Patients on lithium therapy have an increased

chance of having a baby with:

a) PDA

b) Down Syndrome

b) Potters Syndrome

d) Ebsteins anaomaly

d) ebsteins anaomaly

patients on lithium therapy have an increased

risk of having a baby with ebteins anomaly of the tricuspid valve

Babies with CHD do not typically present with:

a) tachypnea

b)tachycardia

d) respritory distress

d) respritory distress

babies with chd may have tachypnea and tachycardia but do not typically present in respritory distress, unless thier is a significatn increase in pulmonary blood flow or poor systemic output with acidosis

If you see a child that is pale with a sweaty forhead, increased respriory rate, decreased feeding tolerance, and failure to thrive:

a) Influenza

b) Teatnus

c) Chronic Heart Failure

d) Jaundiced

C) Chronic Heart Failure

Normal liver size is

a) 1-2 cm below the costal margin

b) 3-4 cm below the costal margin

c) 5cm below the costal margin

d) 10 cm below the costal margin

a) 1-2 cm below costal margin

If liver enlargment occurs it is a sign of right heart failure

A critical indicator of cardiac output

and overall fluid status in infants and

children with heart failure is:

a) blood pressure

b) equal and symmetrical pulses

c) palpation of the liver for position and size

d) respriation status

c) palpation of the liver for position and size

Palpation and inspection of this is important in determining ventricular overload, cardiomeagly, and presence or absence of thrills:

a) blood pressure

b) radial pulse

c) PMI

d)radial/fem lag

c)PMI

 Midsystolic ejection clicks are

characteristic of:

a) vsd

b) pda

c) mitral valve regurgitation

d)mitral valve prolapse

S1 is the closure of

a) tricuspid and aortic valve

b) mitral and pulmonic valve

c) tricuspid and mitral valve

d) aortic and pulmonic valve

S2 is the closure of

a) tricuspid and aortic valve

b) mitral and pulmonic valve

c) tricuspid and mitral valve

d) aortic and pulmonic valve

S1 is heard best at

a) LLSB at the apex

b) LLSB at the base

c)LUSB at the apex

d)LUSB at the base

S2 is heard best at

a) LUSB at the base

b) LUSB at the apex

c)LLSB at the base

d)LLSB at the apex

Heard at the apex, common finding,

caused by vibrations in the ventricle as it

fills rapidly during diastole.

a) S1

b)S2

c)S3

d)S4

Rare in infants and children. Abnormal

finding that suggests decreased ventricular

compliance and could indicate CHF or

restrictive cardiomyopathy

a)S1

b)S2

c)S3

d)S4

Extra heart sounds that occur

between S1 and S2.

a) ejection clicks

b) S1

c) S2

a) ejection clicks

they suggest a bicuspid aortic valve, pulmonary

valve stenosis, truncus arteriosus, or ebsteins anomaly

When heard, they suggest bicuspid aortic valve, pulmonary valve stenosis, truncus arteriosus, or ebsteins anomaly:

a)S4

b) diastolic murmur

c) ejection clicks

d) S3

Systolic mumurs occur

a) between S1 and S2

b) after S2

c) before S1

 Diastolic murmurs occur:

a) between S1 and S2

b) after S2

c) after S1

 Systolic murmurs are due to

a) mitral valve prolapse

b) mitral valve regurg

c) semilunar valve or great vessel stenosis

d) PDA

Regurgitant murmurs typically begin with

a)S1

b)S2

c) after S2

a) S1

Regurgitant murmurs ususally begin with S1, although they usually do not obscure it, are the result of mitral or tricuspid valve insufficency

Holostolic mumurs:

a) obscure S1

b) do not obscure S1

a) obscure S1

usually caused by VSD

Diastolic mumurs are usually caused by

a) aortic or pulmonic regurgitation

b) mitral stenosis

c) are never normal

d) all of the above

A continuous murmur that has a

machinery like quality, is best heard in the left

clavicular area or back

a) TOGV

b)PDA

c) VSD

d)ASD

Usually heard best at the left lower

sternal border and have a vibratory or musical quality. Short and well located, no louder than a 2-3. Accentuated by high output states ie)fever or exercise

a) diastolic murmur

b) PDA

c) VSD

d) Innocent murmur

EKGS are used to confirm a diagnosis of structural

CHD as opposed to establishing one

a) True

b) False

Last sinuses to develop beginning between 4-8 years and do not develop fully until late adolescence

a) frontal

b)maxillary

c)ethmoid

d)sphenoid

Sinuses present at birth

a)maxillary

b)ethmoid

c)sphenoid

d) maxillary and ethmoid

e)frontal

Cranial Nerve I

a) optic

b) olfactory

c) otitis media

d) abducens

movment of the tooth through alveolar bone is called:

a)teething

b) bifid growth

c) eruption

c) eruption

normally occurs between 4-12 months

How many primary teeth should you have between 24-30 months?
a)32

b)26

c)20

d)10 

Which teeth usually erupt first?

