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1.

Management includes prostaglandin infusion and balloon atrial septostomy
a) Tetralogy of Fallot
b) Hypoplastic left heart syndrome
c) Transposition of the great vessels
d) PDA
e) Coarctation of the Aorta
2. Clinical features may include: active precordium, soft pansystolic or no murmur, loud pulmonary
second souns, tachypnoea, tachycardia and hepatomegaly
a) large ASD
b) mitral stenosis
c) patent ductus arteriosus
d) large VSD
e) aortic stenosis
3. Physical signs include: An ejection systolic murmur and ejection click best heard at the upper left
sternal edge, soft or absent P2, right ventricualr hypertrophy.
a) Adult type coarctation of the aorta
b) Tricuspid regurgitation
c) Mitral stenosis
d) Pulmonary stenosis
e) Aortic stenosis

4. Clinical features include: systemic hypertension in right arm, ejection systolic murmur at upper
sternal edge, radio- femoral delay.
a)Adult type coarctation of the aorta
b)Pulmonary stenosis
c)Tricuspid regurgitation
d)Aortic stenosis
e)Mitral stenosis
5. May be associated with a sudden loss of consciousness during exercise, sress or emotion, usually in
late childhood. may be misdiagnosed as epilepsy.
a)Long QT syndrome
b)Tetralogy of Fallott
c)complete heart block
d)Transposition of the great arteries
e)supraventricular tachycardia
6. Which of the following is most likely to be associated with William's syndrome?
a)aortic valve stenosis or coarctation of the aorta
b)ASD, VSD, or tetralogy of Fallot
c)peripheral pulmonary stenosis or PDA
d)complete heart block
e)supravalvulvar aortic stenosis or peripheral pulmonary artery stenosis
7. In this condition, only the left ventricle is effective, the right being small and non-functional
a)Hypoplastic left heart syndrome
b)Tricuspid atresia
c)Transposition of the great vessels
d)Coarctation of the Aorta
e)Tetralogy of Fallot
8. Which of the following is a LATE sign of infective endocarditis?
a)Fever
b)Anaemia
c)Raised ESR
d)Clubbing
e)Splinter haemorrhages
9. Seldom used diagnostically. Reserved for haemodynamic measurements and intervention
a)Doppler ultrasound
b)ECG
c)echocardiography
d)Chest X-Ray
e)Cardiac catheterisation
10. The "figure 3 sign" is suggestive of
a)Adult type coarctation of the aorta
b)Aortic stenosis
c)Pulmonary stenosis
d)Tricuspid regurgitation
e)Mitral stenosis
11. Consists of right ventricular hypertrophy, ventricular septal defect, abnormal position of the aorta,
and pulmonary valve stenosis.
a)Transposition of the great vessels
b)Duct dependant co-arctation
c)Supravulvular pulmonary stenosis
d)Tetralogy of Fallot
e)ASVSD complex
12. Which of the following is NOT a physical sign of aortic stenosis
a)Small volume, slow rising pulse
b)Apical ejection click
c)Ejection systolic murmur radiating to the neck
d)Carotid thrill
e)Absent aortic second sound
13. What percentage of infants requiring heart surgery in the first six months of life are diagnosed
antenatally?
