PEDIATRIC MCQS: PEDIATRIC CARDIOLOGY

A 1-week-old infant presents to the emergency department with a 1-day history of poor feeding, pallor, diaphoresis, and increasing somnolence. She was born at term, and the delivery was uncomplicated. On physical examination, her heart rate is 180 beats/min, respiratory rate is 90 breaths/min, and blood pressure is 50/30 mm Hg. Her breath sounds are shallow, and cardiac evaluation reveals no murmurs but a gallop rhythm. Her liver is palpable at 3 cm below the costal margin. Her extremities are cool, pale, and mottled, and she has poor distal pulses. After you administer normal saline at 20 mL/kg, her heart rate is 194 beats/min.

Of the following, the MOST appropriate next step is

A. Adenosine infusion at 50 mcg/kg

B. Computed tomography scan of the head

C. Dopamine infusion at 10 mcg/kg per minute

D. Lumbar puncture followed by antibiotics

E. Normal saline infusion at 20 mL/kg

ANSWER ON THURSDAY AT 10 AM

FCPS MCQS: PEDIATRIC CARDIOLOGY

You are evaluating a 13-year-old whose father recently drowned while swimming laps in a pool. Upon further inquiry, a couple of months ago, his father had had a fainting episode after running, but had attributed this to dehydration. Your patient admits that he has had some episodes of dizziness and palpitations during track practice, for which he took breaks, but he has never fainted or had any chest pain. He has a normal CXR and cardiovascular examination. 

What changes on his ECG would be most worrisome?

A. First-degree AV block (prolonged PR interval)
B. Premature atrial contractions
C. Prolonged QTc interval (>460 ms)
D. Sinus arrhythmia
E. Premature ventricular contractions



ANSWER ON MONDAY 10 AM