Thursday, 21 November 2024

MCQ CONGENITAL HEART DISEASE FOR PG EXAM

 

  1. What is the teratogenic risk associated with lithium exposure during pregnancy?
    A. Neural tube defects
    B. Ebstein anomaly
    C. Atrial septal defect
    D. Hypoplastic left heart syndrome
    Correct Answer: B. Ebstein anomaly
    Explanation: Lithium exposure is associated with Ebstein anomaly in retrospective studies.

  2. Which drug is associated with Fetal Hydantoin Syndrome?
    A. Carbamazepine
    B. Phenytoin
    C. Sodium valproate
    D. Trimethadione
    Correct Answer: B. Phenytoin
    Explanation: Phenytoin use during pregnancy causes Fetal Hydantoin Syndrome, characterized by craniofacial and other abnormalities.

  3. What is the recurrence risk of congenital heart disease (CHD) in maternal inheritance?
    A. 3%-7%
    B. 2%-6%
    C. 4%-9%
    D. 5%-10%
    Correct Answer: A. 3%-7%
    Explanation: Maternal inheritance of CHD has a recurrence risk of 3%-7%.

  4. How much does the risk of CHD increase in pregnancies using assisted reproductive technology (IVF/ICSI)?
    A. 20%-30%
    B. 30%-40%
    C. 40%-50%
    D. 50%-60%
    Correct Answer: B. 30%-40%
    Explanation: Assisted reproductive technologies, such as IVF/ICSI, increase CHD risk by 30%-40%.

  5. Which cardiac anomaly is common in monochorionic pregnancies with TTTS?
    A. Tetralogy of Fallot
    B. Truncus arteriosus
    C. Atrial septal defect
    D. Ventricular septal defect
    Correct Answer: C. Atrial septal defect
    Explanation: TTTS in monochorionic pregnancies is commonly associated with atrial septal defects.

  6. What is the recommended maternal phenylalanine level to prevent CHD in phenylketonuria?
    A. >10 mg/dL
    B. >15 mg/dL
    C. <6 mg/dL
    D. <10 mg/dL
    Correct Answer: C. <6 mg/dL
    Explanation: Maternal phenylalanine levels should be maintained below 6 mg/dL to reduce CHD risk.

  7. What is the relative risk of CHD in infants of diabetic mothers compared to non-diabetic mothers?
    A. 3 times
    B. 5-fold
    C. 10-fold
    D. 15-fold
    Correct Answer: B. 5-fold
    Explanation: Diabetic mothers have a 5-fold increased risk of having infants with CHD.

  8. Which fetal condition is associated with maternal alcohol consumption?
    A. Neural tube defects
    B. Fetal Alcohol Syndrome
    C. Gastroschisis
    D. Facial abnormalities
    Correct Answer: B. Fetal Alcohol Syndrome
    Explanation: Fetal Alcohol Syndrome results from maternal alcohol consumption and includes growth and cardiac abnormalities.

  9. What is the main cardiac risk of using NSAIDs during the third trimester?
    A. Pulmonary hypertension
    B. Truncus arteriosus
    C. Premature ductus arteriosus closure
    D. Atrial septal defect
    Correct Answer: C. Premature ductus arteriosus closure
    Explanation: NSAID use during late pregnancy is linked to premature ductus arteriosus closure.

  10. Which medication is linked to neural, craniofacial, and cardiac abnormalities when used during pregnancy?
    A. Folic acid
    B. Retinoic acid
    C. Vitamin A
    D. Selective NSAIDs
    Correct Answer: B. Retinoic acid
    Explanation: Retinoic acid use during pregnancy is associated with craniofacial, neural, and cardiac abnormalities.

  11. Which SSRI is most associated with congenital heart defects?
    A. Citalopram
    B. Paroxetine
    C. Fluoxetine
    D. Sertraline
    Correct Answer: B. Paroxetine
    Explanation: Among SSRIs, paroxetine is most strongly associated with congenital heart defects.

  12. What is the increased CHD risk in mothers with severe obesity?
    A. 2-fold
    B. 1.5-fold
    C. 4.1-fold
    D. 3-fold
    Correct Answer: C. 4.1-fold
    Explanation: Severe obesity increases the risk of CHD by 4.1-fold compared to mothers with normal weight.