a) maxillary incisors

b) mandibular incisors

How many permanant teeth do you have with wisdom teeth?

a) 20

b)21

c)32

b)28

Which two cranial nerves innervate the tounge for sensation and taste?

a) IX glossopharyngeal and X vagus

b) XII hypoglossal and X vagus

c) IX glossopharyngeal and XII hypoglossal

d) XI spinal accessory and I olfactory

Which cranial nerve innervates the tongue for motor function?

a) X vagus

b) IX glossopharyngeal

c) hypoglossal

d) I olfactory 

The sensation of taste is immature at birth and is not fully functional until approx:

a) 1 year

b) 2 years

c) 3 years

d) 4 years

Which glands become inflammed with mumps or parotitis?

a) submandibular gland

b) stenson gland

c) wharton gland

d) parotid glands

Wharton's ducts are

a) on either side of the frenulum

b) opposite the upper second molar

c) in the eye

d) in the vagina

Stensen's ducts are:

a) on either side of the frenulum

b) opposite the upper second molar

c) in the eye

d) in the vagina

An infant may have incrased drooling by:

1-2 months

3-4 months

5-6 months

7-8 months

Transverse crease accross nose caused by an upward swipe with the hand from chronic nasal drainage:

a) nasolabial fold

b) deviated septum

c) allergic salute

Pale, swollen mucosa and edema of the turbinates is associated with:

a) RSV

b) Pneumonia

c) allergic rhinitis

c) foreign body

Reddend inflamed mucosa and turbinates is assoicated with: 

a) allergic rhinitis

b) allergic reaction

c) crying

d) respiratory infections

c) respiratory infections

children with chronic respritory infections may develop polyps that appear as shiny sacs extending into the vestibule

What is your 1st step if a foreign nasal body is suspected:

a) carefully irrigate the nose

b) carefully try to pull the fb out

c) have the child try to pick it out

d) attempt ot have the child blow out the object

d) attempt to have the child blow out the object

then a gentle probe with curette or tweezers can be attempted

What are the only sinuses that can be palpated with physical examination:

a) sphenoid and maxillary

b) sphenoid and frontal

c) none

d) frontal and maxillary

When would drooling be considered abnormal

a) after 2 years

b) after 15 months

c) after 18 months

d) all of the above

d) all of the above

drooling during infancy from 3-15 months of age is normal. Drooling later may indicate nerve damage and loss of control of oral secretions.

White pearly papules at ethe juncture of teh hard and soft palates or ont he anteior surface of teh buccal mucosa:

a) abnormal

b) normal

b) normal

called epsteins pearls resolve spontaneously

benign inflammation of dorsal surface of tongue, causes reddened areas with absent papillae and surrounding whitish border

a) sublingual papule

b) lingual pseudopapillae

c) geographic tongue

If you are assessing a child that is bottle feeding with ease, you do not have to worry about assessing which cranial nerve?

a) XII hypoglossal

b) X vagus

c) IX glossopharyngeal

d) XI spinal accessory

shortnend lingual frenulum

a) pseudofrenulum

b) ankyloglossia

c)  macroglossia

What cranial nerve are you testing if you have the child stick their tongue out and move it from side to side?

a) XII hypoglossal

b) X vagus

c) IX glossopharyngeal

d) XI spinal accessory

What craninal nerve are you testing when you have the child open thier mouth and say "ah" and you observe the  intact soft palate rise symmetrically along with the uvula

a) XII hypoglossal

b) X vagus

c) IX glossopharyngeal

d) XI spinal accessory 

What is a hallmark of chronically enlarged tonsils in children?

a) darkend eye circles

b) sleep apnea

c) dry lips

d) swollen tongue

Dark pink slightly enlarged tonsils may indicate:

a) tonsilitis

b) scarlet fever

c) chronic respritory allergies or infection

d) nothing

Exudate or white/yellow areas of material in the crypts of the tonsils is often associated with

a) bacterial tonsilltis

b) infectious mononucleosis

c) allergies

d) influenza

e) a and b

Would you be concerned if you saw unequal size and colored tonsils also known as peritonsilar abscess?

a) yes

b) no

a) yes

requiers hospitalization or immediate antibiotic therapy and close follow-up