Physician Assistant Education Association's (PAEA)
and End of Rotation (EOR) Pediatrics Topics Exam
Questions with Answers 2024-2025 Graded A+
what are the cyanotic congenital heart conditions?
5 T's: tetraology of fallot, TOGA (transposition of great arteries), TAPVC (total anomalous pulmonary
venous return), truncus arteriosus, tricuspid atresia
? systolic murmur radiating to back/scapula/chest, inc BP in upper > lower extremities, rib notching on
XR (collateral flow), LVH on ECG, bilateral LE claudication (pain), "3 sign" of descending aorta on CXR; ?
: coarctation of aorta
: surgical correction, balloon angioplasty +/- stent, prostaglandin preoperatively to improve blood flow
to LE
what other common abnormality is found in patients w/ coarctation of the aorta?
70% also have bicuspid aortic valves patent ductus arteriosus is a communication between what 2
vessels? what can occur if PDA is left untreated?
-pulmonary artery and descending aorta
-Eisenmenger's syndrome: pulmonary HTN resulting from the L to R shunt switching to R to L over time
resulting in cyanosis
? poor feeding, freq. lower resp tract infxns, continuous machinery murmur loudest at pulmonic area,
bounding peripheral pulses; ?
: patent ductus arteriosus
,: indomethacin (prostaglandin inhibition) closes PDA; if closure fails can do surgical correction
what is the MC type of congenital heart disease?
VSD
what are the 4 types of VSDs? which is MC?
1. perimembranous (80%) one hole near tricuspid valve
2. muscular (5-20%) multiple holes "swiss cheese"
3. inlet (posterior) (10%) posterior to septal leaflet of tricuspid valve
4. supracrustal (outlet) (5%) beneath pulmonic valve +/- aortic valve insufficiency
? loud high-pitched harsh, holosystolic murmur at lower L sternal border, RVH on CXR, LVH/RVH on
EKG, asymptomatic otherwise; ?
: VSD
: if small (<0.5 cm) will usually close spontaneously w/i 10 years or if larger/symptomatic patch closure
Eisenmenger's syndrome (eventual reversal of a L->R shunt to a R->L shunt d/t RV outflow obstruction
from pulmonary stenosis) can occur in
-uncorrected PDA
-large VSDs
? MC cyanotic heart disease, cyanotic baby, squatting/knees to chest relieves spells of cyanosis when
crying/feeding, harsh holosystolic murmur @ L upper sternal border, R ventricular heave, clubbing,
boot-shaped heart on CXR; ?
: tetra ology of fallout
, : surgical repair + prostaglandin E1 to keep ductus arteriosus patent for collateral flow before surgery
can be performed
what are the 4 abnormalities found in tetraology of fallot?
1. pulmonary artery stenosis (RV outflow obstruction)
2. RVH
3. VSD
4. overriding aorta (between ventricles)
rheumatic fever usually presents 2-6 weeks after infection with? what is the most common site for
complications?
-group A beta-hemolytic strep (streptococcus pyogenes "strep throat")
-mitral valve (75-80%), aortic (30%), tricuspid/pulmonic (5%)
2 major or 1 major + 2 minor criteria PLUS recent h/o GABHS infxn are needed from the Jones criteria for
diagnosing rheumatic fever; what are the major & minor criteria?
major:
1. Joint (migratory polyarthritis)- 2+ joints
2. Oh my heart (active carditis)
3. Nodules (subcutaneous)
4. Erythema marginatum
5. Sydenham's chorea
minor:
1. fever ≥101.3 F/38.5 C
2. arthralgia (jt pain)
3. increased acute phase reactants (ESR, CRP, leukocytosis)
, 4. prolonged PR interval on ECG
recent GABHS infxn detected by + throat Cx, rapid antigen detection test, or Ab titers
what is the for rheumatic fever?
1. anti-inflammatory: ASA (2-6 w/ taper) +/- corticosteroids for severe cases & carditis
2. PCN G is abx of choice (or erythromycin in PCN allergic)
what disease is MC in children >5, boys, Asian descent, thought to be d/t an unidentified pathogen with
a propensity towards vascular tissue like the coronary arteries and also known as mucocutaneous lymph
node syndrome?
Kawasaki syndrome
? young Asian boy w/ fever, bilateral non-exudative conjunctivitis, polymorphous rash, peripheral
extremity changes (desquamation, edema, erythema or palms/soles, Beau's lines (transverse nail
grooves), arthritis, cervical LAD, lip swelling/fissures, strawberry tongue; workup? ? complications?
- : Kawasaki syndrome must have fever + 4/5 symptoms (conjunctivitis, rash, extremity changes, cervical
LAD, mucous membrane changes)
-workup: CBC (leukocytosis, inc plts, normochromic/cystic anemia), inc ESR/CRP, UA (pyuria- pus in
urine), echo/angiography if heart complications suspected
- : IV immune globulin + high dose ASA (lowers fever, jt pain, prevents coronary artery thrombosis
aneurysm); corticosteroids if refractive
-complications: coronary vessel arteritis, coronary artery aneurysm, myocardial infarction, pericarditis,
myocarditis, peripheral arterial occlusion
what are the 3 pathophysiologic characteristics of hypertrophic cardiomyopathy?
