NBE Pediatric Echocardiography 3

Question 1

A 2-year-old child with Down syndrome has an atrioventricular septal defect (AVSD). Which component is essential for classifying it as a complete AVSD?

Accepted Answer

Presence of a common AV valve with primum ASD and inlet VSD

Answer

Complete AVSD is defined by a common AV valve orifice combined with a primum ASD and an inlet VSD, all resulting from deficiency of the atrioventricular septum.

Question 2

In pediatric echocardiography, which formula is used to estimate right ventricular systolic pressure (RVSP) from tricuspid regurgitation?

Accepted Answer

RVSP = 4V² + RAP, where V is the TR peak velocity

Answer

Using the simplified Bernoulli equation, RVSP = 4 × (peak TR velocity)² + estimated right atrial pressure.

Question 3

Which echocardiographic finding in a neonate is most characteristic of critical pulmonary stenosis with intact ventricular septum?

Accepted Answer

Severely thickened, doming pulmonary valve with high-velocity antegrade flow and right-to-left ductal shunting

Answer

Critical pulmonary stenosis presents with a severely thickened doming pulmonary valve, high antegrade velocity, right ventricular hypertrophy, and right-to-left shunting at the ductus arteriosus due to ductal dependency.

Question 4

In a child with coarctation of the aorta, which Doppler pattern in the descending aorta is most diagnostic?

Accepted Answer

High-velocity flow with prolonged pressure half-time and diastolic tail

Answer

Coarctation produces a high-velocity jet at the narrowing with a diastolic tail (prolonged pressure half-time and continued forward diastolic flow) due to persistent pressure gradient throughout the cardiac cycle.

Question 5

A newborn with cyanosis has a chest X-ray showing a 'snowman' or 'figure-of-8' heart silhouette. Which echocardiographic finding confirms the likely diagnosis?

Accepted Answer

Pulmonary veins draining into a vertical vein connecting to the innominate vein and SVC (supracardiac TAPVR)

Answer

The 'snowman' silhouette on chest X-ray is classic for supracardiac total anomalous pulmonary venous return (TAPVR), where pulmonary veins drain via a vertical vein to the innominate vein and SVC.

(NBE) National Board of Echocardiography Practice Test

(NBE) National Board of Echocardiography Practice Test

NBE Pediatric Echocardiography 3