18- Pericarditis and Congential Heart Disease

Question 1

Beck’s triad

Answer 1

1. low arterial blood pressure
2. JVD
3. distant, muffled heart sounds

Question 2

Paradoxous pulse

Answer 2

a drop of > 10 mmHg in arterial blood pressure on inspiration

Question 3

3 causes of constrictive pericarditis

Answer 3

1. metastatic neoplasia
2. tuberculosis
3. organization of purulent pericarditis

Question 4

most disorders from faulty embryogenesis occur in weeks

Answer 4

3-8

Question 5

most common congenital heart diseases

Answer 5

1. VSD (43%)
2. ASD (10%)
3. Pulmonary stenosis
4. PDA

Question 6

what percentage of congenital cardiovascular malformations are diagnosed in first year of life

Answer 6

half

Question 7

abnormal communication or opening between cardiac chambers and/or blood vessels thru which abnormal blood flow will occur

Answer 7

shunt

Question 8

an abnormal narrowing causing partial obstruction to normal blood flow

Answer 8

stenosis

Question 9

failure of normal anatomic feature, usually a cardiac valve, to form or develop to a functionally adequate state

Answer 9

atresia

Question 10

initially noncyanotic then later cyanotic (eisenmenger syndrome)

Answer 10

L->R shunt

Question 11

cyanotic CHD

Answer 11

R -> L shunt

Question 12

ASD
VSD
PDA

Answer 12

L-> R shunts

Question 13

clubbing of tips of the fingers and toes

Answer 13

R–> L shunt

Question 14

eisenmenger syndrome

Answer 14

pulmonary vascualr resistance approaches systemic levels, thereby producing a new right to left shunt that introduces unoxygenated blood into the systemic circulation

Question 15

90% of all ASDs are classified as

Answer 15

secundum

deficient or fenestrated oval fossa near the center of the atrial septum

near top = venosus
near bottom = primum

Question 16

essentially a hole in the center of the heart

Answer 16

complete AVSD

Question 17

most common right to left shunt

Answer 17

tetralogy of fallot

Question 18

tetraolgy of fallot

Answer 18

1. obstruction of the right ventricular outflow tract (subpulmonary stenosis)
2. right ventricular hypertrophy
3. aorta that overrides the VSD
4. large VSD

Question 19

enlarged, “boot-shaped” heart

Answer 19

tetralogy of fallot

Question 20

is there lung damage with tetralogy of fallot?

Answer 20

no - pulmonary stenosis protects pulmonary arteries from HTN PVD

Question 21

the aorta arises from the RV and lies anterior and to the right of the pulmonary artery, which emanates from the LV

Answer 21

transposition of the Great Arteries

Question 22

TGA and VSD =

Answer 22

better prognosis, this is a more stable shunt

Question 23

is coarctation of the aorta more common in females or male

Answer 23

males (2:1)

Question 24

observe: cyanosis lower half of the body

Answer 24

coarctation of the aorta with a patent ductus arteriosus

w/o PDA would be asymptomatic

Question 25

observe notched ribs on xray

Answer 25

coarctation of the aorta