CONGENITAL HEART DISEASE

MCQs with Answers Series 1 www.medshortnotes.com

Atrial Septal Defect

a.Shunt is right to left
b.ECG typically shows RBBB c.Splitting of 2nd heart sound decreases in inspiration. d.usually primum type. e.It usually presents in early childhood
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a.Shunt is right to left -T initially left to right. LATE and RARELY right to left occurs b.ECG typically shows RBBB -T in primum there can be LBBB. but as primum is not usual presentation it is not considered as typical until specifically mentioned as primum. c.Splitting of 2nd heart sound decreases in inspiration. -F splitting is fixed and wide. d.usually primum type. - F usually secondum type due to patent fossa ovalis

e.It usually presents in early childhood -F usual presentation is in adult

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Correct statements of Atrial Septal Defect

a.Narrow and fixed 2nd heart sound
b.It is more common in females than males c.It can be complicated by atrial arrhythmias d.Surgical correction should be deferred until secondary pulmonary hypertension develops e.It is characterized by LBBB in ECG.
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a.Narrow and fixed 2nd heart sound -F splitting is fixed and wide. b.It is more common in females than males. - T f>m c.It can be complicated by atrial arrhythmias -T Arrhythmias in 4th decade onwards. Atrial fibrillation( pulmonary resistant increase -> pulmonary hypertension->AF)

d.Surgical correction should be deferred until secondary pulmonary hypertension develops.- F Children with significant ASD need Rx. sASD- cardiac catheterization with insertion of an occlusive device. pAVSD- surgical correction at 3-5 years. e.It is characterized by LBBB in ECG. -F in primum there can be LBBB. but as primum is not usual presentation it is not considered as typical until specifically mentioned as primum.

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congenital heart disease may present:

a. excessive sweating b. cyanosis becoming apparent 2 days after birth.

c. murmur is asymptomatic in 16 year old child.

d. Failure to Thrive e. Recurrent vomiting
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a. excessive sweating T HF causes sweating due to increased sympathetic drive. b. cyanosis becoming apparent 2 days after birth - T cyanotic heart diseases can cause such presentation. c. murmur is asymptomatic in 16 year old child - T in ASD murmur may present as asymptomatic at any age. d. Failure to Thrive - T increased calorie requirement and poor intake will result in poor weight gain which is known as Failure to thrive.

e. Recurrent vomiting - F It may occur due to hepatic congestion and bowel congestion that would occur in the late stage of the disease. therefore, it is less likely to be a presenting symptom.
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Beneficial therapeutic interventions:

a. in a large ventricular septal defect frusemide for a child b. oxygen supply in case of TOF.

c. Prostoglandins E1 in Transposition of great vessles

d. Patent foramen ovale is closed by surgical closure. e. potassium supplement on high dose of diuretic therapy.
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a. in a large ventricular septal defect frusemide for a child-T Diuretic therapy is beneficial in case of HF in VSD,etc. b. oxygen supply in case of TOF.-F O2 therapy rarely of beneficial in cyanotic conditions. c. Prostoglandins E1 in Transposition of great vessels-T infusion of prostoglandins re-opens the arterial duct which will improve systemic oxygenation. d. Patent foramen ovale is closed by surgical closure -F foramen ovale closes soon after birth usually. but in some cases, it may remain unclosed for some months(patent foramen ovale) even though it remains patent, it is asymptomatic. e. potassium supplement on high dose of diuretic therapy.-T Loop diuretic commonly cause hypokalemia. to prevent hypokalemia in diuretic therapy, potassium supplement or potassium sparing diuretics are used. Amiloride is a such kind of drug.
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