ACUTE CARE PNCB COMPREHENSIVE
QUESTIONS AND COMPLETE SOLUTIONS
TEST PAPER
●● Recommend closure of ASD at what age?
Answer: 3-5 y/o
●● Recommend closure of PDA at what age?
Answer: 3 - 6 months old
●● Murmur associated with AV Canal
Answer: systolic regurgitant murmur at LLSB
●● Components of Tetrology of Fallot (4)
Answer: 1. VSD
2. pulmonary stenosis (right ventricular outflow tract obstruction)
3. overriding aorta
4. Right ventricular hypertrophy
●● Murmur associated with tetralogy of Fallot
Answer: holosystolic murmur at left systolic border that radiates to the
back
,●● How to treat hypercyanotic "tet" spells (5 things)
Answer: Increase systemic vascular resistance1. supplemental oxygen
(pulmonary vasodilator)
2. morphine (sedation)
3. bicarb (helps reverse acidosis and acts as pulmonary vasodilator)
4. phenylephrine (selectively increases SVR)
5. knee to chest positioning
●● Murmur with pulmonary atresia
Answer: systolic murmur of PDA and single s1 and s2 sounds
●● Presentation of HLHS
Answer: single S2 sound at LSB; shock, resp distress, heart failure
●● Staged surgical repairs for ductal dependent lesions
Answer: 1. Norwood
2. Glenn
3. Fontan
●● What would oxygen saturations > 90% in a patient who has had a
Norwood procedure indicate?
Answer: pulmonary overcirculation
, ●● Ductal dependent lesions (4)
Answer: 1. HLHS
2. TGA
3. pulmonary atresia
4. tricuspid atresia
5. coarctation
●● CXR finding with coarctation of the aorta
Answer: 3 sign with rib notching
●● CXR finding with PAPVR
Answer: scimitar-shaped opacity along right heart border
●● CXR finding w/ Ebstein anomaly
Answer: box-shaped heart
●● What is Scimitar syndrome
Answer: veins of RLL drain into the IVC
●● CXR finding with TGA
Answer: egg on a string
QUESTIONS AND COMPLETE SOLUTIONS
TEST PAPER
●● Recommend closure of ASD at what age?
Answer: 3-5 y/o
●● Recommend closure of PDA at what age?
Answer: 3 - 6 months old
●● Murmur associated with AV Canal
Answer: systolic regurgitant murmur at LLSB
●● Components of Tetrology of Fallot (4)
Answer: 1. VSD
2. pulmonary stenosis (right ventricular outflow tract obstruction)
3. overriding aorta
4. Right ventricular hypertrophy
●● Murmur associated with tetralogy of Fallot
Answer: holosystolic murmur at left systolic border that radiates to the
back
,●● How to treat hypercyanotic "tet" spells (5 things)
Answer: Increase systemic vascular resistance1. supplemental oxygen
(pulmonary vasodilator)
2. morphine (sedation)
3. bicarb (helps reverse acidosis and acts as pulmonary vasodilator)
4. phenylephrine (selectively increases SVR)
5. knee to chest positioning
●● Murmur with pulmonary atresia
Answer: systolic murmur of PDA and single s1 and s2 sounds
●● Presentation of HLHS
Answer: single S2 sound at LSB; shock, resp distress, heart failure
●● Staged surgical repairs for ductal dependent lesions
Answer: 1. Norwood
2. Glenn
3. Fontan
●● What would oxygen saturations > 90% in a patient who has had a
Norwood procedure indicate?
Answer: pulmonary overcirculation
, ●● Ductal dependent lesions (4)
Answer: 1. HLHS
2. TGA
3. pulmonary atresia
4. tricuspid atresia
5. coarctation
●● CXR finding with coarctation of the aorta
Answer: 3 sign with rib notching
●● CXR finding with PAPVR
Answer: scimitar-shaped opacity along right heart border
●● CXR finding w/ Ebstein anomaly
Answer: box-shaped heart
●● What is Scimitar syndrome
Answer: veins of RLL drain into the IVC
●● CXR finding with TGA
Answer: egg on a string
