ENPC ENPC Cardiovascular Emergencies

Question 1

A 3-month-old presents with poor feeding, pallor, and mottling. The ECG shows a narrow complex tachycardia with HR of 235 bpm. What is the most likely diagnosis?

Accepted Answer

Supraventricular tachycardia (SVT)

Answer

Sinus tachycardia

Answer

Ventricular tachycardia

Answer

Atrial flutter

Question 2

Initial management for a hemodynamically STABLE infant with SVT includes:

Accepted Answer

Vagal maneuvers such as ice bag application to the face

Answer

Synchronized cardioversion at 0.5 J/kg immediately

Answer

IV adenosine 0.1 mg/kg bolus

Answer

Amiodarone infusion over 20 minutes

Question 3

What is the correct defibrillation energy dose sequence for pediatric ventricular fibrillation?

Accepted Answer

2 J/kg initially, then 4 J/kg for subsequent shocks

Answer

1 J/kg for all shocks

Answer

5 J/kg for all shocks

Answer

360 J fixed dose regardless of weight

Question 4

A 10-year-old collapses during soccer. He is unresponsive, pulseless, and a defibrillator is immediately available showing VF. What is the PRIORITY action?

Accepted Answer

Defibrillate immediately without delay

Answer

Establish IV access and administer epinephrine first

Answer

Perform 2 full minutes of CPR before defibrillation

Answer

Intubate the airway before initiating CPR

Question 5

Which finding BEST differentiates cardiogenic shock from septic shock in a pediatric patient?

Accepted Answer

Hepatomegaly, gallop rhythm, and jugular venous distension

Answer

Hypotension and tachycardia present in both

Answer

Fever and elevated white blood cell count

Answer

Prolonged capillary refill time

Question 6

A 2-week-old previously healthy neonate presents with sudden cardiovascular collapse. Which diagnosis MUST be considered?

Accepted Answer

Duct-dependent congenital heart disease with spontaneous ductal closure

Answer

Dehydration from poor feeding

Answer

Neonatal hypoglycemia

Answer

Bacterial meningitis