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CardioPulm 2 > 2] Pediatric <3 Disorders > Flashcards

2] Pediatric <3 Disorders Flashcards

1
Q

What is incidence

A

of new cases

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2
Q

Incidence of peds and heart conditions

A

Congenital heart defects occur in about 1% = 40,000/year

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3
Q

What is prevalence

A

Total # of cases of diseases in a period of time

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4
Q

Prevalence of congenital heart disease

A

1 million kids

1.4 million adults

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5
Q

15% of babies born with CHD have ?

A

Other genetic conditions

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6
Q

How can you identify kids with CHD?

A

Newborn screening - add pulse ox

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7
Q

Cause of CHD?

A

Unknown

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8
Q

What’s the genetic association with CHD?

A

Down syndrome

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9
Q

The heart begins as

A

Two strands

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10
Q

The heart has two adjacent tubes at

A

Day 18

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11
Q

The two heart tubes fuse at

A

Day 21

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12
Q

The heart is beating on

A

Day 22

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13
Q

Single atria chamber and single ventricular chamber pump

A

Blood by day 27

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14
Q

Ventricle forms the

A

Truncus arteriosus

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15
Q

What grows in the truncus arteriosus

A

Septum

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16
Q

Septum forms

A

Aorta and pulmonary artery

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17
Q

Atria wall forms an opening when? And what?

A

Days 27-37 and foramen ovale

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18
Q

Heart is completely developed by

A

Weeks 7-10

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19
Q

What’s formed by weeks 7-10

A

Ductus arteriosus

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20
Q

What kind of resistance is in the fetal lungs and why

A

Higher resistance and fluid follow spath of least resistance

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21
Q

Connection from the pulmonary artery to the aorta

A

Ductus arteriosus

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22
Q

What’s between the atria

A

Foramen ovale

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23
Q

What happens as the baby takes first breath and air fills the lungs

A

Pulmonary arteries and capillaries DIATE and fluid moves into arterioles

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24
Q

Resistance is what in lungs

A

Lower

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25
Q

What happens to foramen ovale ?

A

Closes due to high pressure on L side

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26
Q

When does foramen ovale fuse

A

Before month 3

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27
Q

When oxygen levels rise, muscle in the ductus arteriosus contracts and

A

DA closes 10-15 hours after birth

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28
Q

2 types of congenital heart defects

A

Cyanotic vs acyanotic

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29
Q

Low oxygen saturation

  • tetralogy of Fallot
  • hypoplastic left heart syndrome
A

Cyanotic

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30
Q

Normal oxygen saturation’s

A

Acyanotic

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31
Q

Volume issues to lungs

A

Acyanotic

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32
Q

Right to left shunt

A

Cyanotic

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33
Q

Left to right shunt

A

Acyanotic

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34
Q

Correction of aorta
PDA
ASD
VSD

A

Acyanotic

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35
Q

Signals increase for RC formation in which defect

A

Cyanotic

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36
Q

Increased risk for cerebrovascular insult

A

Cyanotic

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37
Q

What is ASD

A

Atrial septal defect

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38
Q

Which way does the shunt go for ASD

A

Left to right shunt

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39
Q

Characteristics of ASD

A

L heart is less compliant.
Mor epressure on L side.
Which results in increased blood flow to R side

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40
Q

Sx of ASD

A

Dysrythmia
SOB
FTT/poor weight gain
Exercise intolerance

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41
Q

What does ASD present like in adults

A

• In adults, may present with SOB, leg swelling, dysrhythmia’s in 30’s or stroke.

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42
Q

How is ASD repaired

A

By sewing the opening closed or with a patch

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43
Q

What is VSD

A

Ventricular septal defect

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44
Q

40% of congenital heart diseases

A

VSD

45
Q

Shunt for VSD

A

Most commonly results in L to R shunt

46
Q

VSD results in

A

R sided HF
Irreversible lung damage
Turbulent blood flow that damages aortic valve

47
Q

Some may close on their own
– If symptomatic (same sx as ASD), requires patch
• Can now be done percutaneous
– If asymptomatic, will be repaired if large and there is a lot ofblood flow to the lungs

A

Tx for VSD

48
Q

What is PDA

A

Patent ductus arteriosis

49
Q

What does the PDA connect

A

Pulmonary artery to the aorta

50
Q

In PDA, failure to close results in blood flowing

A

From aorta to PA and lungs

51
Q

PDA has an increased risk of

A

Endocarditis

52
Q

a medicine that helps close
PDAs in premature infants. This medicine triggers the PDA to
constrict or tighten, which closes the opening. Indomethacin usually doesn’t work in full-term infants.

A

Indomethacin

53
Q

What’s another medium used to close PDAs in premature infants

A

Ibuprofen

54
Q

What is COA

A

Coarctation of the aorta

55
Q

What does COA mean

A

Narrowing where the DA attached to aorta

56
Q

Can occur in isolation or with other congenital heart abnormalities (VSD)

A

COA

57
Q

Sx of COA

A

Decreased blood flow to body leads to organ damage and diminished pulse

58
Q

FTT
• HTN
• Heart failure

A

Other Sx of COA

59
Q

Treatment for COA

A

Surgery

60
Q

Acyanotic defects (4)

A

ASD
VSD
COA
PDA

61
Q

2 CYANOTIC congenital conditions

A

TOF

HLHS

62
Q

Muscle that separates Aortic valve from pulmonary valve is not in theright location.