a)50%
b)70%
c)10%
d)20%
e)30%
14. With regards to the foetal/newborn circulation, which of the following in FALSE?
a)The ductus arteriosus usually closes around 1-2 days of age
b)Left atrial pressure is low in the foetus
c)With the first breaths, resistance to pulmonary blood flow falls
d)The foramen ovale closes as right sided pressure of the heart increases
e)The right atrium receives blood from the placenta in the foetus
15. Central cyanosis can only be recognised if the concentration of reduced haemoglobin the blood
exceeds
a)1g/dl
b)5g/dl
c)0.5g/dl
d)15g/dl
e)50g/dl
16. The classic finding on X-Ray is a narrow upper mediastinum with and 'egg on the side' appearance
of the cardiac shadow
a)Hypoplastic left heart syndrome
b)Coarctation of the Aorta
c)Transposition of the great vessels
d)PDA
e)Tetralogy of Fallot
17. Management includes diuretics, captopril, extra calories,
and surgery at 3-6 months
a)secundum ASD
b)PDA (term)
c)PDA (preterm)
d)partial AVSD
e)large VSD
18. A defect of the atrioventricular septum
a)situs solitus
b)secundum ASD
c)discordant VAC
d)concordant AVC
e)primum ASD
19. Signs include clubbing in older children, loud harsh ejection systolic murmur at the left sternal edge
from day 1 of life, usually with a single second heart sound. Chest X Ray and ECG may be normal.
a)Tetralogy of Fallot
b)Coarctation of the Aorta
c)Transposition of the great vessels
d)Hypoplastic left heart syndrome
e)PDA
20. Characterised by episodes of tachycardia and ECG signs of ventricular pre-excitation between
attacks. Partly results from abnormal atrio-ventricular conduction along a pathway termed the bundle
of Kent.
a)Woodhouse-Sakati syndrome
b)Weill-Marchesani syndrome
c)Wilson-Mikity syndrome
d)Wolff-Parkinson-White syndrome
e)Wolf-Hirschhorn syndrome
21. Treatment for bacterial endocarditis is usually
a)nitrous oxide and intravenous magnesium sulphate
b)diuretics and ACE inhibitors
c)high dose ciproflaxin with flecainide
d)oral phosphodiesterase inhibitors
e)high dose penicillin with aminoglycoside
22. Which of the following is NOT associated with increased risk of infective endocarditis?
a)VSD
b)PDA
c)secundum ASD
d)coarctation of the aorta
e)AVSD
23. Used for maintenance of ductal patency
a)intravenous NSAIDs
b)intravenous factor VIII
c)intravenous factor IX
d)intravenous prostaglandin
e)intravenous warfarin
24. Suggestive of right ventricular hypertrophy
a)Inverted P wave
b)inverted T wave in V6
c)Angluar P wave
d)Superior QRS axis
e)Upright T wave in V1
25. Capillary refill is used to ascertain
a). Cyanosis
b). Anaemia
C. Dehydration
D. Peripheral perfusion
e)
26. Treatment of cardiomyopathy is symptomatic with
a)nitrous oxide and intravenous magnesium sulphate
b)high dose penicillin with aminoglycoside
c)high dose ciproflaxin with flecainide
d)oral phosphodiesterase inhibitors
e)diuretics and ACE inhibitors
27. Occurs when blood flow through an original left-to-right cardiac shunt becomes reversed or
bidirectional. It is a result of reactive pulmonary hypertension causing pulmonary pressure to exceed
systemic pressure. Deoxygenated blood is mixed with systemic blood producing cyanosis.
