ABP PEDIATRIC CARDIOLOGY CERTIFICATION EXAMINATION
Full-Length Practice Exam – 250 Questions with Verified Answers &
Rationales
Questions 1–250
Question 1
1. A newborn presents with central cyanosis that improves with
crying. Which diagnosis is most likely? E) Truncus arteriosus
A) Tetralogy of Fallot
B) Transposition of the great arteries
C) Total anomalous pulmonary venous connection
D) Hypoplastic left heart syndrome
Answer
Answer B: Transposition of the great arteries
,Rationale
In transposition of the great arteries (TGA), crying increases
pulmonary blood flow and mixing at the atrial level, temporarily
improving cyanosis. Tetralogy of Fallot typically worsens with crying
due to increased right-to-left shunting. ---
Question 2
2. A 3-year-old has a harsh holosystolic murmur at the left lower
sternal border. Echocardiography shows a defect in the
membranous interventricular septum near the aortic valve. What
is the most likely diagnosis? E) Aortic stenosis
A) Atrial septal defect
B) Ventricular septal defect (perimembranous type)
C) Patent ductus arteriosus
D) Pulmonary stenosis
Answer
Answer B: Ventricular septal defect (perimembranous type)
Rationale
A harsh holosystolic murmur at the left lower sternal border is
classic for a ventricular septal defect (VSD). The membranous
,septum is the most common location for congenital VSDs. ---
Question 3
3. A continuous "machinery" murmur best describes which lesion?
E) Coarctation of the aorta
A) Ventricular septal defect
B) Atrial septal defect
C) Patent ductus arteriosus
D) Pulmonary stenosis
Answer
Answer C: Patent ductus arteriosus
Rationale
The classic continuous "machinery" murmur is pathognomonic for
patent ductus arteriosus (PDA), heard best at the left upper sternal
border. ---
Question 4
4. A 3-day-old term newborn is noted to have central cyanosis and
a systolic ejection murmur at the left upper sternal border. Which
, is the most likely diagnosis? E) Hypoplastic left heart syndrome
A) Tetralogy of Fallot
B) Pulmonary atresia with intact ventricular septum
C) Truncus arteriosus
D) Total anomalous pulmonary venous connection
Answer
Answer B: Pulmonary atresia with intact ventricular septum
Rationale
Cyanosis with a systolic ejection murmur at the left upper sternal
border in a term newborn suggests pulmonary atresia with intact
ventricular septum. The murmur is from tricuspid regurgitation or
flow across a patent ductus arteriosus. ---
Question 5
5. A 2-year-old child presents with a harsh systolic murmur at the
left upper sternal border. What is the most likely diagnosis? E)
Tricuspid atresia
A) Pulmonary stenosis
B) Ventricular septal defect
C) Atrial septal defect
D) Aortic stenosis
Full-Length Practice Exam – 250 Questions with Verified Answers &
Rationales
Questions 1–250
Question 1
1. A newborn presents with central cyanosis that improves with
crying. Which diagnosis is most likely? E) Truncus arteriosus
A) Tetralogy of Fallot
B) Transposition of the great arteries
C) Total anomalous pulmonary venous connection
D) Hypoplastic left heart syndrome
Answer
Answer B: Transposition of the great arteries
,Rationale
In transposition of the great arteries (TGA), crying increases
pulmonary blood flow and mixing at the atrial level, temporarily
improving cyanosis. Tetralogy of Fallot typically worsens with crying
due to increased right-to-left shunting. ---
Question 2
2. A 3-year-old has a harsh holosystolic murmur at the left lower
sternal border. Echocardiography shows a defect in the
membranous interventricular septum near the aortic valve. What
is the most likely diagnosis? E) Aortic stenosis
A) Atrial septal defect
B) Ventricular septal defect (perimembranous type)
C) Patent ductus arteriosus
D) Pulmonary stenosis
Answer
Answer B: Ventricular septal defect (perimembranous type)
Rationale
A harsh holosystolic murmur at the left lower sternal border is
classic for a ventricular septal defect (VSD). The membranous
,septum is the most common location for congenital VSDs. ---
Question 3
3. A continuous "machinery" murmur best describes which lesion?
E) Coarctation of the aorta
A) Ventricular septal defect
B) Atrial septal defect
C) Patent ductus arteriosus
D) Pulmonary stenosis
Answer
Answer C: Patent ductus arteriosus
Rationale
The classic continuous "machinery" murmur is pathognomonic for
patent ductus arteriosus (PDA), heard best at the left upper sternal
border. ---
Question 4
4. A 3-day-old term newborn is noted to have central cyanosis and
a systolic ejection murmur at the left upper sternal border. Which
, is the most likely diagnosis? E) Hypoplastic left heart syndrome
A) Tetralogy of Fallot
B) Pulmonary atresia with intact ventricular septum
C) Truncus arteriosus
D) Total anomalous pulmonary venous connection
Answer
Answer B: Pulmonary atresia with intact ventricular septum
Rationale
Cyanosis with a systolic ejection murmur at the left upper sternal
border in a term newborn suggests pulmonary atresia with intact
ventricular septum. The murmur is from tricuspid regurgitation or
flow across a patent ductus arteriosus. ---
Question 5
5. A 2-year-old child presents with a harsh systolic murmur at the
left upper sternal border. What is the most likely diagnosis? E)
Tricuspid atresia
A) Pulmonary stenosis
B) Ventricular septal defect
C) Atrial septal defect
D) Aortic stenosis
