Self-Assessment Examination

Accreditation is provided by the University of Michigan. Take the test online at http://www.phjournal.org/2011Summer/

  1. The required method to diagnose pulmonary arterial hypertension in children is which of the following?

    1. Electrocardiogram

    2. Echocardiogram

    3. Cardiac catheterization

    4. CT scan

  2. Which of the following statements regarding the updated Dana Point classification of pulmonary hypertension published in 2009 is correct?

    1. Excludes children with congenital heart disease

    2. Aids in determination of potential causes of PH in children

    3. Is not useful, because children do not develop thromboembolic disease

    4. Defines 7 groups of PH

  3. In the evaluation of PH, echocardiography does which of the following?

    1. Rules out many types of congenital heart disease

    2. Is sufficient for the diagnosis of PAH

    3. Accurately predicts mean pulmonary artery pressure

    4. Can always accurately predict right ventricular systolic pressure by the tricuspid regurgitation jet

  4. The most common causes of PH in children include which of the following?

    1. Connective tissue disease and congenital heart disease

    2. Congenital heart disease and idiopathic PAH

    3. Idiopathic PAH and connective tissue disease

    4. Thromboembolic disease and congenital heart disease

  5. Presenting symptoms of PH in children include which of the following?

    1. Shortness of breath

    2. Syncope

    3. Chest pain

    4. Seizures

    5. All of the above

  6. Which of the following should be trialed in a WHO FC III child who is acutely responsive to vasodilator testing?

    1. ERA

    2. PDE-5 inhibitor

    3. IV epoprostenol

    4. High dose calcium channel blockade

  7. Which of the following have been identified as genetic mutations associated with the development of PAH?

    1. BMPR2 (bone-morphogenetic protein receptor type 2)

    2. Alk-1 (activin-like kinase-type 1)

    3. Eng (endoglin)

    4. All of the above

  8. Which of the following can contribute to high pulmonary artery pressure in infants with BPD?

    1. High pulmonary vascular tone

    2. Abnormal vasoreactivity

    3. Hypertensive vascular remodeling

    4. Decreased surface area

    5. Left ventricular diastolic dysfunction (LVDD)

    6. All of the above

  9. Which of the following is not a goal of cardiac catheterization in a BPD patient?

    1. Assess the severity of PH

    2. Exclude or document the severity of associated anatomic cardiac lesions

    3. PDA ligation in the presence of bidirectional shunting

    4. Pulmonary venous obstruction or left heart dysfunction

    5. Assess pulmonary vascular reactivity in patients who fail to respond to oxygen therapy alone

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