a)Edwards syndrome
b)Eisenmenger's syndrome
c)Eales syndrome
d)Fabry's syndrome
e)Ehrlichiosis syndrome
28. Has been associated with the use of cisapride and erythromycin (rare)
a)Long QT syndrome
b)supraventricular tachycardia
c)Transposition of the great arteries
d)Tetralogy of Fallott
e)complete heart block
29. The most common form of long term damage to the heart from rheumatic fever
a)Pulmonary stenosis
b)Mitral stenosis
c)Rhabdomyoma
d)Aortic stenosis
e)Tricuspid stenosis
30. The most common causative organism for bacterial endocarditis
a)Streptococcus pneumoniae
b)Staphlococcus aureus
c)Streptococcus pyogenes
d)Streptococcus agalactiae
e)Streptococcus viridians
31. A superior QRS axis woiuld be suggestive of
a)Tetralogy of Fallott
b)Patent Ductus Arteriosus
c)Partial AVSD
d)Secundum ASD
e)Transposition of the great vessels
32. Can confirm cyanotic congenital heart disease if echocardiography is not available
a)hyperoxia (C02 washout) test
b)hypercardia (platelet washout) test
c)hypo-oxia (nitrogen washout) text
d)hypo-oxia (C02 washout) test
e)hyperoxia (nitrogen washout) text
33. Which of the following may be used in maintenance therapy for supraventricular tachycardia?
a)flecainide
b)sotalol
c)propanalol
d)all of these
e)digoxin
34. Which of the following is most likely to be associated with systemic lupus erythematosus?
a)ASD, VSD, or tetralogy of Fallot
b)supravalvulvar aortic stenosis or peripheral pulmonary artery stenosis
c)peripheral pulmonary stenosis or PDA
d)complete heart block
e)aortic valve stenosis or coarctation of the aorta
35. Physical signs may include: thrill at lower sternal edge, loud pansystolic murmur at lower sternal
edge, quiet pulmonary scond sound
a)small ASD
b)aortic stenosis
c)patent ductus arteriosus
d)mitral stenosis
e)small VSD
36. The management of this condition consists of a difficult neonatal operation caled the Norwood
procedure.
a)Tetralogy of Fallot
b)Coarctation of the Aorta
c)Transposition of the great vessels
d)PDA
e)Hypoplastic left heart syndrome
37. Which of the following is most likely to be associated with maternal rubella infection?
a)ASD, VSD, or tetralogy of Fallot
b)supravalvulvar aortic stenosis or peripheral pulmonary artery stenosis
c)aortic valve stenosis or coarctation of the aorta
d)complete heart block
e)peripheral pulmonary stenosis or PDA
38. Which of the following manifestations of rheumatic fever is the least common?
a)Sydenham's chorea
b)Subcutaneous nodules
c)Erythema marginatum
d)Pancarditis
e)Polyarthritis
39. The treatment of choice to restore sinus rythm in supraventricular tachycardia
a)intravous propanalol
b)intravenous adrenaline
c)intravenous alpha adrenoceptor agonist
d)intravenous protaglandin
e)intravenous adenosine
40. One feature of this condition is a defect in the middle of the heart with a single five leaflet valve
between the artia and the ventricles which stretches accross the entrie atrioventricular junction
a)Coarctation of the Aorta
b)Transposition of the great vessels
c)Hypoplastic left heart syndrome
d)cAVSD
e)Tetralogy of Fallot
41. Management includes a Blalock-Taussing shunt in children who are severely cyanosed and
pulmonary artery banding if breathless
a)Transposition of the great vessels
b)Tricuspid atresia
c)Coarctation of the Aorta
d)Hypoplastic left heart syndrome
e)Tetralogy of Fallot
42. The most common childhood arrythmia
a)ectopic atrial tachycardia
b)complete heart block
c)Long QT syndrome
d)supraventricular tachycardia
e)atrial fibrillation
43. Deep S wave in V2 and tall R wave in V6, along with a downgoing T wave wouldbe suggestive of
a)Adult type coarctation of the aorta
b)Pulmonary stenosis
c)Aortic stenosis
d)Tricuspid regurgitation
e)Mitral stenosis
44. VSDs account for ____% of all cases of congenital heart disease
a)30
b)20
c)5
d)50
e)10
45. Susceptible individuals are prone to group A Beta haemolytic streptococcal infection. After a latent
interval of 2- 6 weeks following a pharyngeal infection, polyarthritis, mild fever and malaise develop.
