Deck 30: Alterations of Cardiovascular Function in Children
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Deck 30: Alterations of Cardiovascular Function in Children
1
Acquired heart disease is the most common cardiovascular disease in children.
False
2
What is the function of a patent opening between the left and right atria in a fetus?
A) It allows right-to-left shunt.
B) It allows left-to-right shunt
C) It allows blood to flow from the umbilical cord.
D) It allows blood to flow to the lungs for oxygenation.
A) It allows right-to-left shunt.
B) It allows left-to-right shunt
C) It allows blood to flow from the umbilical cord.
D) It allows blood to flow to the lungs for oxygenation.
It allows right-to-left shunt.
3
Fetal heart contractions begin by approximately the twenty-eighth day of gestation.
True
4
Closure of the ductus arteriosus normally occurs immediately after birth.
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5
Iron deficiency anemia may result from polycythemia that develops from chronic hypoxia.
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6
Conditions in which a patent foramen ovale may continue past the first month of life include pulmonary hypertension,right ventricular failure,and tricuspid atresia.
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7
Lesions that increase the pulmonary blood flow are called right-to-left shunts.
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8
When does most cardiovascular development occur?
A) By the twenty-eighth day of gestation
B) Between the fourth and seventh weeks of gestation
C) Between the eighth and tenth weeks of gestation
D) Between the twelfth and fourteenth weeks of gestation
A) By the twenty-eighth day of gestation
B) Between the fourth and seventh weeks of gestation
C) Between the eighth and tenth weeks of gestation
D) Between the twelfth and fourteenth weeks of gestation
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9
Which of the following statements is true?
A) At birth,both systemic resistance and pulmonary resistance fall.
B) At birth,there is a shift in gas exchange from the placenta to the lung.
C) At birth,systemic resistance falls and pulmonary resistance rises.
D) At birth,both systemic resistance and pulmonary resistance rise.
A) At birth,both systemic resistance and pulmonary resistance fall.
B) At birth,there is a shift in gas exchange from the placenta to the lung.
C) At birth,systemic resistance falls and pulmonary resistance rises.
D) At birth,both systemic resistance and pulmonary resistance rise.
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10
In general,the pathophysiologic mechanisms of congestive heart failure are very different in children than in adults.
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11
Kawasaki disease is a self-limiting systemic vasculitis.
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12
In some cases of total anomalous pulmonary venous return,pulmonary veins drain into the vena cava.
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13
Congenital heart defects that cause acyanotic congestive heart failure usually involve:
A) right-to-left shunts.
B) left-to-right shunts.
C) obstructive lesions.
D) mixed lesions.
A) right-to-left shunts.
B) left-to-right shunts.
C) obstructive lesions.
D) mixed lesions.
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14
Diagnosis of primary hypertension in children is difficult since the early stages are often asymptomatic.
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15
Common clinical manifestations of right ventricular failure in children include failure to thrive and periorbital edema.
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16
When does systemic vascular resistance in infants begin to rise?
A) One month before birth
B) During the beginning stage of labor
C) One hour after birth
D) Once the placenta is removed from circulation
A) One month before birth
B) During the beginning stage of labor
C) One hour after birth
D) Once the placenta is removed from circulation
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17
All hypertension in children is considered primary hypertension.
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18
Most cardiovascular development occurs between the fourth and seventh weeks of gestation.
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19
Complete transposition of the great vessels is a congenital heart defect in which the left ventricle pumps blood to the pulmonary circulation.
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20
The purpose of the foramen ovale is to allow a right-to-left shunt necessary for fetal circulation.
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21
Coarctation of the aorta may be located:
A) exclusively on the aortic arch.
B) anywhere proximal to the brachiocephalic artery.
C) anywhere between the origin of the aortic arch and the bifurcation of the aorta in the lower abdomen.
D) anywhere between the origin of the aortic arch and the origin of the first intercostal artery.
A) exclusively on the aortic arch.
B) anywhere proximal to the brachiocephalic artery.
C) anywhere between the origin of the aortic arch and the bifurcation of the aorta in the lower abdomen.
D) anywhere between the origin of the aortic arch and the origin of the first intercostal artery.
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22
How do children with tetralogy of Fallot compensate to relieve hypoxic spells?
A) They lie on their left side.
B) They perform the Valsalva maneuver.
C) They squat.
D) They hyperventilate.
A) They lie on their left side.
B) They perform the Valsalva maneuver.
C) They squat.
D) They hyperventilate.
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23
Elevation of which laboratory test suggests an onset of essential hypertension in children?
A) Serum uric acid
B) Serum sodium
C) Brain natriuretic peptide (BNP)
D) Protein in the urine
A) Serum uric acid
B) Serum sodium
C) Brain natriuretic peptide (BNP)
D) Protein in the urine
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24
Which congenital heart defects occur in trisomy 13,trisomy 18,and Down syndrome?
A) Coarctation of the aorta and pulmonary stenosis
B) Tetralogy of Fallot and persistent truncus arteriosus
C) Atrial septal defect and dextrocardia
D) Ventricular septal defect and patent ductus arteriosus
A) Coarctation of the aorta and pulmonary stenosis
B) Tetralogy of Fallot and persistent truncus arteriosus
C) Atrial septal defect and dextrocardia
D) Ventricular septal defect and patent ductus arteriosus
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25
Which of the following is consistent with the cardiac defect of transposition of the great vessels?
A) The aorta arises from the right ventricle.
B) The pulmonary trunk arises from the right ventricle.
C) The right ventricle pumps blood to the lungs.
D) All of the above.
A) The aorta arises from the right ventricle.
B) The pulmonary trunk arises from the right ventricle.
C) The right ventricle pumps blood to the lungs.
D) All of the above.
