A 3-Month-Old Girl with a Persistent Cough and Respiratory Distress Margot L. Savoy, MD, and Amy D. Crawford-Faucher, MD At the time this article was written, Dr. Savoy was a resident, Crozer Keystone Family Medicine Residency Program, Springfield, PA; she is now an attending physician, Crozer Chester Medical Center, Chester, PA. Dr. Crawford-Faucher is director of obstetrics, Crozer Keystone Family Medicine Residency Program, Springfield, PA. The questions below are based on the July 2005 Pediatric Rounds article, “A 3-Month-Old Girl with a Persistent Cough and Respiratory Distress” Choose the single best answer for each question.
	1. In the work-up of vascular rings, which of the following can reliably exclude the diagnosis? Viral respiratory panel Echocardiogram Chest radiograph Electrocardiogram (ECG) Complete blood count (CBC) Click here to compare your answer. 2. Which of the following is true regarding vascular rings? They account for 5% of all congenital cardiac abnormalities They are associated with deletions in band 22q11 They affect males more commonly than females They affect Asian Americans twice as often as Caucasians They occur more often in the northeastern United States Click here to compare your answer.		3. Which of the following statements regarding the postoperative course after successful surgical repair of vascular rings is true? Up to 30% of children will continue to have persistent cough In children with gastroesophageal reflux disease (GERD), the risk of persistent postsurgical reflux symptoms will be dramatically reduced Between 45% and 50% of children will be entirely asymptomatic Younger children will have shorter postsurgical recovery times because of their Many children will not notice relief from symptoms for several weeks Click here to compare your answer. 4. A 25-year-old female athlete presents for a routine physical examination. She has no complaints. She reports that as a child she had asthma, but she has not required medications or treatment for many years. Last month she had a chest radiograph in the emergency department after a motor vehicle accident, which showed evidence of a right-sided aortic arch. Her physical examination is entirely normal. What is the next step in the management of this patient? Refer her immediately to surgery for evaluation and treatment Perform electrocardiography and if normal reassure the patient Refer her for an echocardiogram Reassure the patient and refer her for pulmonary function testing Reassure the patient and perform no additional testing at this time Click here to compare your answer.
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