ABP PEDIATRIC CARDIOLOGY CERTIFICATION EXAM
ACTUAL EXAM 2026/2027 TEST BANK PRACTICE
QUESTIONS AND STUDY GUIDE ACCURATE EXAM
COMPLETE REAL QUESTIONS AND CORRECT DETAILED
SOLUTIONS WITH RATIONALES (RELIABLE ANSWERS)
LATEST UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+ |FULL REVISED EXAM |JUST
RELEASED
1. A 2-day-old newborn presents with cyanosis that does not improve
with 100% oxygen. Hyperoxia test shows PaO₂ of 45 mm Hg (on
FiO₂ 1.0). Chest X-ray shows normal heart size and decreased
pulmonary vascularity. What is the most likely diagnosis?
A) Tetralogy of Fallot (TOF)
B) Transposition of the great arteries (TGA)
C) Truncus arteriosus
D) Total anomalous pulmonary venous return (TAPVR)
Correct Answer: B
Rationale: Transposition of the great arteries (d-TGA) presents with
early cyanosis (first hours to days), a failed hyperoxia test (PaO₂
<50–100 mm Hg on 100% FiO₂), and a chest X-ray showing an "egg-
on-a-string" appearance (narrow superior mediastinum) with
,increased pulmonary vascular markings. TOF typically presents with
cyanotic spells later (after 2–6 months) and a boot-shaped heart.
2. A neonate with d-TGA is started on a prostaglandin E1 infusion.
The primary purpose of this therapy is to:
A) Prevent closure of the patent ductus arteriosus (PDA)
B) Increase pulmonary blood flow
C) Decrease pulmonary vascular resistance
D) Promote spontaneous closure of the PDA
Correct Answer: A
Rationale: Prostaglandin E1 maintains patency of the PDA, allowing
mixing of oxygenated and deoxygenated blood in d-TGA. This is a
critical bridge until an atrial septostomy or surgical repair can be
performed.
3. A newborn with duct-dependent pulmonary blood flow is started
on prostaglandin E1. This condition is typical of which of the
following lesions?
A) Hypoplastic left heart syndrome
B) Pulmonary atresia with intact ventricular septum
C) d-TGA
,D) Truncus arteriosus
Correct Answer: B
Rationale: Pulmonary atresia with intact ventricular septum is duct-
dependent for pulmonary blood flow. Prostaglandin E1 maintains
ductal patency to provide pulmonary perfusion.
4. A 6-week-old infant presents with poor feeding, tachypnea, and
failure to thrive. On examination, there is a grade 3/6 holosystolic
murmur at the left lower sternal border with a palpable thrill. Chest
X-ray shows cardiomegaly and increased pulmonary vascular
markings. What is the most likely diagnosis?
A) Ventricular septal defect (VSD)
B) Atrial septal defect (ASD)
C) Patent ductus arteriosus (PDA)
D) Pulmonic stenosis (PS)
Correct Answer: A
Rationale: VSD is the most common congenital heart defect. Large
VSD presents at 4–8 weeks (when pulmonary vascular resistance
drops) with heart failure (tachypnea, poor feeding, failure to thrive).
The murmur is holosystolic at the left lower sternal border. Chest X-
ray shows cardiomegaly and increased pulmonary vascularity.
, 5. A 3-year-old has a harsh holosystolic murmur at the left lower
sternal border. Echocardiogram shows a defect in the membranous
interventricular septum near the aortic valve. Which VSD type is
this?
A) Muscular
B) Perimembranous
C) Inlet (AV canal type)
D) Outlet (supracristal/conal)
Correct Answer: B
Rationale: Perimembranous VSDs are the most common type (~70–
80%) and lie in the membranous septum adjacent to the tricuspid
and aortic valves. They may be associated with aortic valve prolapse
and aortic regurgitation. Muscular VSDs occur within the trabecular
septum; inlet VSDs are seen with AV canal defects; outlet
(supracristal) VSDs lie beneath the pulmonary valve.
6. A 4-year-old is found to have fixed splitting of S₂ and a soft
systolic ejection murmur at the left upper sternal border.
Echocardiogram shows a defect in the mid-atrial septum at the fossa
ovalis. Which ASD type is this?