a)Kawasaki's disease
b)Pulmonary hypertension
c)Grave's disease
d)Rheumatic fever
e)Tuberculosis
46. Neonatal infants may be treated by surgical placement of an artificial tube between the subclavian
artery and the pulmonary artery. Hypercyanotic spells require treatment with pain relief, intravenous
propranolol, volume administration, bicarbonate, and artificial ventilation
a)PDA
b)Tetralogy of Fallot
c)Coarctation of the Aorta
d)Transposition of the great vessels
e)Hypoplastic left heart syndrome
47. Used to restore sinus rythm in supraventricular tachycardia if adenosine fails
a)Intravous propanalol
b)Electrical cardioversion with synchronised DC shock (0.5- 2J/kg body weight)
c)Circulatory and respiratory support
d)Carotid sinus massage
e)Blalock-Taussing manoeuvre
48. A defect in the centre of the atrial septum involving the foramen ovale
a)primum ASD
b)situs solitus
c)concordant AVC
d)secundum ASD
e)discordant VAC
49. Management includes coil or device closure by cardiac catheter
a)large VSD
b)partial AVSD
c)PDA (preterm)
d)PDA (term)
e)Mitral stenosis
50. Which of the following is most likely to be associated with Down's syndrome?
a)complete heart block
b)peripheral pulmonary stenosis or PDA
c)aortic arch anomalies or tetralogy of fallot
d)supravalvulvar aortic stenosis or peripheral pulmonary artery stenosis
e)atrioventricular septal defect, VSD
51. An ACE inhibitor used in the treatment of essential hypertension, either alone or with a thiazide. It is
also used as an adjunct in the treatment of congestive heart failure.
a)Catapres
b)Caduet
c)Cataflam
d)Captopril
e)Cabergoline
52. The commonest cause of death from congenital heart disease in the first week of life. There is
disturbed intrauterine development of the whole left heart, possibly due to premature closure of the
foramen ovale. The condition is characterised by a small left atrium, mitral valve, left ventricle and
aortic root are small.
a)ASD VSD complex
b)Hypoplastic left heart syndrome
c)Persistent ductus arteriosus
d)Tetralogy of fallot
e)Transposition of the great vessels
53. Which of the following is NOT a characteristic of an innocent murmur?
a)Soft blowing systolic murmur, usually from the right side
b)Localised ot the left sternal edge
c)No diastolic component
d)No added sounds
e)Radiates to the axilla
54. Management includes fluid restriction, indomethacin or ibuprofen, or surgical ligation
a)PDA (preterm)
b)PDA (term)
c)partial AVSD
d)secundum ASD
e)large VSD
55. Which of the following is FALSE?
a)Ventricular septal defects are the most common congenital heart defect
b)1-2% of live births have some cardiovascular abnormality
c)Atrial septal defect accounts for 7% of congental heart defects
d)Persistent ductus arteriosus accounts for 20% of congenital heart defects
e)8 per 1000 live births have significant cardiac malformations
56. Suggestive of left ventricular strain
a)Superior QRS axis
b)inverted T wave in V6
c)Angluar P wave
d)Inverted P wave
e)Upright T wave in V1
57. The most common cause of cyanotic congenital heart disease
a)Tetralogy of Fallot
b)PDA
c)Coarctation of the Aorta
d)Hypoplastic left heart syndrome
e)Transposition of the great vessels
58. May act on the pulmonary vasculature on the cyclic GMP pathway
a). Oral phosphodiesterase inhibitors
b). intravenous magnesium sulphate
c). inhalend nitrous oxide
d). Intravenous prostacyclin
e)A, B or C
59. A rare condition usually related to the presence of anti-Ro or anti-La antibodies in the maternal
serum
a)Long QT syndrome
b)complete heart block
c)ectopic atrial tachycardia
d)atrial fibrillation
e)supraventricular tachycardia
60. Which of the following is most likely to be associated with Chromosome 22q11.2 deletion
a)supravalvulvar aortic stenosis or peripheral pulmonary artery stenosis
b)complete heart block
c)atrioventricular septal defect, VSD
d)aortic arch anomalies or tetralogy of fallot+
e)peripheral pulmonary stenosis or PDA
61. Most children present with a continuous murmur from beneath the left clavicle
a)Eisenmenger's syndrome
b)PDA
c)ASD
d)VSD
e)PFA
62. Which of the following is most likely to be associated with Turner's syndrome?
a)aortic valve stenosis or coarctation of the aorta
b)supravalvulvar aortic stenosis or peripheral pulmonary artery stenosis
c)peripheral pulmonary stenosis or PDA
d)complete heart block
e)ASD, VSD, or tetralogy of Fallot
63. Characterised by a fixed and widely split second heart sound, and an ejection systolic or pansystolic
murmur.
