WorksheetsPEDIA MIDTERM
Total questions: 87
Worksheet time: 44mins
Which of the following is true of Eisenmenger syndrome?
Pulmonary artery systolic and diastolic pressure is decreased
The degree of right to left shunt is minimal
Desaturation of blood in the LV is encountered
The apex of the heart is formed by what chamber?
Left ventricle
Right ventricle
Which of the following forms a large supracardiac shadow on CXR and gives a snowman appearance?
TOF
TAPVR
What characteristic histopathologic lesion is seen in Rapidly Progressive Glomerulonephritis?
Crescent formation
Deposition of IgA
What is the surgical treatment for TOF?
Balloon atrial septostomy
Modified Blalock-Taussig
Which of the following is functionally closed at 3 months of life?
Foramen ovale
Ductus arteriosus
A 3 month old male with fever and vomiting with no other signs and symptoms was noted to have pyuria on urinalysis. What should be the next step?
Treat the patient and perform urine culture and ultrasound
Treat the patient and perform an ultrasound
The advantage of Peritoneal Dialysis are the following:
Less restrictive diet
Freedom to attend school
Technically easier
All of the above
A 5 year old patient with a weight of 20kg and height of 100cm was brought in the ER because of edema and oliguria for 2 days. She was noted to have hematuria for the past 3 days. On further history, she claimed to have sore throat and lymphadenopathy 1 week prior. On admission, her creatinine was 100 umol/L, What is her glomerular filtration rate?
20 ml/min
36 ml/min
Chronic Kidney Disease is defined as:
GFR < 60 ml/min/1.73m2 for > 3 months
GFR < 90 ml/min/1.73m2 for > 3 months
Which of the following pathophysiology of ASD is correct?
Saturated and unsaturated blood mixes at the area of the right ventricle
There is normal cardiac output
Renal replacement therapy or dialysis should be considered immediately in the following except:
A 3 day old infant with seizures and with positive newborn screening test result of Maple Syrup Urine Disease with normal creatinine
A 10 year old male with Dengue Shock Syndrome with pulmonary congestion, decreasing urine output and hemoconcentration
Which chamber forms the base of the heart?
Right atrium
Left atrium
Which type of ventricular outflow obstruction causes heart failure and weak pulses in all extremities?
Aortic valve stenosis
Coarctation of the aorta
Pyuria is defined as
WBC > 5/hpf
WBC > 10/hpf
Which type of cardiac lesion causes a disparity in pulsation and blood pressure in the arms and legs?
Mitral valve prolapse
Coarctation of the aorta
Steroid resistant Nephrotic syndrome is defined as:
Failure to respond to steroids after 6 weeks of treatment
Failure to respond to steroids after 8 weeks of treatment
Which of the following cardiac defects is common in children with Down syndrome?
AV septal defect
ASD
VSD
Which of the following is not a type of ASD?
Sinus venosus
Sinus arteriosus
Which of the following is true of transition from neonatal to adult circulation?
Pulmonary vascular resistance is markedly decreased
Closure of the ductus arteriosus and the fall in pulmonary vascular resistance leads to decrease in pulmonary arterial and right ventricular pressure
The major decline in pulmonary resistance from the high fetal levels to adult levels occurs within the first 2-3 days
All of the above
Which of the following is the most common type of ASD?
Secundum
Sinus arteriosus
How long can microscopic hematuria persists in acute poststreptococcal glomerulonephritis?
6 months
1-2 years
The closure of which of the following valves produces the first heart sound?
Tricuspid valve
Mitral valve
Aortic valve
Which of the following is true of fetal circulation?
The liver provides for gas and metabolite exchange
Ductus venosus, foramen ovale, ductus arteriosus are present
The closure of which of the following valves produces the second heart sound?
Pulmonic valve
Tricuspid valve
Aortic valve
Mitral valve
Which of the following is the correct flow of fetal circulation?
Umbilical venous blood—hepatic circulation – IVC via ductus arteriosus – right atrium
Umbilical venous blood – IVC – right atrium --- foramen ovale – left atrium
Umbilical venous blood – IVC – right atrium --- right ventricle – pulmonary artery
In doing a complete cardiac history, which of the following is important, except?