  13. What supplement is known to significantly reduce the risk of CHD?
    A. Vitamin D
    B. Iron
    C. Folic acid
    D. Calcium
    Correct Answer: C. Folic acid
    Explanation: Folic acid supplementation has been proven to reduce CHD risk when taken preconceptionally.

  14. What is the incidence of CHD per 1000 live births?
    A. 6-8 per 1000
    B. 8-9 per 1000
    C. 10-12 per 1000
    D. 7-9 per 1000
    Correct Answer: B. 8-9 per 1000
    Explanation: CHD incidence is estimated to be 8-9 per 1000 live births globally.

  15. Which fetal condition is associated with maternal phenylketonuria if not controlled?
    A. Truncus arteriosus
    B. Septal defects
    C. Ventricular hypertrophy
    D. Neural tube defects
    Correct Answer: B. Septal defects
    Explanation: Poor control of maternal phenylketonuria increases the risk of septal defects in the fetus.


  1. Which drug is linked to craniofacial abnormalities and oxidative metabolite effects during pregnancy?
    A. Carbamazepine
    B. Sodium valproate
    C. Phenytoin
    D. Trimethadione
    Correct Answer: C. Phenytoin
    Explanation: Phenytoin causes craniofacial abnormalities and oxidative metabolite effects in fetuses.

  2. What is the recurrence risk of CHD in paternal inheritance?
    A. 3%-7%
    B. 2%-6%
    C. 4%-9%
    D. 5%-10%
    Correct Answer: B. 2%-6%
    Explanation: The recurrence risk of CHD is 2%-6% in cases of paternal inheritance.

  3. Which condition increases the risk of CHD by 30%-40%?
    A. Maternal diabetes
    B. IVF/ICSI pregnancies
    C. Phenylketonuria
    D. Lithium exposure
    Correct Answer: B. IVF/ICSI pregnancies
    Explanation: Assisted reproductive technologies (e.g., IVF/ICSI) are associated with a 30%-40% increase in CHD risk.

  4. Which syndrome is caused by phenytoin exposure during pregnancy?
    A. Ebstein anomaly
    B. Fetal Hydantoin Syndrome
    C. Retinoic Acid Syndrome
    D. Persistent Pulmonary Hypertension Syndrome
    Correct Answer: B. Fetal Hydantoin Syndrome
    Explanation: Phenytoin exposure is associated with Fetal Hydantoin Syndrome, which includes craniofacial defects.

  5. What is the primary effect of maternal alcohol consumption on the fetus?
    A. Facial abnormalities
    B. Cardiac anomalies
    C. Growth retardation
    D. All of the above
    Correct Answer: D. All of the above
    Explanation: Fetal Alcohol Syndrome encompasses facial abnormalities, growth retardation, and cardiac defects.

  6. Which SSRI is least associated with congenital heart defects?
    A. Paroxetine
    B. Fluoxetine
    C. Citalopram
    D. Sertraline
    Correct Answer: C. Citalopram
    Explanation: Citalopram has the lowest association with congenital heart defects compared to other SSRIs.

  7. What is the CHD incidence in pregnancies complicated by phenylketonuria?
    A. 5%-10%
    B. 10%-15%
    C. 15%-20%
    D. 20%-25%
    Correct Answer: B. 10%-15%
    Explanation: Uncontrolled maternal phenylketonuria increases CHD risk by 10%-15%.

  8. What is the fetal risk associated with ACE inhibitor use in pregnancy?
    A. Persistent pulmonary hypertension
    B. ACE inhibitor fetopathy
    C. Neural tube defects
    D. Retinoic Acid Syndrome
    Correct Answer: B. ACE inhibitor fetopathy
    Explanation: ACE inhibitors are associated with growth restriction, oligohydramnios, and renal failure in fetuses.

  9. What supplementation significantly reduces CHD risk when taken preconceptionally?
    A. Vitamin D
    B. Folic acid
    C. Iron
    D. Omega-3 fatty acids
    Correct Answer: B. Folic acid
    Explanation: Folic acid supplementation before conception is proven to lower CHD risk.

  10. Which maternal condition is linked to persistent pulmonary hypertension in newborns?
    A. Phenylketonuria
    B. Obesity
    C. NSAID use in late pregnancy
    D. Diabetes mellitus
    Correct Answer: C. NSAID use in late pregnancy
    Explanation: Late pregnancy NSAID use is associated with persistent pulmonary hypertension in newborns.