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26
MATCHING
Match the phrases with the corresponding terms.
Septum secundum
A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting
Match the phrases with the corresponding terms.
Septum secundum
A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting
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27
Which heart defect produces a systolic ejection click at the upper left sternal border with a thrill palpated at the upper left sternal border?
A) Coarctation of the aorta
B) Pulmonic stenosis
C) Aortic stenosis
D) Hypoplastic left heart syndrome
A) Coarctation of the aorta
B) Pulmonic stenosis
C) Aortic stenosis
D) Hypoplastic left heart syndrome
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28
Classic manifestations of epistaxis,cyanosis of the lower extremities,and decreased or absent femoral pulse are indicative of which congenital defect?
A) Tetralogy of Fallot
B) Aortic stenosis
C) Ventricular septum defect
D) Postductal aortic coarctation
A) Tetralogy of Fallot
B) Aortic stenosis
C) Ventricular septum defect
D) Postductal aortic coarctation
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29
MATCHING
Match the phrases with the corresponding terms.
Truncus arteriosus
A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting
Match the phrases with the corresponding terms.
Truncus arteriosus
A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting
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30
An infant has a continuous-machine type of murmur best heard at the left upper sternal border throughout systole and diastole.The infant has a bounding pulse and a thrill on palpation.These clinical findings are consistent with which congenital heart defect?
A) Atrial septal defect (ASD)
B) Ventricular septal defect (VSD)
C) Patent ductus arteriosus (PDA)
D) Atrioventricular canal defect (AVC)
A) Atrial septal defect (ASD)
B) Ventricular septal defect (VSD)
C) Patent ductus arteriosus (PDA)
D) Atrioventricular canal defect (AVC)
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31
What are characteristics of patent ductus arteriosus?
A) It causes an intermittent murmur.
B) It may be asymptomatic.
C) It should be surgically repaired in the first year of life.
D) It is part of a triad of congenital defects.
A) It causes an intermittent murmur.
B) It may be asymptomatic.
C) It should be surgically repaired in the first year of life.
D) It is part of a triad of congenital defects.
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32
An infant has a crescendo-decrescendo systolic ejection murmur located between the second and third intercostal spaces along the left sternal border.There is also a wide fixed splitting of the second heart sound.These clinical findings are consistent with which congenital heart defect?
A) Atrial septal defect (ASD)
B) Ventricular septal defect (VSD)
C) Patent ductus arteriosus (PDA).
D) Atrioventricular canal defect (AVC)
A) Atrial septal defect (ASD)
B) Ventricular septal defect (VSD)
C) Patent ductus arteriosus (PDA).
D) Atrioventricular canal defect (AVC)
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33
Which heart defect results in a single vessel arising from both ventricles providing blood to both the pulmonary and systemic circulations?
A) Coarctation of the aorta
B) Tetralogy of Fallot
C) Total anomalous pulmonary connection
D) Truncus arteriosus
A) Coarctation of the aorta
B) Tetralogy of Fallot
C) Total anomalous pulmonary connection
D) Truncus arteriosus
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34
Which of the following describes total anomalous pulmonary venous return?
A) The foramen ovale closes after birth.
B) Pulmonary venous return is to the right atrium.
C) Pulmonary venous return is to the left atrium.
D) The left atrium receives oxygenated blood.
A) The foramen ovale closes after birth.
B) Pulmonary venous return is to the right atrium.
C) Pulmonary venous return is to the left atrium.
D) The left atrium receives oxygenated blood.
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35
Congenital heart defects that cause hypoxemia,and therefore cyanosis,usually involve:
A) right-to-left shunts.
B) left-to-right shunts.
C) obstructive lesions.
D) mixed lesions.
A) right-to-left shunts.
B) left-to-right shunts.
C) obstructive lesions.
D) mixed lesions.
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36
The foramen ovale is covered by a flap that creates a check valve allowing blood to flow unidirectionally from the _____ to the _____.
A) right atrium;right ventricle
B) right ventricle;left ventricle
C) right atrium;left atrium
D) left atrium;left ventricle
A) right atrium;right ventricle
B) right ventricle;left ventricle
C) right atrium;left atrium
D) left atrium;left ventricle
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37
What is the most important clinical manifestation of aortic coarctation in the neonate?
A) Left heart failure
B) Cor pulmonale
C) Pulmonary hypertension
D) Cerebral hypertension
A) Left heart failure
B) Cor pulmonale
C) Pulmonary hypertension
D) Cerebral hypertension
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38
MATCHING
Match the phrases with the corresponding terms.
Foramen ovale
A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting
Match the phrases with the corresponding terms.
Foramen ovale
A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting
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39
An infant has a loud,harsh,holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck.These clinical findings are consistent with which congenital heart defect?
A) Atrial septal defect (ASD)
B) Ventricular septal defect (VSD)
C) Patent ductus arteriosus (PDA)
D) Atrioventricular canal defect (AVC)
A) Atrial septal defect (ASD)
B) Ventricular septal defect (VSD)
C) Patent ductus arteriosus (PDA)
D) Atrioventricular canal defect (AVC)
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40
Which heart defect produces a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border with an occasional ejection click?
A) Coarctation of the aorta
B) Pulmonic stenosis
C) Aortic stenosis
D) Hypoplastic left heart syndrome
A) Coarctation of the aorta
B) Pulmonic stenosis
C) Aortic stenosis
D) Hypoplastic left heart syndrome
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41
MATCHING
Match the phrases with the corresponding terms.
Bulbus cordis
A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting
Match the phrases with the corresponding terms.
Bulbus cordis
A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting
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42
MATCHING
Match the phrases with the corresponding terms.
Ostium primum
A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting
Match the phrases with the corresponding terms.
Ostium primum
A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting
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