Paediatric Cardiology & Nephrology

Topics in this chapter

• Congenital Heart Defects
• Cyanotic Congenital Heart Disease
• Neonatal Cardiac Care
• Rheumatic Fever and Heart Disease
• Paediatric Glomerular Disorders
• Paediatric UTI and Vesicoureteral Reflux
• Paediatric Renal Tumors

Practice questions

1. Question 1Q-F0758C

   A 3-year-old child presents with recurrent upper respiratory tract infections and a continuous machinery murmur best heard at the left upper sternal border. Femoral pulses are bounding, and wide pulse pressure is noted. Which of the following is the most appropriate initial pharmacological agent for closure of this lesion if the child was a premature neonate?

   1. A.Prostaglandin E1
   2. B.Indomethacin
   3. C.Furosemide
   4. D.Digoxin
   See the answer and solution
2. Question 2Q-948BAE

   A 5-year-old boy presents with periorbital edema, generalized swelling, and frothy urine for the last 5 days. Laboratory investigations reveal massive proteinuria (> 40 mg/m²/hour), serum albumin of 2.1 g/dL, and hyperlipidemia. Serum creatinine is normal, and complement levels (C3) are normal. What is the most common underlying renal histopathology in this age group?

   1. A.Membranoproliferative glomerulonephritis
   2. B.Minimal change disease
   3. C.Focal segmental glomerulosclerosis
   4. D.Membranous nephropathy
   See the answer and solution
3. Question 3Q-2E1DA3

   A newborn infant presents with severe cyanosis and respiratory distress shortly after birth, which does not improve significantly with administration of 100% oxygen. Physical examination reveals a single second heart sound and no significant murmurs. Chest radiograph shows a narrow mediastinum giving an 'egg on a string' appearance. What is the definitive diagnosis?

   1. A.Tetralogy of Fallot
   2. B.Transposition of the great arteries
   3. C.Tricuspid atresia
   4. D.Truncus arteriosus
   See the answer and solution
4. Question 4Q-82A50D

   An 8-year-old girl is brought to the emergency department with gross hematuria, facial puffiness, and mild hypertension 12 days after recovering from a skin infection. Laboratory tests reveal elevated anti-streptolysin O (ASO) titers and low serum C3 complement levels. Which of the following is the hallmark electron microscopic finding in renal biopsy of this condition?

   1. A.Podocyte foot process effacement only
   2. B.Subepithelial humps
   3. C.Subendothelial deposits
   4. D.Basal lamina splitting ('basket-weave' appearance)
   See the answer and solution
5. Question 5Q-F1E72B

   A 4-year-old child with Tetralogy of Fallot suddenly becomes extremely cyanotic, agitated, and hyperpneic while crying, followed by limpness and syncopal episode. The mother notices that the child instinctively squats on the floor. Which of the following hemodynamic changes best explains the beneficial effect of squatting in this condition?

   1. A.Decrease in systemic vascular resistance
   2. B.Increase in systemic vascular resistance
   3. C.Increase in pulmonary vascular resistance
   4. D.Decrease in heart rate
   See the answer and solution