Cardiology Prometric Style Questions – 50 Cases with Answers

What this deck covers

Cardiology Prometric Style Questions, Set 1 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. A rate of 290 that will not vary
2. Pauses and runs after atrial surgery
3. What made the stroke happen
4. Hoarse voice and a murmur to the neck
5. A murmur that got quieter
6. What indometacin actually does
7. Screening the newborn with trisomy 21
8. Six weeks of fever after a repair
9. Cyanosis with a leftward axis
10. A split that does not move
11. Bounding pulses on day five
12. Still failing on a diuretic
13. A joint that moved, and a new murmur
14. A short PR and a slurred upstroke
15. Heart failure with a normal heart
16. Collapse on the football pitch
17. Blue after crying, murmur fades
18. Irregular and broad in pre-excitation
19. A first trimester exposure
20. Broad, regular, and still well
21. The largest heart on the film
22. Sweating at the breast at seven weeks
23. Why the baby looks well today
24. Grey and mottled at 300 a minute
25. The axis that points upwards
26. Fast but pink on day two
27. Sawtooth on the baseline
28. A click that moves when she stands
29. A pulse with no pattern at all
30. Slow from twenty two weeks
31. The sign that belongs elsewhere
32. Collapsed on day three
33. Shocked, but with a big liver
34. Where the duct actually runs
35. Tachycardia the fever does not explain
36. Short, unpubertal, and hypertensive
37. The shock that did not work
38. Fainted while running
39. A giant wave in the neck
40. Six days of fever and red lips
41. A giant aneurysm at three months
42. What the echo has to show
43. Tall, long fingered, and a lens that moved
44. The T wave that should be inverted
45. Where to put the stethoscope
46. Sixty kilograms in arrest
47. A murmur that changes with posture
48. Blue but not distressed
49. Two spells in a fortnight
50. Who needs cover at the dentist

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Rapid push intravenous adenosine, Valvular aortic stenosis, Tetralogy of Fallot, A fourth heart sound, Penicillin prophylaxis for years, Synchronised cardioversion at 1 J/kg, Transposition of the great arteries, Atrial septal defect, Superior QRS axis with left axis deviation, Hypertrophic cardiomyopathy, Tachypnoea and sweating with feeds, The right atrium and the left atrium, 2 J/kg, synchronised, Intravenous ceftriaxone for ten days in hospital.

Clinical pearls from this deck

• Read what has already been done before you answer: the same child, before any vagal manoeuvre, is ice to the face rather than adenosine.
• Extensive atrial surgery damages the sinus node; when a repaired child faints, look for the pause, not the tachycardia.
• Replace the iron and never venesect a cyanotic child for a high haemoglobin; the rigid cells are the danger, not the count.
• The ejection click is the whole question: its absence puts the obstruction above the valve, and the Williams face tells you why.
• A shunt murmur that fades while the child gets better is the sound of the lungs closing down, not of the heart healing.
• Prostaglandin holds the duct open, so blocking its synthesis shuts it and infusing it keeps it open; every duct question turns on that one axis.

This deck is open to everyone with no sign-in. Work through it once for recognition, then again a week later to test yourself.

More from this system: all cardiology case decks · pediatric reference values.