A

TOF

63
Q

What does TOF stand for

A

Tetralogy of Fallot

64
Q

4 deficits of TOF

A

1] Obstructs pulmonary flow
2] VSD
3] aorta lies over VSD (overriding aorta)
4] R ventricular hypertrophy

65
Q

Obstruction of pulmonary flow with TOF causes

A

Decreased oxygen- cyanosis

66
Q

What’s an overriding aorta with TOF

A

Aorta shifted to the R and sits over the VSD

67
Q

Surgery for TOF

A

Shunt to address obstruction- connects a small branch off aorta to pulmonary artery

68
Q

What happens with a full repair in TOF

A

VSD repair with patch that reduces pulmonary flow obstruction

69
Q

Long term issues of TOF

A

If pulmonary valve is leaky- exercise intolerance need for surgery as adult.
Dysryhtmia.
Risk for endocarditis.

70
Q

What does HLHS stand for

A

Hypoplastic left heart syndrome

71
Q

What is HLHS

A

Underdevelopment of the L side of the heart

72
Q

If HLHS is found early?

A

Prostaglandins is given to keep ductus arteriosis open

73
Q

HLHS can be picked up on

A

Prenatal ultrasound

74
Q

Surgical options for HLHS

A

Transplant or staged reconstruction

75
Q

Where is the apical pulse

A

4th ICS

76
Q

Typical newborn HRs are at ?

A

100-180 b/m

77
Q

Femoral pulse- hyperdynamic pulses may indicate

A

PDA

78
Q

Shape of thorax at 0-3 months

A

Triangle

79
Q

Shape of thorax after 3 months

A

Rectangle

80
Q

Direction of ribs 0-6 months

A

Horizontal

81
Q

Direction of ribs 6-12 months

A

Angled down

82
Q

Primary muscles used for inspire at 0-3 months

A

Diaphragm

83
Q

Primary muscles used for inspire 3-6 months

A

Diaphragm and accessory muscles

84
Q

Primary muscles used for inspiration at 6 - 12 months

A

Diaphragm and intercostals

85
Q

Kids start sitting at

A

6 months

86
Q

After correction of underlying problem and medical clearance, the AHA recommends ?

A

30 minutes of light to moderate exercise

87
Q

Would static be good for CHD?

A

Static exercises cause a higher blood pressure response, especially with valslava maneuver.

88
Q

What happens with static exercises ?

A

Puts an afterload pressure on the LV

89
Q

What about dynamic exercises with CHD?

A

Dynamic exercises cause an increase in volume to the left ventricle.

90
Q

Equation for dynamic exercises

A

For every 1/min increase in oxygen uptake, there is a 5-6 L/m COincrease needed

91
Q

What happens with dynamic exercises ?

A

Puts a VOLUME load on the LV

92
Q

If they have ASD and no PH, they can

A

Participate in all sports

93
Q

AD with PH can

A

Participate in class IA sports

94
Q

ASD with PH, R to L shunt can ?

A

No participation in competitive sports but possibly IA after Evaluation

95
Q

ASD treated: Post-op 3-6 months, no PH ,no RV Dysfunction, No Dysrhythmia can ?

A

Participate in all sports

96
Q

Small VSD, no PH can

A

Play all sports

97
Q

Large VSD and PH can

A

Pay IA sports

98
Q

3-6 months post op, no dysrhythmia, no PH

A

All sports

99
Q

3-6 months post op with PH can play

A

IA ports

100
Q

3-6 months post op with atrial or ventricular tachycardias

A

Must be evaluated by an

electrophysiologist before any sportacctivity

101
Q

If cyanotic heart disease is stable on CPET and no dysrhythmias or significant desaturation may

A

May be considered for IA sports

102
Q

With Marfan syndrome you have to have 1 copy of

A

• Autosomal dominant connective tissue disorder

103
Q

What happens in Marfan syndrome?

A

Abnormalities in microfibrils diminish structuralintegrity of vessel walls

104
Q

Can cause compression of RA/RV and decreases vital capacity

A

Excavatum (depression) in Marfan

105
Q

Rigid chest wall, increased energy

consumption for breathing, alveolar hypoventilation, Cor pulmonale

A

Carinatum (pigeon chest) in Marfan

106
Q

Wrap 1st and 5th digits around opposite wrist. (+) if overlap

A

+ stein berg

107
Q

Scoliosis
• Limited elbow extension
• Visual changes
• Flat feet

A

Marfan syndrome

108
Q

People with Marfan syndrome may participate in low/moderate static and dynamic sports (IA and IIA) unless they have:

A

Aortic root dilation
– Moderate or severe Mitral regurgitation
– LV systolic dysfunction c. L

CardioPulm 2 (5 decks)

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