Edema
Jaundice
Orthopnea
The following are functions of the kidney except:
EPO production
Filtration
Bone metabolism
None of the above
Most common etiologic agent in UTI:
E. Coli
Streptococcus sp
Which of the following is correct about heart sounds and murmurs?
Pulmonic valve heard best in the 2nd and 3rd left interspaces close to the sternum
Tricuspid valve heard best at or near the lower left sternal border
Mitral valve heard at and around the cardiac apex
All of the above
The most likely pathophysiology for PSGN is:
Antigen-antibody complex deposition in the GBM
In situ immune-complex formation in the mesangium
Mainstay therapy for the treatment of anemia in CKD is/are:
Blood transfusion
Erythropoietin injections
What is the recommended urine collection method for infants?
Mead stream clean catch urine collection
Suprapubic catheterization
A patient presents with facial edema, joint pains and severe abdominal pain with violaceous rash on both lower extremities. What is the likely diagnosis?
Rheumatoid Arthritis
Systemic Lupus Erythematosus
The following are typical of Hemolytic Uremic Syndrome except:
Renal failure
Purpuric rash
Which of the following is the most common cardiac anomaly
AV cushion defect
VSD
ASD
Criteria for the diagnosis of Nephrotic Syndrome includes the following except:
Edema
Renal insufficiency
The preferred Renal Replacement Therapy modality in a patient with AKI with sepsis or hemodynamic instability:
Peritoneal Dialysis
Hemodialysis
Which of the following cyanotic heart disease causes a decrease pulmonary blood flow?
TOF
TOGV
Truncus arteriosus
All of the above
Diagnostic modality of choice for diagnosing Vesicoureteral reflux:
VCUG
Intravenous Pyelogram
In newborns with D-TOGA, survival is determined by which of the following?
Foramen ovale
Regurgitant mitral valve
Which of the following determines the timing of the onset of symptoms and severity of cyanosis in TOF?
Pulmonic valve stenosis
Aortic valve stenosis
Typical of glomerular causes of hematuria except:
Presence of dysmorphic RBC cells
Presence of RBC casts
What of the following denotes systole?
Atrial contraction
Ventricular contraction
Prerenal AKI, in contrast to Renal AKI, is characterized by the following:
FeNa < 1%
UNa > 40 mEq/L
What chamber of the heart causes the rounded apical shadow in TOF?
Right ventricle
Left ventricle
A patient with hypertension, hematuria and edema comes to the Emergency Room. On history, the patient had throat infection 2 weeks prior. What diagnostic test result will support the diagnosis of PSGN?
Decreased C3
Albumin +4
Which of the following medical treatment is used for TOF, except?
Oral propranolol
Prostaglandin E2
Which of following shunt/defect produces a volume load abnormality, except.
Aortic valve stenosis
Patent ductus arteriosus
What is the recommended urine collection method for older children?
Suprapubic catheterization
Mead stream clean catch urine collection
Catheterization
Urine bag collection
Most common etiologic agent of Spontaneous bacterial peritonitis in Nephrotic syndrome:
Haemophilus influenza
E. coli
Which of the following determines the shunting of blood in ASD?
Size of the defect
Compliance of all cardiac chambers
Which chamber of the heart forms the right border?
Right atrium
Right ventricle
Which of the following clinical manifestation is true of VSD, except?
Varies according to the size of the defect
Small VSDs causes symptoms
Which of the following is part of the treatment in TOF, except?
Blood glucose measurement
Surgical treatment
Normal body temperature
All of the above
What is responsible for efferent arteriole vasoconstriction?
Aldosterone
Angiotension II
When is C3 expected to return to normal after Post Streptococcal Glomerulonephritis
6-8 weeks
10-12 weeks
Which of the following pathophysiology of VSD is correct?
Pulmonary arterial saturation may be further decreased because of incomplete mixing at right ventricular level
There is increased oxygen saturation in the right ventricle
Acyanotic heart disease is classified in terms of volume and pressure abnormality, which of the following produces a volume load abnormality?
