What happens to the A-a gradient?
• In dextro-transposition of the great arteries (D-TGA), which coronary pattern is most commonly observed?
• Pathophys of DORV subpulmonic VSD: effect of PVR
• What best describes the 'side-to-side' great-artery relationship in DORV?
• In truncus arteriosus with an interrupted aortic arch, the most common type is Type B.
• Pathology of Mobitz II is usually?
• Which PV Doppler pattern corresponds to Severe diastolic dysfunction Grade III (reversible)?
• Which of the following is NOT a Class IA antiarrhythmic?
• Which statement about conus in TOF-like and TGA-like DORV is correct?
• Class IC antiarrhythmics are contraindicated in which patients?
• V/Q = 0 is associated with which gas pattern?
• Which statement describes the Bohr effect?
• Which component of the atrial pressure tracing is used as a surrogate for RVEDP?
• Waterson shunt connects which vessels?
• In Tetralogy of Fallot, what is the most common coronary artery anomaly?
• Which statement about VSD or PDA is true regarding their clinical presentation after birth?
• Which mechanism best explains Belhassen VT?
• Initial energy for synchronized cardioversion in a child with a narrow, regular tachycardia?
• What is the pediatric code dose of epinephrine according to the material?
• What is the upper limit for normal left ventricular base dimension in adults?
• How is the A-a gradient defined, and what is a typical normal value?
• What determines the oxygen carrying capacity of blood?
• Which DORV subtype is most common?
• According to PAPi, what value indicates right heart failure after LVAD support?
• What is the effect of gravity on V/Q in the dependent lower regions of the lung?
• Which statement best describes chemoreceptor control of ventilation?
• At high altitude, how does the arterial PO2 compare to alveolar PO2?
• DORV w/ doubly committed VSD refers to a VSD that is associated with what?
• Which idiopathic fascicular VT type is defined by RBBB and LBBB features?
• In a Glenn shunt patient, can you calculate Qp/Qs?
• What is the definitive treatment for methemoglobinemia?
• Depth to gums for pediatric endotracheal tube insertion is estimated with which formula?
• In truncus arteriosus, which associated finding ranks third in frequency?
• What does someone's SpO2 tell you?
• Class IC antiarrhythmics are contraindicated in which condition?
• Flecainide belongs to which class of antiarrhythmic?
• Type A WPW Syndrome is characterized by which description?
• How does red yeast rice lower LDL-C?
• What is the normal E/e' ratio?
• Which of the following is a nondepolarizing neuromuscular blocker?
• What Doppler finding defines a normal E/A ratio on echo?
• In idiopathic fascicular VT, approximately 90% originate from which region?
• Grade IV diastolic dysfunction on TWD is characterized by which finding?
• In tissue Doppler imaging, which grade corresponds to e' < a' and E/e' > 10?
• What best describes the conus in fetal cardiac development?
• In pulmonary vein Doppler, atrial fibrillation or other left atrial dysfunction typically affects the S1 waveform how?
• Psyllium, among the listed nutraceuticals, is associated with approximately what percent reduction in LDL-C?
• Shunting is minimized by which mechanism?
• Which of the following can cause methemoglobinemia?
• In pediatric wide complex tachycardia with a regular rhythm, what energy and mode should be used for cardioversion?
• In Mobitz II, the QRS width can be
• What is the pediatric atropine dose when given by weight-based dosing?
• Which is an adverse effect associated with rapid fentanyl administration?
• What is the next most common leaflet count after 3 for the truncal valve?
• Postnatal murmur heard immediately after birth includes which differential?
• Which of the following is a nondepolarizing neuromuscular blocker?
• Which combination defines Grade III diastolic dysfunction?
• Which statement describes a maneuver that decreases Still's murmur?
• The truncal valve leaflets are most commonly how many?
• Which statement about oxygen content in the delivery equation is true?
• Why is CoQ10 often recommended to statin users?
• What is the Flamm equation for calculating systemic venous admixture?
• According to ASE 2015, what are the normal right ventricular diastolic basal size and mid-chamber size?
• In the Van Praagh classification, which variant includes IAA (usually type B) with the PDA supplying the descending aorta?
• What is the recommended IE prophylaxis antibiotic for patients with penicillin allergy?
• Class IB antiarrhythmics are best described by which of the following statements about their effect on the ventricular action potential?
• Fentanyl infusion dose (per hour) for pediatric sedation is?
• Which equation correctly defines the right ventricular myocardial performance index (RVMPI)?
• Rate of erosion with Amplatzer septal device closure is:
• Which statement is true regarding IST pharmacologic therapy?
• In children aged 6-12 with coarctation of the aorta treated with balloon angioplasty, which complication occurs more frequently than with stenting or surgery?
• Dexmedetomidine is associated with minimal respiratory depression. Which option reflects that statement?
• What is the oxygen carrying capacity equation?
• In Doppler studies for severe aortic regurgitation, holodiastolic flow reversal is most specific in which arterial segment?
