Rosh Pediatrics Practice Exam 2026 - Free Pediatrics Exam Practice Questions and Study Resource.

In the context of a 4-year-old with a cardiac murmur, the intensity of many benign murmurs typically decreases when the child is sitting compared to when they are in a supine position. This is primarily due to changes in blood flow dynamics and venous return associated with body position. When a child is supine, the return of blood to the heart is increased, which can enhance the intensity of certain benign murmurs. In contrast, sitting can lead to a decrease in venous return and consequently, may reduce the murmur's intensity.

It's important to consider that some murmurs, particularly benign ones often found in children, fluctuate with changes in body position due to the varying hemodynamics. Therefore, if a murmur is noted to have less intensity in the sitting position, it aligns with the expected behavior of many physiological murmurs in pediatric patients.