Cardiology – Set 3

What this deck covers

Cardiology – Set 3 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. Blue at 36 hours despite a headbox
2. Does age change how the duct reacts
3. Dusky on crying, murmur at 6 weeks
4. Film of a baby blue since day one
5. Banana-shaped ventricle at 6 weeks
6. Blocked or nearly blocked outflow
7. Limp and blue after a delayed feed
8. X-ray of a slowly bluer infant
9. No better despite an open duct
10. Risk to watch on the duct infusion
11. Low oximetry screen, superior axis
12. Oxygen that makes no difference
13. Parents want to wait for more weight
14. Why the gap between the atria matters
15. Sealed valve, well-formed ventricle
16. A quieter murmur in a bluer child
17. Fits, a split palate and a murmur
18. When to book the corrective operation
19. Still blue ten minutes into a spell
20. Grey baby on day four
21. Bluer by the hour on day two
22. Scan after a superior axis ECG
23. Bluer as the duct narrows on day 3
24. Why this baby is only slightly blue
25. Racing heart hours after repair
26. A medicine that tightens the outflow
27. Cold and oliguric after the switch
28. What the duct does for this baby
29. Will this blue baby go into failure
30. One fault behind three scan findings
31. First move before the scan arrives
32. Dizzy teenager after a Senning
33. Tantrum, then twenty minutes of blue
34. Arriving late for a newborn operation
35. Outgrowing her first-stage operation
36. ECG marker of danger after repair
37. Valve open, yet still blue
38. How the last-line infusion works
39. ST change on the night of a switch
40. Test that maps the blue baby’s heart
41. Sleepy and blue at 48 hours
42. Big baby, deep blue, silent chest
43. Tiring at 12, years after repair
44. Falling saturation, team on its way
45. Four weeks to wait after a spell
46. What to look for before decompression
47. Last planned step for one ventricle
48. Collapse on the basketball court
49. What yearly scans are looking for
50. Tracing of a blue, calm newborn

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Parenchymal lung disease, Snowman-shaped heart with a wide upper mediastinum, Intubation and mechanical ventilation, Hypertension, Tube feed to 8 kg, then repair, His septal defect has closed spontaneously, IV adrenaline and a saline bolus, Aorta overriding a VSD with a narrowed outflow tract, Atrial flutter with 2:1 block, It supplies all of his systemic blood flow, High-flow nasal oxygen and antibiotics, Assess for LV retraining or a supported switch, Atrial shunt from a stiff right ventricle, Cardiac catheterisation.

Clinical pearls from this deck

• Blue in oxygen but calm in breathing: think of the heart before the lungs.
• Preterm ducts respond to prostaglandin and ignore oxygen; term ducts respond to oxygen and stop responding to prostaglandin with age.
• A murmur that softens as the baby turns bluer comes from the outflow tract, not the septal defect.
• Egg on a string: transposition; boot: tetralogy; snowman: supracardiac anomalous veins; box: Ebstein.
• In transposition with an intact septum, the left ventricle has a use-by date of about 3 weeks.
• Same blue baby, same duct: only forward flow at the valve tells critical stenosis from atresia.

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.