  11. What is the recommended maternal HbA1c level to reduce CHD risk?
    A. <6%
    B. <7%
    C. <8%
    D. <5%
    Correct Answer: A. <6%
    Explanation: Maintaining maternal HbA1c <6% is crucial for reducing CHD risk in the fetus.

  12. Which maternal condition is linked to truncus arteriosus in the fetus?
    A. Obesity
    B. Diabetes mellitus
    C. Phenylketonuria
    D. Hypertension
    Correct Answer: B. Diabetes mellitus
    Explanation: Truncus arteriosus is commonly linked to pregnancies affected by maternal diabetes.

  13. What is the major teratogenic risk of valproate use during pregnancy?
    A. Neural tube defects
    B. Craniofacial abnormalities
    C. Growth restriction
    D. Ventricular septal defect
    Correct Answer: A. Neural tube defects
    Explanation: Sodium valproate is highly associated with neural tube defects in the fetus.

  14. Which maternal metabolic disorder increases CHD risk by fivefold?
    A. Phenylketonuria
    B. Diabetes mellitus
    C. Hypertension
    D. Obesity
    Correct Answer: B. Diabetes mellitus
    Explanation: Maternal diabetes increases CHD risk by fivefold compared to pregnancies without diabetes.

  15. What fetal abnormality is associated with elevated phenylalanine levels in phenylketonuria?
    A. Atrial septal defect
    B. Neural tube defects
    C. Septal defects
    D. Ventricular hypertrophy
    Correct Answer: C. Septal defects
    Explanation: Poorly controlled phenylketonuria leads to an increased risk of septal defects in the fetus.


  1. Which maternal condition increases the risk of atrial and ventricular septal defects?
    A. Phenylketonuria
    B. Obesity
    C. Diabetes mellitus
    D. Hypertension
    Correct Answer: C. Diabetes mellitus
    Explanation: Diabetes mellitus is associated with atrial and ventricular septal defects in fetuses.

  2. What is the CHD risk increase in children born to severely obese mothers?
    A. 2-fold
    B. 1.5-fold
    C. 4.1-fold
    D. 3-fold
    Correct Answer: C. 4.1-fold
    Explanation: Severe maternal obesity increases CHD risk by 4.1 times compared to normal-weight mothers.

  3. What is the primary preventive measure for reducing CHD risk?
    A. Vitamin D supplementation
    B. Folic acid supplementation
    C. Iron supplementation
    D. Omega-3 fatty acids
    Correct Answer: B. Folic acid supplementation
    Explanation: Folic acid taken preconceptionally significantly reduces CHD risk.

  4. Which fetal condition is caused by maternal alcohol consumption?
    A. Atrial septal defect
    B. Neural tube defects
    C. Fetal Alcohol Syndrome
    D. Persistent pulmonary hypertension
    Correct Answer: C. Fetal Alcohol Syndrome
    Explanation: Maternal alcohol use during pregnancy leads to Fetal Alcohol Syndrome, characterized by growth retardation, facial abnormalities, and CHD.

  5. Which maternal condition is associated with persistent pulmonary hypertension in the newborn?
    A. NSAID use in late pregnancy
    B. Obesity
    C. Diabetes mellitus
    D. Phenylketonuria
    Correct Answer: A. NSAID use in late pregnancy
    Explanation: Persistent pulmonary hypertension in newborns is linked to NSAID use during the third trimester.

  6. What is the incidence of CHD per 1000 live births?
    A. 10-12 per 1000
    B. 8-9 per 1000
    C. 6-8 per 1000
    D. 7-10 per 1000
    Correct Answer: B. 8-9 per 1000
    Explanation: CHD incidence is approximately 8-9 cases per 1000 live births.

  7. Which medication is contraindicated in pregnancy due to craniofacial and cardiac risks?
    A. Retinoic acid
    B. Paroxetine
    C. Lithium
    D. Sodium valproate
    Correct Answer: A. Retinoic acid
    Explanation: Retinoic acid exposure during pregnancy can lead to neural, craniofacial, and cardiac abnormalities.

  8. Which drug is a common cause of Ebstein anomaly?
    A. Lithium
    B. Phenytoin
    C. Valproate
    D. Carbamazepine
    Correct Answer: A. Lithium
    Explanation: Lithium exposure in pregnancy is strongly linked to Ebstein anomaly.