• What happens to pulmonary arterioles when PAO2 is increased?
• Which combination best describes mild diastolic dysfunction on Doppler?
• Which clinical feature is typical of methemoglobinemia?
• Which of the following is NOT used to assess right ventricular systolic function?
• What is the normal threshold for tricuspid regurgitation velocity (TRV) used in diastolic assessment per ASE guidelines?
• A large V wave in the right atrial pressure tracing is most commonly associated with which condition?
• In portopulmonary hypertension, what mechanism contributes to gas exchange abnormality?
• Belhassen VT features include which QRS duration?
• Which EKG finding most strongly suggests dextrocardia?
• Bidirectional VT is most commonly associated with which condition?
• CXR finding in Ebstein's anomaly?
• In DORV, where is the VSD most often located relative to the septomarginal band?
• Which unit expresses oxygen carrying capacity?
• In Doppler assessment of diastolic function, which deceleration time (DT) range is typical when the E/A ratio is normal?
• Which of the following is a differential diagnosis for orthodeoxia?
• In tissue Doppler imaging, which parameter reflects myocardial relaxation?
• Which description best fits rocuronium in terms of onset and duration?
• According to Collette & Edwards, which type describes each pulmonary artery arising from a separate origin from the posterior aspect of the truncal root?
• Mobitz I pathology is usually?
• What is the most common coronary issue with DORV?
• Fentanyl bolus dose for pediatric sedation is?
• Which MPI threshold indicates abnormal right ventricular function? (PWD and TDI differences)
• How is oxygen capacity defined?
• Which statement is true regarding the E/e' ratio and LV filling pressures?
• Classic Blalock–Taussig shunts versus modified shunts differ in that they connect RSCVA to RPA using which combination?
• Pulmonary atresia on exam is typically associated with which finding?
• Which statement is true regarding Class IA antiarrhythmics?
• Which of the following is NOT a common cause of a continuous murmur in a child?
• Procainamide dosing for SVT in children is 15 mg/kg IV over which duration?
• In a chest radiograph of Tetralogy of Fallot, which cardiac silhouette finding is described?
• If hemoglobin is 10 g/dL, what is the maximum oxygen-carrying capacity per deciliter of blood?
• Base buffer composition: which statement is true regarding base buffers in base excess calculation?
• Endotracheal tube size in French units for a child is estimated with which formula?
• Which statement best describes the mechanism of Class IA antiarrhythmics?
• Which condition will cause the PVa wave to increase on pulmonary vein Doppler?
• What is the appropriate timing for IE prophylaxis before a dental procedure?
• Among nutraceuticals, which has shown the largest reduction in LDL-C?
• DORV with subpulmonic VSD is described as which type of lesion?
• What is the upper limit for normal right ventricular base dimension?
• Why is the flow (L/min) equation using Fick often not written with a real AVO2 difference in routine calculations?
• Which hematocrit level defines polycythemia in this material?
• Which patient scenario should receive infective endocarditis prophylaxis before a dental procedure?
• Which criterion indicates high-degree second-degree AV block?
• When left-to-right shunt is present, which site is preferred for obtaining MVO2?
• Direct Gerbode defect is defined as a VSD that directly communicates from which chamber to which?
• Which echocardiographic finding is most characteristic of acute pulmonary embolism?
• Hypoxemia refers to a decrease in which of the following?
• Which description best characterizes a left Bohr shift?
• In a newborn with tricuspid atresia, where is the most reliable ventricular impulse felt?
• Which option correctly identifies the venous structure with the lowest saturation entering the right atrium?
• Acute pancreatitis due to severe hypertriglyceridemia generally occurs when triglycerides exceed what level?
• How much oxygen can each gram of hemoglobin hold (the Hufner factor)?
• In tissue Doppler imaging, what does the a' velocity represent?
• Carboxyhemoglobin is defined as:
• Partial anomalous pulmonary venous return (PAPVR) primarily causes what type of overload?
• How is dexmedetomidine clearance described in neonates?
• What is the epinephrine spritzer concentration mentioned?
• Which statement best describes the Bohr effect?
• Which statement correctly describes the Bohr shift with respect to oxygen affinity?
• A patient has mitral inflow pattern with E/A 2.4 and DT 150 ms. What grade of diastolic dysfunction is this?
• Which therapy has shown superiority in IST studies compared with beta blockers?
• Which statement correctly describes the Bohr shift with respect to oxygen affinity?
• Which perioperative risk is increased for children with Williams syndrome?
• In DORV with subpulmonic VSD, which condition is associated with neonatal cyanosis?
• In the four-letter pacemaker code, what does the second letter denote?
• What is a risk associated with VOO asynchronous pacing?
• Which statement about pulse oximetry in methemoglobinemia is accurate?
• Plasmapheresis is particularly considered in hypertriglyceridemia–induced pancreatitis under which scenario?
• In truncus arteriosus, which feature is commonly observed in infancy?