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CHD Quiz

Total questions: 38

Worksheet time: 20mins

Name
Class
Date
1.

According to the NADA's criteria for congenital heart disease ,which of the following is not classified as a major criterion

a)

Systolic murmur of grade 3 or more

b)

Diastolic murmur of any grade

c)

Cyanosis

d)

Abnormal chest x ray

2.

Which of the following statements concerning the physiology of fetal circulation is INCORRECT?

a)

A. The umbilical vein conveys the most highly oxygenated blood within the fetal circulation.

b)

B. The foramen ovale functions as a right-to-left atrial shunt, directing oxygen-rich blood preferentially toward the left atrium.

c)

C. The ductus arteriosus serves to divert right ventricular output from the pulmonary artery into the descending aorta, thereby bypassing the nonventilated fetal lungs.

d)

D. The inferior vena cava returns exclusively desaturated systemic venous blood to the right atrium.

3.

The structural closure of foramen ovale occurs by

a)

5-10 days after birth

b)

3-7 days after birth

c)

10-21 days after birth

d)

3 months to few years after birth

4.

Which of the following describes the usual pattern of inheritance of most of the congenital heart diseases

a)

Autosomal dominant

b)

Autosomal recessive

c)

Multifactorial

d)

X-linked recessive

5.

A 6-year-old boy presents with shortened forearms and absent thumbs bilaterally. On examination, he has a systolic murmur at the left upper sternal border. His father has similar hand abnormalities. Echocardiography shows a congenital heart defect.Which type of Congenital Heart Disease is most commonly associated with this Syndrome

a)

VSD

b)

ASD

c)

Tetralogy of fallot

d)

Patent Ductus arteriosus

6.

A 12 year old girl of Turner's Syndrome presents for evaluation of short stature and delayed puberty. On examination, she has a webbed neck , widely spaced nipples and short 4th metacarpal. Which CHD is most likely responsible for long term mortality in this patient

a)

bicuspid aortic valve

b)

coarctation of aorta

c)

Atrial septal defect

d)

transposition of great arteries

7.

A 2-month-old infant presents with feeding difficulty and cyanosis.On examination, there are facial dysmorphic features including micrognathia, low-set ears, and cleft palate.The patient also has hypocalcemia and recurrent infections. Genetic testing confirms a 22q11.2 deletion.Which congenital heart defect is commonly associated with this condition?

a)

Trunchus arteriosus

b)

Ebstein anomaly

c)

TAPVC

d)

Ventricular septal defect

8.

Which chest X-ray sign is classically seen in coarctation of the aorta?

a)

Boot Shaped heart

b)

Egg on string appearance

c)

Inferior rib notching

d)

Snowman appearance

9.

Which of the following statements regarding coarctation of the aorta is INCORRECT?

a)

A. It is most commonly located distal to the left subclavian artery (juxtaductal).

b)

B. It causes hypertension in the upper limbs and weak pulses in the lower limbs.

c)

C. Rib notching occurs due to collateral circulation through the intercostal arteries.

d)

D. It typically causes right ventricular hypertrophy due to pressure overload.

10.

Assertion (A): Coarctation of the aorta can lead to hypertension in the upper limbs.Reason (R): The obstruction is proximal to the right atrium, causing pressure overload in the upper body.

a)

Both assertion and reason are correct and reason is the correct explanation of assertion

b)

Both assertion and reason are correct but reason is not the correct explanation of assertion

c)

Assertion is true but reason is false

d)

Both assertion and reason are false

11.

A 3-month-old infant presents with poor feeding and failure to thrive. On examination, the infant is active, with a bounding pulse and wide pulse pressure. Cardiovascular examination reveals a continuous “machinery” murmur best heard at the left infraclavicular region.What is the most likely diagnosis

a)

Ventricular septal defect

b)

Trunchus arteriosus

c)

TAPVC

d)

Patent Ductus arteriosus

12.

Continuous murmur is heard in:1.Patent Ductus Arteriosus 2.Rupture sinus of valsalva 3.Ventricular septal defect 4.Aortopulmonary window 5.AV malformations

a)

1,2,4,5

b)

1,2,3

c)

1,3,5

d)

2,3,5

13.

