Chapter 400-500

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2-The classic triad of findings in pulmonary hemosiderosis includes:

A. Cough, iron deficiency anemia, infiltrates on chest radiograph

B. Clubbing, anemia of chronic disease, bronchiectasis on CT

C. Hypoxia, hemoptysis, multiple alveolar infiltrates on chest radiograph

D. Hemoptysis, iron deficiency anemia, multiple alveolar infiltrates on chest radiograph

E. Respiratory distress, anemia, multiple alveolar infiltrates on chest radiograph

6- Empyema may be distinguished from simple pleural effusion by which characteristics?

A. pH < 7. 2

B. Bacteria on Gram stain of pleural fluid

C. Pleural fluid neutrophils > 100, 000/µL

D. Fluid shift on PA → lateral decubitus chest radiograph

E. Septations on ultrasound evaluation

7-A 17 yr old previously healthy boy presents to the emergency department with shortness of breath and chest pain. Symptoms started while playing videogames. He is tall and thin, with no history of atopy. He has no fever. Respiratory rate 35 breaths/min and oxygen saturation is 97%. Chest radiography is most likely to show:

A. Pneumothorax

B. Right lower lobe pneumonia

C. Globular heart

D. Subsegmental atelectasis

E. Diffuse alveolar infiltrates

8-The most common cause of pneumomediastinum in pediatric patients is:

A. Asthma

B. Pneumonia

C. Foreign body

D. Esophageal tear

E. Dental extraction

9-. Which statement regarding pectus excavatum is NOT true?

A. It is generally present at birth

B. It has a 9: 1 male predominance

C. It may cause significant psychologic distress

D. It typically causes cardiac symptoms in childhood and respiratory symptoms in adulthood

E. The Nuss procedure may improve cardiopulmonary symptoms

14-Many nonpulmonary diseases have respiratory manifestations. Which of the following respiratory symptoms is incorrectly associated with a nonpulmonary cause?

A. Wheezing—Congestive heart failure

B. Chest pain—Pericarditis

C. Cyanosis—Anxiety

D. Exercise Intolerance—Anemia

E. Tachypnea—Metabolic acidosis

15-Large VSDs in infants usually cause symptoms at what age?

A. 1st day of life

B. 1st wk of life

C. 2nd wk of life

D. 1 to 2 mo of age

E. 4 mo of age

29-Which statement about mitral valve prolapse (MVP) is INCORRECT?

A. MVP is predominantly congenital but may not be recognized until adolescence or adulthood

B. It is common in patients with Marfan syndrome, pectus excavatum, scoliosis, and Ehlers-Danlos syndrome

C. Antibiotic prophylaxis is recommended prior to dental procedures

D. MVP is associated with premature ventricular contractions

E. Specific therapy is not required during childhood

32-The primary developmental defect in tetralogy of Fallot that is responsible for the characteristic 4 cardiac defects is what?

A. Anomaly in arch development

B. Anterior displacement of the infundibular septum

C. Downward displacement of the tricuspid valve

D. Abnormal cardiac looping

E. Failure of atrial septum secundum to fuse with the septum primum

35-Which cardiac defect has the worst prognosis, without immediate surgical correction?

A. d-TGA with no associated defects

B. l-TGA with no associated defects

C. d-TGA with large ASD

D. d-TGA with restrictive VSD

E. l-TGA with restrictive VSD

37-A 6 mo old presents to the emergency department with wheezing. A chest radiograph shows massive cardiomegaly. ECG shows deep Q waves in the lateral leads. The most likely diagnosis is:

A. Anomalous left coronary artery arising from the pulmonary artery

B. Hypertrophic cardiomyopathy

C. Supraventricular tachycardia

D. Atrioventricular canal defect

E. Pentology of Cantrell

42-You order an ECG on an adolescent female who fainted while on an amusement park ride. The corrected QT interval is 470. There is a family history of sudden death in an uncle. You consider ordering genotype for long QT syndrome (LQTS). Which of the following is not true about genotyping for this condition?

A. Genotyping may be useful in the diagnosis of asymptomatic family members

B. Genotype may predict clinical manifestations in a patient with LQTS

C. Genotype may predict a higher risk for sudden death

D. Genotype may predict nonresponse to conventional pharmacotherapy

E. A negative genotype (i. e., no mutation) may rule out the disorder in suspected cases

48- The most common valve involved in rheumatic fever is:

A. Aortic

B. Mitral

C. Pulmonary

D. Tricuspid

53- The most common cardiac tumor in pediatrics is:

A. Rhabdomyoma

B. Lipoma

C. Myxoma

D. Fibroma

E. Rhabdosarcoma

89- Leukemia in infants is commonly associated with:

A. A better prognosis than in older children

B. Philadelphia chromosome

C. FAB L3 (Burkitt) type

D. A translocation involving chromosome 11

E. Spontaneous resolution

91-A 7 yr old boy weighing 24 kg presents with painless right supraclavicular lymphadenopathy. Chest radiograph reveals a mediastinal mass measuring more than one third of the thoracic diameter. Biopsy of the lymph node reveals Hodgkin disease, nodular sclerosing type. Which of the following indicates a poorer prognosis?

A. Hilar lymphadenopathy

B. Unilateral cervical adenopathy

C. Fever > 39°C

D. Pruritus

E. Weight loss of 2 kg

103-A 5 yr old boy presents with pain and swelling of the proximal right lower leg over the past 2 wk, with limitation of movement of the right knee. A radiograph of the tibia shows a lytic bone lesion with periosteal reaction or " onion-skinning. " The most likely diagnosis is:

A. Acute osteomyelitis

B. Chronic osteomyelitis

C. Osteoid osteoma

D. Ewing sarcoma

E. Osteosarcoma

113-Leukocoria is associated with this cancer:

A. Wilms tumor

B. Germ cell tumor

C. Retinoblastoma

D. Rhabdomyosarcoma

E. Leiomyosarcoma

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