ABP PEDIATRIC CARDIOLOGY CERTIFICATION
EXAM Practice Questions & Answers |
Comprehensive Board Review Study Guide 2
Versions
Maximize your board review efficiency and pass the
American Board of Pediatrics subspecialty test with this
targeted Pediatric Cardiology certification practice exam.
This high-yield resource features comprehensive clinical
questions covering congenital heart disease, arrhythmias,
pharmacology, and advanced cardiac imaging. It is an
indispensable tool for pediatric cardiology fellows and
practicing physicians seeking board certification or
maintenance of certification (MOC).
1. A 2-day-old term newborn is noted to have cyanosis and a harsh
systolic murmur at the left upper sternal border. The chest x-ray shows
a "boot-shaped" heart. Which of the following is the most appropriate
initial medical therapy?
A) Prostaglandin E1 infusion
B) Oxygen therapy
C) Antibiotics
D) Diuretics
Answer: A
Rationale: Prostaglandin E1 is the initial medical therapy for ductal-
dependent cyanotic heart defects such as Tetralogy of Fallot. It maintains
,ductus arteriosus patency, improving pulmonary blood flow. Chest x-ray
shows classic "boot-shaped" heart (coeur en sabot) .
2. A 3-day-old infant with Down syndrome has a murmur and a chest
x-ray showing cardiomegaly with increased pulmonary vascular
markings. Which of the following is the most likely diagnosis?
A) Ventricular Septal Defect
B) Atrioventricular Septal Defect
C) Tetralogy of Fallot
D) Atrial Septal Defect
Answer: B
Rationale: Atrioventricular Septal Defect (AVSD) is the most common
congenital heart defect in Down syndrome, occurring in 40-50% of affected
infants. It presents with a murmur and cardiomegaly with increased
pulmonary markings .
3. A 2-week-old infant has a continuous "machine-like" murmur heard
best at the left upper sternal border. Which of the following is the
most likely diagnosis?
A) Ventricular Septal Defect
B) Patent Ductus Arteriosus
C) Pulmonary Stenosis
D) Coarctation of the Aorta
Answer: B
,Rationale: Patent Ductus Arteriosus (PDA) produces a continuous, "machine-
like" murmur heard best at the left upper sternal border. This is the classic
presentation of PDA in newborns .
4. A 1-day-old infant has a prenatally diagnosed coarctation of the
aorta. Which of the following is the most appropriate initial therapy?
A) Prostaglandin E1 infusion
B) Indomethacin
C) Oxygen therapy
D) Surgical repair
Answer: A
Rationale: Prostaglandin E1 is the initial therapy for ductal-dependent
lesions such as coarctation of the aorta. It maintains ductus arteriosus
patency to ensure systemic blood flow .
5. A 4-day-old infant with cyanosis has a chest x-ray showing an "egg-
on-a-string" appearance. Which of the following is the most likely
diagnosis?
A) Transposition of the Great Arteries
B) Tetralogy of Fallot
C) Truncus Arteriosus
D) Total Anomalous Pulmonary Venous Return
Answer: A
Rationale: The "egg-on-a-string" appearance on chest x-ray is characteristic
of Transposition of the Great Arteries. The narrow superior mediastinum
represents the great vessels .
, 6. A 3-week-old infant with a large VSD is in congestive heart failure.
Which of the following medications is most appropriate for afterload
reduction?
A) Captopril
B) Furosemide
C) Digoxin
D) Spironolactone
Answer: A
Rationale: Captopril (ACE inhibitor) reduces afterload by decreasing
systemic vascular resistance, thereby decreasing left-to-right shunting and
improving cardiac output .
7. A newborn with pulmonary atresia and a VSD has a ductus-
dependent pulmonary blood flow. Which of the following is the most
appropriate initial therapy?
A) Prostaglandin E1 infusion
B) Oxygen therapy
C) Antibiotics
D) Surgery
Answer: A
Rationale: Prostaglandin E1 is essential for maintaining ductal patency in
patients with pulmonary atresia, providing pulmonary blood flow .