A) Sinus venosus (superior)
ACTUAL EXAM 2026/2027 TEST BANK PRACTICE
QUESTIONS AND STUDY GUIDE ACCURATE EXAM
COMPLETE REAL QUESTIONS AND CORRECT DETAILED
SOLUTIONS WITH RATIONALES (RELIABLE ANSWERS)
LATEST UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+ |FULL REVISED EXAM |JUST
RELEASED
1. A 2-day-old newborn presents with cyanosis that does not improve
with 100% oxygen. Hyperoxia test shows PaO₂ of 45 mm Hg (on
FiO₂ 1.0). Chest X-ray shows normal heart size and decreased
pulmonary vascularity. What is the most likely diagnosis?
A) Tetralogy of Fallot (TOF)
B) Transposition of the great arteries (TGA)
C) Truncus arteriosus
D) Total anomalous pulmonary venous return (TAPVR)
Correct Answer: B
Rationale: Transposition of the great arteries (d-TGA) presents with
early cyanosis (first hours to days), a failed hyperoxia test (PaO₂
<50–100 mm Hg on 100% FiO₂), and a chest X-ray showing an "egg-
on-a-string" appearance (narrow superior mediastinum) with
,increased pulmonary vascular markings. TOF typically presents with
cyanotic spells later (after 2–6 months) and a boot-shaped heart.
2. A neonate with d-TGA is started on a prostaglandin E1 infusion.
The primary purpose of this therapy is to:
A) Prevent closure of the patent ductus arteriosus (PDA)
B) Increase pulmonary blood flow
C) Decrease pulmonary vascular resistance
D) Promote spontaneous closure of the PDA
Correct Answer: A
Rationale: Prostaglandin E1 maintains patency of the PDA, allowing
mixing of oxygenated and deoxygenated blood in d-TGA. This is a
critical bridge until an atrial septostomy or surgical repair can be
performed.
3. A newborn with duct-dependent pulmonary blood flow is started
on prostaglandin E1. This condition is typical of which of the
following lesions?
A) Hypoplastic left heart syndrome
B) Pulmonary atresia with intact ventricular septum
C) d-TGA
,D) Truncus arteriosus
Correct Answer: B
Rationale: Pulmonary atresia with intact ventricular septum is duct-
dependent for pulmonary blood flow. Prostaglandin E1 maintains
ductal patency to provide pulmonary perfusion.
4. A 6-week-old infant presents with poor feeding, tachypnea, and
failure to thrive. On examination, there is a grade 3/6 holosystolic
murmur at the left lower sternal border with a palpable thrill. Chest
X-ray shows cardiomegaly and increased pulmonary vascular
markings. What is the most likely diagnosis?
A) Ventricular septal defect (VSD)
B) Atrial septal defect (ASD)
C) Patent ductus arteriosus (PDA)
D) Pulmonic stenosis (PS)
Correct Answer: A
Rationale: VSD is the most common congenital heart defect. Large
VSD presents at 4–8 weeks (when pulmonary vascular resistance
drops) with heart failure (tachypnea, poor feeding, failure to thrive).
The murmur is holosystolic at the left lower sternal border. Chest X-
ray shows cardiomegaly and increased pulmonary vascularity.
, 5. A 3-year-old has a harsh holosystolic murmur at the left lower
sternal border. Echocardiogram shows a defect in the membranous
interventricular septum near the aortic valve. Which VSD type is
this?
A) Muscular
B) Perimembranous
C) Inlet (AV canal type)
D) Outlet (supracristal/conal)
Correct Answer: B
Rationale: Perimembranous VSDs are the most common type (~70–
80%) and lie in the membranous septum adjacent to the tricuspid
and aortic valves. They may be associated with aortic valve prolapse
and aortic regurgitation. Muscular VSDs occur within the trabecular
septum; inlet VSDs are seen with AV canal defects; outlet
(supracristal) VSDs lie beneath the pulmonary valve.
6. A 4-year-old is found to have fixed splitting of S₂ and a soft
systolic ejection murmur at the left upper sternal border.
Echocardiogram shows a defect in the mid-atrial septum at the fossa
ovalis. Which ASD type is this?
A) Sinus venosus (superior)
