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<quiz>
    <question type="matching">
        <name>
            <text>Theme: Cardiac investigations...</text>
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                <![CDATA[Theme: Cardiac investigationsChoose the best investigation from the list above for the three situations described below. Each option may be used once, more than once or not at all.]]>
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                <![CDATA[CARDIAC INVESTIGATIONS(None of the above)This has all the features of an innocent murmur; soft, systolic, positional. Up to 30% of children have such a murmur detected at some stage often while they are being auscultated for other reasons. In this case the 'louder sitting' characteristic suggests a venous hum as opposed to a Still's murmur or pulmonary flow (both of which are best heard lying down). No investigation is needed and only parental reassurance is necessary.(24-hour ECG)Though these may be simple panic attacks the girl's complaint requires that supraventricular tachycardia is ruled out. A 24 hour tape may show runs of supra-ventricular tachycardia and it is helpful to carry this out with an event monitoring facility. A standard ECG may show signs of Wolf—Parkinson—White (short PR interval with a delta wave).(Cardiac catheter)This child's aortic valve is re-stenosing until proved otherwise. Doppler echo studies will be suggestive but the gold standard remains cardiac catheterisation. This child is likely to require percutaneous transluminal redilatation open repair should this fail.]]>
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        </generalfeedback>
        <defaultgrade>3.0000000</defaultgrade>
        <penalty>0.0000000</penalty>
        <hidden>0</hidden>
        <shuffleanswers>1</shuffleanswers>
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                <![CDATA[A 2-year-old boy sent to outpatients with a murmur. He is well and pink with normal pulses. There is a soft systolic murmur at the right supraclavicular area louder on sitting.]]>
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            <answer>
                <text>None of the above</text>
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                <![CDATA[A 14-year-old girl with recurrent 'panic attacks' with a fast heart rate of 'at least 120 at rest'. On examination she is well with a normal cardiac examination.]]>
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            <answer>
                <text>24-hour ECG</text>
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                <![CDATA[A 5-year-old boy, who had an aortic stenosis repaired at age 18 month, presents with increasing shortness of breath. There is a systolic murmur on examination best heard over the 'aortic' area.]]>
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            <answer>
                <text>Cardiac catheter</text>
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            <answer>
                <text>24-hour ECG</text>
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            <answer>
                <text>Cardiac catheter</text>
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                <text>Thoracic magnetic resonance imaging (MRI) scan</text>
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                <text>Chest X-ray</text>
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                <text>Arterial compliance studies</text>
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            <answer>
                <text>None of the above</text>
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        </subquestion>
        <tags>
            <tag>
                <text>cardiology</text>
            </tag>
        </tags>
    </question>
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