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1 | |
An infant with a history of cyanotic heart disease is brought to your clinic by his father. The child has been diagnosed with tetralogy of Fallot.
Which of the following combinations describes the findings in tetralogy of Fallot? |
| | A) | Pulmonary artery stenosis, intraventricular communication, right ventricular outlet obstruction, complete or partially right-sided aortic outflow. |
| | B) | Pulmonary artery stenosis, aortic stenosis, patent ductus arteriosis, coarctation of the aorta. |
| | C) | Pulmonary artery stenosis, intraventricular communication, right ventricular outlet obstruction, coarctation of the aorta, aortic outlet obstruction, patent ductus arteriosis. |
| | D) | None of the above. |
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2 | |
Generally, patients with tetralogy of Fallot have fixed anatomical lesions. Functionally, which one of these statements is the most true? |
| | A) | They have variable degrees of aortic outlet obstruction. |
| | B) | They have a ductus arteriosis that persists into late childhood, which helps reduce shunting. |
| | C) | They have dysfunctional left heart muscle. |
| | D) | They have a varying degree of right ventricular outflow obstruction. |
| | E) | None of the above. |
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3 | |
The patient looks well in your office until he sees the needles for immunization. The child starts to cry, becomes upset, and becomes progressively more cyanotic and anxious. This really does not respond well to oxygen at 60% by mask. The next best treatment for this condition is: |
| | A) | Increase the FiO2 to 100%. |
| | B) | Put the child in the knee-to-chest position. |
| | C) | Administer morphine to the child. |
| | D) | Administer a diuretic because it is likely that this patient is in heart failure. |
| | E) | B and C. |
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