8.3 Congenital Defects

Question 1

Cause of Rheumatic Fever

Answer 1

M protein of Strep A causes molecular mimicry in antibodies that will cause an autoimmune reaction

Question 2

What is the most common congenital heart defect?

Answer 2

VSD

Question 3

What is VSD associated with?

Answer 3

Fetal Alcohol Syndrome

Question 4

What is the main shunt in VSD?

Answer 4

Left to right

Question 5

What is the progression of VSD?

Answer 5

The left to right shunt will cause pulmonary HTN that leads to reversal of the shunt eventually leading to a right to left shunt.

Question 6

What are the findings with ASD?

Answer 6

Splitting of S2 due to the RA being overfilled that leads to delay of the closure of the pulmonic valve.

Paradoxical comboli due to crossing over of emboli

Question 7

What is the main shunt in ASD?

Answer 7

Left to right

Question 8

What is patent ductus arteriosus?

Answer 8

Failure of the ductus arteriosus to close after birth

Question 9

What is the progression of PDA?

Answer 9

Blood crosses over from the aorta into the pulmonary artery that eventually leads to pulmonary HTN which will then leads to reversal of the shunt as the pressure becomes very high. Blue blood will then cross into the aorta and to the extremities.

Question 10

What are the findings of PDA?

Answer 10

Lower extremity cyanosis

Question 11

What is the treatment for PDA?

Answer 11

Indomethacin

Question 12

What are the 4 problems of Tetralogy of Fallot?

Answer 12

• Stenosis of the RV outflow
• RV hypertrophy
• VSD
• Aorta that overrides the VSD

Question 13

What is the shunt in Tetralogy of Fallot?

Answer 13

Right to left

Question 14

What are the findings of Tetralogy of Fallot?

Answer 14

Early cyanosis

Question 15

What is the X-ray finding of ToF?

Answer 15

Boot shaped heart

Question 16

What is transposition of the great vessels associated with?

Answer 16

Maternal Diabetes

Question 17

What is coarctation of the aorta?

Answer 17

Narrowing of the aorta

Question 18

Infantile Coarctation of the Aorta

Answer 18

Block at the aorta causes shunting via the PDA that presents with lower extremity cyanosis

Question 19

What is Infantile Coarctation of the Aorta associated with?

Answer 19

Turner’s Syndrome

Question 20

Adult Coarctation of the Aorta

Answer 20

HTN in the upper extremities and low BP in the lower extremities - associated with a bicuspid aortic valve

Question 21

What is the main valve affected by rheumatic fever?

Answer 21

Mitral Valve (Aortic is the second)

Question 22

What is the main microscopic indication of endocarditis from rheumatic fever?

Answer 22

Aschoff Bodies

Question 23

What are major cell findings in Aschoff bodies?

Answer 23

Caterpillar (Anitschkow Cells) Cells

Question 24

What is the appearance of the aortic valve that is affected by chronic rheumatic fever?

Answer 24

“Fish mouth” valve