  9. What is the teratogenic risk of anticonvulsant use during pregnancy?
    A. Neural tube defects
    B. Facial abnormalities
    C. Both A and B
    D. None
    Correct Answer: C. Both A and B
    Explanation: Anticonvulsants are associated with both neural tube defects and facial abnormalities.

  10. Which fetal abnormality is linked to maternal obesity?
    A. Persistent pulmonary hypertension
    B. Craniofacial abnormalities
    C. Cardiac defects
    D. Neural tube defects
    Correct Answer: C. Cardiac defects
    Explanation: Severe maternal obesity increases the likelihood of fetal cardiac defects.

  11. Which syndrome is most associated with phenytoin use during pregnancy?
    A. Ebstein anomaly
    B. Fetal Hydantoin Syndrome
    C. Persistent Pulmonary Hypertension Syndrome
    D. Neural Tube Defect Syndrome
    Correct Answer: B. Fetal Hydantoin Syndrome
    Explanation: Phenytoin is linked to Fetal Hydantoin Syndrome, involving craniofacial and limb defects.

  12. Which drug is most associated with atrial and ventricular septal defects when used during pregnancy?
    A. Paroxetine
    B. Retinoic acid
    C. Lithium
    D. Sodium valproate
    Correct Answer: A. Paroxetine
    Explanation: Paroxetine is an SSRI strongly linked to congenital cardiac defects, especially septal defects.

  13. Which maternal metabolic condition is associated with truncus arteriosus?
    A. Phenylketonuria
    B. Diabetes mellitus
    C. Obesity
    D. Hypertension
    Correct Answer: B. Diabetes mellitus
    Explanation: Truncus arteriosus is more common in pregnancies complicated by maternal diabetes.

  14. What is the fetal risk associated with ACE inhibitors in pregnancy?
    A. Premature closure of ductus arteriosus
    B. ACE inhibitor fetopathy
    C. Retinoic Acid Syndrome
    D. Persistent pulmonary hypertension
    Correct Answer: B. ACE inhibitor fetopathy
    Explanation: ACE inhibitors can cause fetopathy, including growth restriction, oligohydramnios, and renal failure.

  15. What is the most critical preventive measure for maternal phenylketonuria?
    A. Weight management
    B. Glycemic control
    C. Phenylalanine level <6 mg/dL
    D. Folic acid supplementation
    Correct Answer: C. Phenylalanine level <6 mg/dL
    Explanation: Maintaining phenylalanine levels <6 mg/dL reduces CHD risk in phenylketonuria pregnancies.

  16. What is the key teratogenic risk of sodium valproate use during pregnancy?
    A. Neural tube defects
    B. Growth retardation
    C. Craniofacial abnormalities
    D. Ventricular hypertrophy
    Correct Answer: A. Neural tube defects
    Explanation: Sodium valproate is strongly associated with neural tube defects in fetuses.

  17. What is the CHD risk increase in pregnancies achieved through IVF/ICSI?
    A. 10%-20%
    B. 20%-30%
    C. 30%-40%
    D. 40%-50%
    Correct Answer: C. 30%-40%
    Explanation: CHD risk increases by 30%-40% in pregnancies achieved via IVF/ICSI.

  18. Which maternal factor increases the risk of atrial septal defects?
    A. Retinoic acid exposure
    B. Obesity
    C. Diabetes mellitus
    D. NSAID use
    Correct Answer: C. Diabetes mellitus
    Explanation: Diabetes mellitus is linked to an increased risk of atrial septal defects.

  19. What fetal abnormality is commonly seen with poorly controlled maternal phenylketonuria?
    A. Atrial septal defect
    B. Septal defects
    C. Neural tube defects
    D. Tetralogy of Fallot
    Correct Answer: B. Septal defects
    Explanation: Uncontrolled phenylketonuria significantly increases the risk of septal defects in the fetus.

  20. Which supplement significantly reduces the risk of CHD when taken preconceptionally?
    A. Vitamin D
    B. Folic acid
    C. Calcium
    D. Omega-3 fatty acids
    Correct Answer: B. Folic acid
    Explanation: Preconceptional folic acid supplementation is proven to lower the risk of CHD.



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