Aortic valve stenosis
Coarctation of the aorta
Most commonly used dialysis modality in children:
Peritoneal dialysis
Hemodialysis
What is the correct sequence in doing a cardiac physical examination?
Inspection, Auscultation, Palpation, Percussion
Inspection, Palpation, Percussion, Auscultation
What is the most common cause of chronic glomerulonephritis in children?
Post infectious glomerulonephritis
Alport Syndrome
Which is true of cardiac lesions resulting in increased volume load?
There is communication between systemic and pulmonary side
Pressure and resistance are the most important factors
According to the AAP, in which patient should ultrasound be done immediately?
A 5 year old male who developed fever and vomiting for which appropriate antibiotics were given but still remained febrile on the 4th day of medications
A 3 year female who had fever and pyuria with growth of Proteus mirabilis with good response to medications within 48 hours
Signs and symptoms of acute nephritic syndrome except:
Hypertension
Proteinuria
Which chamber of the heart cannot be examined directly because it is mostly posterior?
Left atrium
Left ventricle
Which of the following are the treatment goals of large VSD?
To control heart failure
To prevent the development of pulmonary vascular disease
To maintain normal growth
All of the above
Which of the following cardiac defects causes a classic continuous murmur-machinery or rolling thunder heart sound?
PDA
ASD
Which heart sound is considered abnormal when present in adults?
S4
S1
A 15 year old female comes to the clinic because of 1 month history of fever accompanied by edema, malar rash, pallor and joint pain. What test will you do next k to confirm your diagnosis?
Anti- GBM test
Anti- dsDNA
Which of the following is true of D-Transposition of the Great Arteries?
Causes cyanosis
Aorta arises from right ventricle
Desaturated blood returning from the body to the right side of the heart goes inappropriately right out the aorta and back to the body again
All of the above
What is the confirmatory test to diagnose Urinary tract infection?
Urine dipstick
Urine culture
A 3 year old boy comes to the emergency room because of anasarca with a BP of 100/70 mmHg, +4 protein on urinalysis. What pathologic finding is most likely to be seen?
Glomerular inflammation with infiltration of neutrophils
Foot process effacement
Light microscopy finding in Minimal Change Disease
Normal glomerulus
Sclerosis
Which of the following imaging or tests is/are useful in evaluating an infant with congenital heart disease, except?
CXR
EEG
Which of the following produces a left to right shunting?
Coarctation of the aorta
AV septal defects
The holosystolic murmur in Ebstein anomaly is secondary to which abnormality?
Mitral valve regurgitation
Tricuspid regurgitation
Which of the following is true of PDA?
Common in males
Associated with maternal rubella infection
Common problem in both term and preterm infants
All of the above
On physical examination, the patient was anasarcous, with a BP of 120/80, CR – 100bpm, crackles on both lungs fields, full pulses with an empty bladder. What is the next course of action?
Hydrate the patient with PNSS at 20cc/kg
Give Furosemide
Refer for Renal replacement therapy
All of the above
Which of the following is commonly seen in girls that causes billowing of one or both of the leaflets into one of the heart chambers?
Left to right shunts
MVP
Myocarditis
Risk factors for UTI include the following:
Uncircumcised males
Abdominal mass
Meningocoele
All of the above
What is the single best antibody titer to document cutaneous streptococcal infection?
Skin Biopsy
Antistreptolysin O titer
Which defect in Ebstein anomaly is responsible for cyanosis and polycythemia?
Foramen ovale
Regurgitant mitral valve
Which of the following is true of ASD, except?
Autosomal recessive inheritance
Majority of cases are sporadic
Is a type of volume load abnormality
Is a type of left to right shunt
Which of the following happens during systole?
Aortic valve is open
Mitral valve is open
Ejection of blood from the right ventricle
All of the above
Grade 3 Vesicoureteral reflux refers to:
Reflux into the ureter and renal pelvis with no evidence of ureteral distention
Reflux up to the ureters only with mild dilatation
Which abnormality is found in Ebstein anomaly?
Right atrium is huge
Mitral valve is regurgitant
