Answer and Explanation 25

25.  The correct answer is C.  As a rule of thumb during fetal circulation blood shunts from the higher pressure of the right heart to the lower pressure of the left heart during fetal circulation.  All of the above are correct except the patent ductus arterosis shunts blood from the pulmonary artery (not vein) to the aorta.

Question 25

25.  All of the following describe fetal circulation accurately except:

A.  Foramen ovale patent allowing for shunting of blood to the left atrium to the right atrium

B.  Patent Ductus Arteriosis allowing for shunting of the blood from the pulmonary artery to the aorta

C.  Patent Ductus Arteriosis allowing for shunting of blood from the pulmonary vein to the aorta

D.  The right heart pressure is much higher then the left side

Answer and Explanation 24

24.  The correct answer is C.  Tetrology of Fallot is characterized by the following pulmonary stenosis, overriding aorta, right ventricular hypertrophy, and ventricular septal defect.  Transposition of the great vessels is not part of the constellation of physical findings.

Question 24

24.  Which of the following is not part of the findings in the patient with Tetrology of Fallot?

A.   Pulmonary Stenosis and Overriding Aorta

B.  Right Ventricular Hypertrophy

C.  Transposition of the Great Vessels

D.  Ventricular Septal Defect (VSD)

Answer and Explanation 23

23.  The correct answer is B.  This patients history and physical indicates she likely has aortic stenosis.  An Echocardiogram would be helpful for assessing this.  MRA of the Brain or Carotid Dopplers should be ordered at some point in her evaluation.  Cardiac catheterization would not likely be helpful initially unless something else showed up in her work up.

Question 23

23.  You are evaluating an 88 year old female that comes in complaining of dizziness.  You have detected a II/VI Systolic murmur over the aortic area and there are no carotid bruits.  Which of the following tests may help confirm the diagnosis supported by your physical exam findings?

A.  MRA of the Brain

B.  Echocardiogram

C.  EKG

D.  Cardiac Catheterization

Answer and Explanation 22

22. The correct answer is B.  African Americans have been shown to have elevated levels of renin, thus making ACE inhibitors less effective in the management of hypertension.  Calcium channel blockers have been shown to be effective as beta blockers.