Congenital heart defect recognition and pediatric asthma and bronchiolitis management scenarios tested on USMLE Step 2 CK.
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- What is the most common congenital heart defect?
- Ventricular septal defect (VSD)
- What type of murmur is heard with a ventricular septal defect (VSD)?
- Holosystolic (pansystolic) murmur at the left lower sternal border
- What is the classic auscultatory finding in atrial septal defect (ASD)?
- Wide, fixed splitting of S2
- What type of murmur is heard with a patent ductus arteriosus (PDA)?
- A continuous 'machinery' murmur
- Which maternal infection during pregnancy is classically associated with PDA in the newborn?
- Rubella
- In coarctation of the aorta, how do blood pressures in the arms and legs typically compare?
- Blood pressure is higher in the arms than in the legs
- Which chromosomal condition is classically associated with coarctation of the aorta?
- Turner syndrome (45,X)
- What chest x-ray finding may appear in older children with coarctation of the aorta?
- Rib notching, from erosion by enlarged collateral vessels
- What are the four components of tetralogy of Fallot?
- Ventricular septal defect, right ventricular outflow tract (pulmonary) stenosis, right ventricular hypertrophy, and an overriding aorta
- What is the classic chest x-ray finding in tetralogy of Fallot?
- A boot-shaped heart
- What maneuver classically relieves a hypercyanotic ('tet') spell in tetralogy of Fallot?
- Squatting, which increases systemic vascular resistance
- What classic chest x-ray finding is described in transposition of the great arteries?
- An 'egg on a string' appearance
- When does cyanosis typically present in transposition of the great arteries?
- Within the first day of life
- What medication is given to maintain ductal patency in a newborn with a ductal-dependent congenital heart defect?
- Prostaglandin E1 (alprostadil)
- What medication is used to pharmacologically close a patent ductus arteriosus?
- Indomethacin, a prostaglandin synthesis inhibitor