a)PDA
b)ASD
c)TOF
d)VSD
e)PFO
64. May act on the cycluic AMP pathway
a). inhalend nitrous oxide
b). Intravenous prostacyclin
c). inhaled iloprost
d)B or C
e)A, B or C
65. Which of the following is most likely to be associated with fetal alcohol syndrome?
a)aortic valve stenosis or coarctation of the aorta
b)supravalvulvar aortic stenosis or peripheral pulmonary artery stenosis
c)complete heart block
d)peripheral pulmonary stenosis or PDA
e)ASD, VSD, or tetralogy of Fallot
66. 1 in ___ children in England and Wales attend A&E every year
a) 6
b) 4
c) 10
d) 8
e) 2
67. What percentage of the neonate is comprised of water?
a) 70
b) 55
c) 80
d) 45
e) 60
68. Which of the following types on intervention study is thought to be the most valid?
a) Case controlled study
b) Case report
c) Cohort study
d) Individual RCT
e) Systematic review of RCTs
69. The guideline that a doctor can give contraceptives to a girl under 16 without parental consent,
providing it is in her best interests and she can not be persuaded to tell her parents
a) Lawton guidelines
b) Roberts guidelines
c) Peterson guidelines
d) Gillick guidelines
e) Fraser guidelines
70. An ethical justification for some trials that there is no good reason to suspect that one treatment
will be better than the other
a) therapeutic autonomy
b) double blinding
c) therapeutic equipoise
d) experimenter expectancy
e) therapeutic equidistance
71. Regarding medications for children, which of the following is FALSE?
a) In neonates, drug biotransformation is increased
b) Are usually presecribed per kg of body weight
c) Renal excretion is reduced in neonates
d) Oral formulations should be given as liquids if possible
e) IM drugs should be avoided
72. Another way of saying 'do no harm'
a) utility
b) autonomy
c) non-maleficence
d) rights
e) beneficence
73. Which of the following is the most common reason for paediatric medical admission to a DGH?
a) Gastroenterology
b) Infection
c) Neurology
d) Respiratory
e) Trauma
74. What is the most common reason for a child to be seen by their GP?
a)Skin problems
b)Asthma
c)Ear problems
d)Respiratory infection
e)Diarrhoea/vomiting
75. What is the UK stillbirth rate per 1000?
a)3
b)5
c)6
d)7
e)8
76. Defined as deaths in the first 7 days per 1000 live births
a)Stillbirth rate
b)Infant mortality rate
c)Early neonatal mortality rate
d)Perinatal mortality rate
e)Under 5 mortality rate
77. Children under the age of 16 comprise ___ of the population in the UK
a)10
b)50
c)30
d)20
e)40
78. Was is the least common cause of childhood death?
a)Cerebrovascular incidents
b)Chronic respiratory disease
c)Homicide/probably homicide
d)Epilepsy
e)Influenza / pneumonia
79. What is the most common cause of death in childhood?
a)Accidents
b)Meningitis
c)Cerebral palsy
d)Malignant neoplasms
e)Congenital malformations
80. What is the definition of stillbirth? A child born dead after the __th week of pregnancy
a)18
b)20
c)26
d)24
e)22
81. Defined as stillbirths + 1st week deaths per 1000 live births
a)Infant mortality rate
b)Perinatal mortality rate
c)Stillbirth rate
d)Early neonatal mortality rate
e)Under 5 mortality rate