EXAM Practice Questions & Answers |
Comprehensive Board Review Study Guide 2
Versions
Maximize your board review efficiency and pass the
American Board of Pediatrics subspecialty test with this
targeted Pediatric Cardiology certification practice exam.
This high-yield resource features comprehensive clinical
questions covering congenital heart disease, arrhythmias,
pharmacology, and advanced cardiac imaging. It is an
indispensable tool for pediatric cardiology fellows and
practicing physicians seeking board certification or
maintenance of certification (MOC).
1. A 2-day-old term newborn is noted to have cyanosis and a harsh
systolic murmur at the left upper sternal border. The chest x-ray shows
a "boot-shaped" heart. Which of the following is the most appropriate
initial medical therapy?
A) Prostaglandin E1 infusion
B) Oxygen therapy
C) Antibiotics
D) Diuretics
Answer: A
Rationale: Prostaglandin E1 is the initial medical therapy for ductal-
dependent cyanotic heart defects such as Tetralogy of Fallot. It maintains
,ductus arteriosus patency, improving pulmonary blood flow. Chest x-ray
shows classic "boot-shaped" heart (coeur en sabot) .
2. A 3-day-old infant with Down syndrome has a murmur and a chest
x-ray showing cardiomegaly with increased pulmonary vascular
markings. Which of the following is the most likely diagnosis?
A) Ventricular Septal Defect
B) Atrioventricular Septal Defect
C) Tetralogy of Fallot
D) Atrial Septal Defect
Answer: B
Rationale: Atrioventricular Septal Defect (AVSD) is the most common
congenital heart defect in Down syndrome, occurring in 40-50% of affected
infants. It presents with a murmur and cardiomegaly with increased
pulmonary markings .
3. A 2-week-old infant has a continuous "machine-like" murmur heard
best at the left upper sternal border. Which of the following is the
most likely diagnosis?
A) Ventricular Septal Defect
B) Patent Ductus Arteriosus
C) Pulmonary Stenosis
D) Coarctation of the Aorta
Answer: B
,Rationale: Patent Ductus Arteriosus (PDA) produces a continuous, "machine-
like" murmur heard best at the left upper sternal border. This is the classic
presentation of PDA in newborns .
4. A 1-day-old infant has a prenatally diagnosed coarctation of the
aorta. Which of the following is the most appropriate initial therapy?
A) Prostaglandin E1 infusion
B) Indomethacin
C) Oxygen therapy
D) Surgical repair
Answer: A
Rationale: Prostaglandin E1 is the initial therapy for ductal-dependent
lesions such as coarctation of the aorta. It maintains ductus arteriosus
patency to ensure systemic blood flow .
5. A 4-day-old infant with cyanosis has a chest x-ray showing an "egg-
on-a-string" appearance. Which of the following is the most likely
diagnosis?
A) Transposition of the Great Arteries
B) Tetralogy of Fallot
C) Truncus Arteriosus
D) Total Anomalous Pulmonary Venous Return
Answer: A
Rationale: The "egg-on-a-string" appearance on chest x-ray is characteristic
of Transposition of the Great Arteries. The narrow superior mediastinum
represents the great vessels .
, 6. A 3-week-old infant with a large VSD is in congestive heart failure.
Which of the following medications is most appropriate for afterload
reduction?
A) Captopril
B) Furosemide
C) Digoxin
D) Spironolactone
Answer: A
Rationale: Captopril (ACE inhibitor) reduces afterload by decreasing
systemic vascular resistance, thereby decreasing left-to-right shunting and
improving cardiac output .
7. A newborn with pulmonary atresia and a VSD has a ductus-
dependent pulmonary blood flow. Which of the following is the most
appropriate initial therapy?
A) Prostaglandin E1 infusion
B) Oxygen therapy
C) Antibiotics
D) Surgery
Answer: A
Rationale: Prostaglandin E1 is essential for maintaining ductal patency in
patients with pulmonary atresia, providing pulmonary blood flow .
