Cardiology – Set 1

What this deck covers

Cardiology – 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 paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Posture-dependent sound at age 4
2. Infant signs, the odd one out
3. Sweaty breathless feeder at 10 weeks
4. Loud murmur, nothing palpable
5. Fast head growth, sweaty feeds
6. Reading an infant’s Q waves
7. Chest film in a large shunt
8. Trisomy 21 infant in heart failure
9. Newborn heart check red flag
10. Puffy eyelids at 8 weeks
11. ECG when the lung pressure is high
12. Well for weeks, then breathless
13. Fixed split and chest infections
14. Echo despite a normal baby check
15. First medicine for a failing infant
16. Sizing a septal shunt on echo
17. Why this newborn’s heart fails
18. Pale toddler with a gallop
19. ECG clue in trisomy 21 with failure
20. Crying during feeds with failure
21. The finding that needs referral
22. Failing despite full medical therapy
23. When unloading the heart is unsafe
24. Where an upper sternal murmur arises
25. Grey and breathless on day 5
26. Never repaired, the gravest risk
27. Confirming the cause on echo
28. Tiring infant who is not growing
29. The trigger for closing the hole
30. Which holes shut on their own
31. School nurse hears a soft murmur
32. Root cause in a toddler’s diet
33. Best timing of the definitive repair
34. Still failing on a diuretic
35. Is an invasive study needed first
36. Significant shunt with good rims
37. Why the apical valve leaks
38. Bronchiolitis on top of a shunt
39. Warning signs in the lung vessels
40. Bruit over the head on day 3
41. ECG with a fixed split sound
42. Small outlet hole under yearly review
43. Why a second operation is needed
44. Failing heart, very low Hb
45. Next pregnancy, chance of a repeat
46. Definitive plan once stabilised
47. Conduction risk of a patch repair
48. Antibiotics before a tooth extraction
49. Acidosis on a post-operative infusion
50. Cerebral shunt, controlled failure

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Small muscular ventricular septal defect, Grade 5 of 6, Boot-shaped heart with a concave pulmonary bay, Onset of oedema before 3 months of age, Mild pulmonary valve stenosis, High-velocity jet with a steep pressure gradient, Right axis deviation with rSR′ in V1, Surgical closure of the defect within weeks, Duct-dependent left heart obstruction, Restrict milk to two-thirds of the usual volume, Echocardiogram before any competitive sport, Oral sildenafil, Myxomatous prolapse of the mitral leaflets, Colour Doppler cranial ultrasound.

Clinical pearls from this deck

• A musical murmur that fades on standing in a well preschool child is the Still murmur.
• In a baby, look for oedema at the eyelids and sacrum, not the ankles.
• A large VSD is quiet at birth and declares itself at 6 to 10 weeks as pulmonary resistance falls.
• Grade 4 begins where the thrill begins.
• Always listen over the head of an infant in unexplained heart failure.
• Infarct Q waves in an infant: ask where the left coronary comes from.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

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