1. hypertrophied septum
2. systolic anterior motion of mitral valve
and End of Rotation (EOR) Pediatrics Topics Exam
Questions with Answers 2024-2025 Graded A+
what are the cyanotic congenital heart conditions?
5 T's: tetraology of fallot, TOGA (transposition of great arteries), TAPVC (total anomalous pulmonary
venous return), truncus arteriosus, tricuspid atresia
? systolic murmur radiating to back/scapula/chest, inc BP in upper > lower extremities, rib notching on
XR (collateral flow), LVH on ECG, bilateral LE claudication (pain), "3 sign" of descending aorta on CXR; ?
: coarctation of aorta
: surgical correction, balloon angioplasty +/- stent, prostaglandin preoperatively to improve blood flow
to LE
what other common abnormality is found in patients w/ coarctation of the aorta?
70% also have bicuspid aortic valves patent ductus arteriosus is a communication between what 2
vessels? what can occur if PDA is left untreated?
-pulmonary artery and descending aorta
-Eisenmenger's syndrome: pulmonary HTN resulting from the L to R shunt switching to R to L over time
resulting in cyanosis
? poor feeding, freq. lower resp tract infxns, continuous machinery murmur loudest at pulmonic area,
bounding peripheral pulses; ?
: patent ductus arteriosus
,: indomethacin (prostaglandin inhibition) closes PDA; if closure fails can do surgical correction
what is the MC type of congenital heart disease?
VSD
what are the 4 types of VSDs? which is MC?
1. perimembranous (80%) one hole near tricuspid valve
2. muscular (5-20%) multiple holes "swiss cheese"
3. inlet (posterior) (10%) posterior to septal leaflet of tricuspid valve
4. supracrustal (outlet) (5%) beneath pulmonic valve +/- aortic valve insufficiency
? loud high-pitched harsh, holosystolic murmur at lower L sternal border, RVH on CXR, LVH/RVH on
EKG, asymptomatic otherwise; ?
: VSD
: if small (<0.5 cm) will usually close spontaneously w/i 10 years or if larger/symptomatic patch closure
Eisenmenger's syndrome (eventual reversal of a L->R shunt to a R->L shunt d/t RV outflow obstruction
from pulmonary stenosis) can occur in
-uncorrected PDA
-large VSDs
? MC cyanotic heart disease, cyanotic baby, squatting/knees to chest relieves spells of cyanosis when
crying/feeding, harsh holosystolic murmur @ L upper sternal border, R ventricular heave, clubbing,
boot-shaped heart on CXR; ?
: tetra ology of fallout
, : surgical repair + prostaglandin E1 to keep ductus arteriosus patent for collateral flow before surgery
can be performed
what are the 4 abnormalities found in tetraology of fallot?
1. pulmonary artery stenosis (RV outflow obstruction)
2. RVH
3. VSD
4. overriding aorta (between ventricles)
rheumatic fever usually presents 2-6 weeks after infection with? what is the most common site for
complications?
-group A beta-hemolytic strep (streptococcus pyogenes "strep throat")
-mitral valve (75-80%), aortic (30%), tricuspid/pulmonic (5%)
2 major or 1 major + 2 minor criteria PLUS recent h/o GABHS infxn are needed from the Jones criteria for
diagnosing rheumatic fever; what are the major & minor criteria?
major:
1. Joint (migratory polyarthritis)- 2+ joints
2. Oh my heart (active carditis)
3. Nodules (subcutaneous)
4. Erythema marginatum
5. Sydenham's chorea
minor:
1. fever ≥101.3 F/38.5 C
2. arthralgia (jt pain)
3. increased acute phase reactants (ESR, CRP, leukocytosis)
, 4. prolonged PR interval on ECG
recent GABHS infxn detected by + throat Cx, rapid antigen detection test, or Ab titers
what is the for rheumatic fever?
1. anti-inflammatory: ASA (2-6 w/ taper) +/- corticosteroids for severe cases & carditis
2. PCN G is abx of choice (or erythromycin in PCN allergic)
what disease is MC in children >5, boys, Asian descent, thought to be d/t an unidentified pathogen with
a propensity towards vascular tissue like the coronary arteries and also known as mucocutaneous lymph
node syndrome?
Kawasaki syndrome
? young Asian boy w/ fever, bilateral non-exudative conjunctivitis, polymorphous rash, peripheral
extremity changes (desquamation, edema, erythema or palms/soles, Beau's lines (transverse nail
grooves), arthritis, cervical LAD, lip swelling/fissures, strawberry tongue; workup? ? complications?
- : Kawasaki syndrome must have fever + 4/5 symptoms (conjunctivitis, rash, extremity changes, cervical
LAD, mucous membrane changes)
-workup: CBC (leukocytosis, inc plts, normochromic/cystic anemia), inc ESR/CRP, UA (pyuria- pus in
urine), echo/angiography if heart complications suspected
- : IV immune globulin + high dose ASA (lowers fever, jt pain, prevents coronary artery thrombosis
aneurysm); corticosteroids if refractive
-complications: coronary vessel arteritis, coronary artery aneurysm, myocardial infarction, pericarditis,
myocarditis, peripheral arterial occlusion
what are the 3 pathophysiologic characteristics of hypertrophic cardiomyopathy?
1. hypertrophied septum
2. systolic anterior motion of mitral valve