Which of the following is not a medical therapy option for PDA closure?

a)

Ibuprofen

b)

Alprostadil

c)

Acetaminophen

d)

Indomethacin

14.

Which of the following is a contraindication for medical closure of patent ductus arteriosus (PDA)?A. Platelet count > 1,50,000/mm³ B. Serum creatinine < 1.4 mg/dL C. Necrotizing enterocolitis D . Any active bleeding

a)

A and B

b)

B and C

c)

Only D

d)

C and D

15.

Which type of VSD is most likely to close spontaneously?

a)

Membranous VSD

b)

Muscular VSD

c)

Supracristal VSD

d)

inlet VSD

16.

Which of the following statements regarding ventricular septal defect (VSD) are correct?1. VSD is the most common congenital heart defect overall. 2. A loud holosystolic murmur at the lower left sternal border usually indicates a small restrictive VSD. 3. Large VSDs always present with cyanosis at birth. 4. VSD may be associated with Down syndrome. 5. Eisenmenger physiology can develop if a large VSD is left untreated.

a)

1245

b)

134

c)

235

d)

All statement are correct

17.

A 10-year-old child with a history of a large ventricular septal defect (VSD) presents with fever, malaise, and new-onset heart murmur. Echocardiography shows vegetations on the right ventricular side of the septal defect, consistent with infective endocarditis.Which is the most likely causative organism in this patient

a)

Streptococcus viridans

b)

Staphylococcus aureus

c)

enterococcus faecalis

d)

pseudomonas aerogenosa

18.

A 6-year-old child presents with exercise intolerance and recurrent respiratory infections. On examination: fixed split of S2, mid-systolic ejection murmur at the pulmonary area. Which pathophysiologic explanation accounts for the fixed split?

a)

increased left ventricular output

b)

delayed right ventricular emptying due to left to right shunt

c)

pulmonary hypertension

d)

tricuspid regurgitation

19.

Which ECG finding is characteristic of secundum ASD in older children?

a)

Normal ECG

b)

left ventricular hypertrophy

c)

left axis deviation

d)

right axis deviation with RBBB Pattern

20.

In which of the following Cyanotic CHD,pulmonary blood flow is decreased

a)

TOF and TAPVC

b)

Ebstein anomaly and TGA

c)

TOF and tricuspid atresia

d)

Tricuspid atresia and TAPVC

21.

A 2-year-old child presents with mild cyanosis and a systolic murmur at the left upper sternal border. Echocardiography reveals pulmonary stenosis, right ventricular hypertrophy, and an atrial septal defect.Which of the following best describes the congenital heart defect

a)

Tetralogy of fallot

b)

Trilogy of fallot

c)

TAPVC

d)

Transposition of great arteries

22.

A 1-year-old child with known Tetralogy of Fallot presents with sudden onset of intense cyanosis, irritability, and rapid breathing while playing. On examination, the child is hyperpneic, agitated, and has a loud systolic murmur at the left upper sternal border.Which of the following drugs is NOT used in the acute management of this condition

a)

Morphine

b)

Sodium bicarbonate

c)

Phenylephrine

d)

Calcium channel blockers

23.

A 4-year-old child with cyanotic congenital heart disease and decreased pulmonary blood flow is planned for palliative surgery to increase pulmonary perfusion. One option considered is a surgical anastomosis between the ascending aorta and the right pulmonary artery.This procedure is known as

a)

Blalock Taussig shunt

b)

Waterston stunt

c)

Potts stunt

d)

Glen shunt

24.

Identify the procedure shown in image

a)

Norwood procedure

b)

Rastelli procedure

c)

Glen shunt

d)

Fontan shunt

25.

A 3-month-old infant presents with cyanosis, tachypnea, and hepatomegaly. On examination, there is a loud holosystolic murmur at the lower left sternal border and a widely split S1–S2. Echocardiography shows apical displacement of the tricuspid valve with atrialization of the right ventricle.Which maternal exposure is most strongly associated with this congenital heart defect?

a)

phenytoin

b)

lithium

c)

valproate

d)

carbamazepine

26.

