ABP Pediatric Cardiology Certification
Examination Practice Questions And
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
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1. A 2-week-old neonate presents with cyanosis unresponsive to oxygen
therapy. Echocardiography shows parallel great arteries. Which
intervention is most appropriate initially?
A. Surgical arterial switch
B. Balloon atrial septostomy
C. Prostaglandin E1 infusion
D. Inhaled nitric oxide
Correct Answer: C
Rationale: Prostaglandin E1 maintains ductal patency to allow mixing in
transposition of the great arteries until definitive intervention.
, 2. Which congenital heart defect is most commonly associated with
Down syndrome?
A. Tetralogy of Fallot
B. Secundum atrial septal defect
C. Complete atrioventricular septal defect
D. Coarctation of the aorta
Correct Answer: C
Rationale: Complete AV septal defect is strongly associated with trisomy
21.
3. A continuous “machinery” murmur is most characteristic of which
condition?
A. Ventricular septal defect
B. Patent ductus arteriosus
C. Aortic stenosis
D. Pulmonary stenosis
Correct Answer: B
Rationale: PDA classically produces a continuous machinery murmur due to
persistent flow throughout the cardiac cycle.
4. Which ECG finding is typical in untreated Ebstein anomaly?
A. Left axis deviation
, B. Short PR interval
C. Tall R waves in V1
D. Prolonged QT interval
Correct Answer: B
Rationale: Ebstein anomaly is associated with accessory pathways and
Wolff-Parkinson-White pattern, including a short PR interval.
5. The most common cause of heart failure in infants is:
A. Dilated cardiomyopathy
B. Viral myocarditis
C. Congenital heart disease with left-to-right shunt
D. Arrhythmia
Correct Answer: C
Rationale: Large left-to-right shunts (e.g., VSD, PDA) are the leading cause
of infant heart failure.
6. A systolic ejection murmur at the left upper sternal border with wide
fixed splitting of S2 suggests:
A. Ventricular septal defect
B. Pulmonary hypertension
C. Atrial septal defect
D. Mitral regurgitation
, Correct Answer: C
Rationale: Fixed splitting of S2 is classic for atrial septal defect.
7. Which congenital lesion most commonly presents with differential
cyanosis?
A. Truncus arteriosus
B. Transposition of the great arteries
C. Coarctation of the aorta with PDA
D. Total anomalous pulmonary venous return
Correct Answer: C
Rationale: In coarctation with PDA, lower extremities receive desaturated
blood, causing differential cyanosis.
8. The primary determinant of oxygen delivery to tissues is:
A. Hemoglobin concentration
B. Cardiac output
C. Arterial oxygen saturation
D. Systemic vascular resistance
Correct Answer: B
Rationale: Oxygen delivery equals cardiac output multiplied by arterial
oxygen content.
Examination Practice Questions And
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf
1. A 2-week-old neonate presents with cyanosis unresponsive to oxygen
therapy. Echocardiography shows parallel great arteries. Which
intervention is most appropriate initially?
A. Surgical arterial switch
B. Balloon atrial septostomy
C. Prostaglandin E1 infusion
D. Inhaled nitric oxide
Correct Answer: C
Rationale: Prostaglandin E1 maintains ductal patency to allow mixing in
transposition of the great arteries until definitive intervention.
, 2. Which congenital heart defect is most commonly associated with
Down syndrome?
A. Tetralogy of Fallot
B. Secundum atrial septal defect
C. Complete atrioventricular septal defect
D. Coarctation of the aorta
Correct Answer: C
Rationale: Complete AV septal defect is strongly associated with trisomy
21.
3. A continuous “machinery” murmur is most characteristic of which
condition?
A. Ventricular septal defect
B. Patent ductus arteriosus
C. Aortic stenosis
D. Pulmonary stenosis
Correct Answer: B
Rationale: PDA classically produces a continuous machinery murmur due to
persistent flow throughout the cardiac cycle.
4. Which ECG finding is typical in untreated Ebstein anomaly?
A. Left axis deviation
, B. Short PR interval
C. Tall R waves in V1
D. Prolonged QT interval
Correct Answer: B
Rationale: Ebstein anomaly is associated with accessory pathways and
Wolff-Parkinson-White pattern, including a short PR interval.
5. The most common cause of heart failure in infants is:
A. Dilated cardiomyopathy
B. Viral myocarditis
C. Congenital heart disease with left-to-right shunt
D. Arrhythmia
Correct Answer: C
Rationale: Large left-to-right shunts (e.g., VSD, PDA) are the leading cause
of infant heart failure.
6. A systolic ejection murmur at the left upper sternal border with wide
fixed splitting of S2 suggests:
A. Ventricular septal defect
B. Pulmonary hypertension
C. Atrial septal defect
D. Mitral regurgitation
, Correct Answer: C
Rationale: Fixed splitting of S2 is classic for atrial septal defect.
7. Which congenital lesion most commonly presents with differential
cyanosis?
A. Truncus arteriosus
B. Transposition of the great arteries
C. Coarctation of the aorta with PDA
D. Total anomalous pulmonary venous return
Correct Answer: C
Rationale: In coarctation with PDA, lower extremities receive desaturated
blood, causing differential cyanosis.
8. The primary determinant of oxygen delivery to tissues is:
A. Hemoglobin concentration
B. Cardiac output
C. Arterial oxygen saturation
D. Systemic vascular resistance
Correct Answer: B
Rationale: Oxygen delivery equals cardiac output multiplied by arterial
oxygen content.