Norwood procedure is performed for

a)

Hypoplastic left heart syndrome

b)

Trunchus arteriosus

c)

Trilogy of fallot

d)

TAPVC

27.

In TGA with intact ventricular septum, the typical presentation is:A.. Mild cyanosis after 6 months B. Intense cyanosis at birth or soon after birth C. Continuous murmur at the left upper sternal border D. Systolic murmur at the apex only

a)

A

b)

B

c)

C

d)

D

28.

Which of the following is the main factor for Ductal closure postnatally

a)

decrease in pulmonary venous resistance

b)

increase in circulating prostaglandin

c)

increase in systemic vascular resistance

d)

increase in partial pressure of oxygen

29.

Given is the X ray of an infant .Which is not seen in this condition

a)

Atrial septal defect

b)

overriding of aorta

c)

RVOT

d)

VSD

30.

The most common type of TAPVC is

a)

supracardiac

b)

infracardiac

c)

cardiac

d)

mixed

31.

A neonate was found to have cyanosis of the oral mucosa. Chest X ray revealed a snow man appearance of the cardiac silhouette. What is the most likely diagnosis

a)

TAPVC

b)

TGA

c)

Tricuspid atresia

d)

Trunchus arteriosus

32.

In a 13 year old child with Ebstein anomaly,echocardiography would likely reveal

a)

mitral regurgitation

b)

tricuspid regurgitation

c)

tricuspid stenosis

d)

mitral stenosis

33.

A term neonate, now one week of age, is evaluated in the post-operative cardiac ward. The infant had presented immediately after birth with profound and persistent central cyanosis unresponsive to supplemental oxygen. Prostaglandin E1 infusion was initiated to maintain ductal patency, following which a balloon atrial septostomy was undertaken to augment intercirculatory mixing. Subsequently, a striking amelioration of cyanosis was observed. Which congenital cardiac malformation most appropriately explains this clinical scenario?

a)

Tetralogy of fallot

b)

Complete transposition of great arteries

c)

persistent trunchus arteriosus

d)

tricuspid valve artesia

34.

Regarding Patent Ductus Arteriosus (PDA), which of the following statements are correct?

a)

Continuous “machinery” murmur is classically best heard in the first right intercostal space near the sternum.

b)

Left atrial and left ventricular dilatation may occur in large, uncorrected PDAs due to volume overload.

c)

Indomethacin or ibuprofen therapy is commonly used for PDA closure in preterm infants.

d)

Differential cyanosis (cyanosis of lower limbs with pink upper limbs) is seen in PDA since birth

35.

Which of the following statements are correct regarding Tetralogy of Fallot?

a)

Cyanotic spells are relieved by squatting due to increased systemic vascular resistance.

b)

Box shaped heart on Chest X ray

c)

Pulmonary stenosis severity determines the degree of cyanosis

d)

Equivalent of squatting is knee chest position in infants

e)

Isoprenaline is used in management of tet spells

36.

Which of the following statements are correct regarding Ebstein’s anomaly?

a)

It is characterized by downward displacement of the tricuspid valve leaflets into the right ventricle.

b)

Boot Shaped heart on Chest X ray

c)

It is the most common congenital heart disease associated with maternal rubella infection.

d)

Wolff–Parkinson–White (WPW) syndrome may coexist due to accessory pathways.

e)

It is strongly associated with maternal lithium therapy during pregnancy.

37.

Regarding Transposition of the Great Arteries (TGA), which of the following statements are correct?

a)

TGA is characterized by a ventriculoarterial discordance with aorta arising from the right ventricle.

b)

Severe cyanosis may be present in the first hours of life.

c)

Prostaglandin E1 is used to close the ductus arteriosus.

d)

Balloon atrial septostomy may improve oxygenation before surgery.

38.

Which of the following are used in the management of Tet spells

a)

Oxygen

b)

Bicarbonate

c)

Knee chest position

d)

Squatting position

e)

prazosin