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Pediatrics > BRS- Cardio > Flashcards

BRS- Cardio Flashcards

1
Q

Compensatory mechanisms seen in cardiac failure

A
  • Na/H2O retention
  • Catecholamine release
  • ^HR, CX
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2
Q

Congenital lesions causing increased pulmonary blood flow

A

TGA
TAPVC
Large VSD/PDA

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3
Q

Endgame for congenital heart lesions (^pulm flow or obstructive etc)

A

CHF

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4
Q

What acquired diseases may lead to CHF? (8)

A 
viral myocarditis 
fluid changes: anemia/ overload 
chronic hypoxia 
hyperthyroid 
doxo 
cardiomyopathy 
ischemic disease
dysrhythmias
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5
Q

Three general symptoms assc with CHF

A

FTT
poor feeds
exercise intolerance

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6
Q

Two vital sign changes assc with CHF

A

tachypnea, tachycardia

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7
Q

How does digoxin improve cardiac fxn?

A

increases efficiency of contractions, relieves tachycardia

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8
Q

How do PDEi improve cardiac fxn?

A

reduce afterload to enhance contractility

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9
Q

Four drug classes used in CHF for kiddos:

A
  • Dig
  • Diuretics
  • Ionotropics
  • PDEi
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10
Q

List the three “innocent” murmurs of childhood

A
  • Stills
  • Pulmonic Systolic
  • Venous Hum
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11
Q

Which of the three innocent murmurs are systolic? continuous?

A

stills + pulmonic systolic= systolic murmurs

venous hum= continuous

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12
Q

Which of the three innocent murmurs are loudest when supine? standing?

A

supine + exercise= stills, pulmonic systolic

standing= venous hum

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13
Q

List the most prominent location of the three innocent murmurs:

A

Neck: venous hum
upper left: pulmonic systolic
lower left: stills

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14
Q

Which of the three innocent murmurs changes with jugular venous compression

A

venous hum

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15
Q

Systolic ejection murmur at left sternal border with split S2 is characteristic of what lesion?

A

ASD

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16
Q

Holosystolic murmur at the left lower sternal border is characteristic of what lesion?

A

VSD

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17
Q

Constant machine like murmur at upper left sternal border is characteristic of what lesion?

A

PDA

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18
Q

What congenital lesion may present with a murmur similar to aortic stenosis (systolic, upper right sternal border)?

A

Coarctation

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19
Q

To where does the murmur of aortic stenosis radiate?

A

carotids

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20
Q

Systolic ejection murmur at upper left sternal border with a click is characteristic of what lesion?

A

Pulmonic stenosis

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21
Q

Innocent heart murmurs: ages

A
  • venous: school age
  • pulmonic systolic: any age
  • stills: ages 2-7
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22
Q

Of the acyanotic congenital heart diseases, which present with RAD on ECG

A

ASD, pulmonic stenosis

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23
Q

Of the cyanotic heart lesions which may be normal on ECG or have LVH?

A

coarctation, aortic stenosis

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24
Q

Of the acyanotic lesions, which present with LVH until PHTN occurs, then RVH?

A

VSD, PDA

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25
Q

What are the three types of ASD?

A

primum (low)
secundum (mid)
sinus venosus (high)

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26
Q

Which of the three types of ASD is most common? Assc with Downs?

A

primum- downs (primum= one= trisomy twenty ONE)

secundum- most common

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27
Q

Where do pulmonary veins drain in sinus venosus type ASD?

A

RA, SVC

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28
Q

What are the three types of VSD?

A

inlet
outlet, supracristal
trabecular, muscular

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29
Q

When must VSD be emergently operated on?

A

When causing PHTN, PHTN is irreversible if left over time.

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30
Q

Symptoms of VSD

A

small: none
mod-large: CHF
PHTN develops: CHF disappears

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31
Q

Of the six acyanotic congenital heart lesions, which may have a diastolic rumble at the apex?

A

ASD, VSD, PDA

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32
Q

Symptoms of PDA

A
  • brisk pulses
  • widened pulse pressure
  • CHF if severe
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33
Q

Direction of blood flow in case of PDA

A

aorta –> PA

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34
Q

MC location of aortic coarctation

A

just below LSCA, proximal to ductus

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35
Q

Drugs that may be used to treat coarctation before surgery

A

IV PGE

ionotropes

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36
Q

Signs & symptoms of coarc

A
  • elevated BP in RUE
  • bruit at left upper back
  • rip notching on CXR
  • CHF at time of PDA closure
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37
Q

Pathophys of aortic stenosis

A

commissural fusion

38
Q

Symptoms of coarctation when CHF develops

A

no murmur

poor pulses all four extremities

39
Q

What are the five cyanotic heart lesions?

A

1) tet
2) truncus
3) tricuspid atresia
4) transposition
5) TAPVC

40
Q

Test for diagnosing Cardiac related causes of CHF

A

100% O2 challenge

41
Q

Noncardiac causes cyanosis

A
  • pulm dz
  • sepsis
  • hypoglycemia
  • polycythemia
  • NM disease = chest wall dysfxn
42
Q

Murmur of tet is predominately caused by _____

A

pulm stenosis

systolic murmur at ULSB with click

43
Q

What causes a “tet” spell and how is it reversed?

A

decreased SVR = cyanosis

valsalva, squatting, HTN= increased SVR= relieved cyanotic spell

44
Q

When does cyanosis occur in tet?

A

PDA closure

45
Q

CXR finding in tet

A

boot shaped heart

46
Q

What are the four features of tet?

A 
IHOP
interventricular septal defect 
hypertrophy of the right ventricle 
overriding aorta 
pulmonic stenosis
47
Q

Transposition of the great arteries causes _____circulation

A

parallel instead of series

48
Q

CXR finding in transposition

A

egg on a string

49
Q

What is usually present in Tricuspid atresia?

A

ASD, VSD

50
Q

How is tricuspid atresia repaired?

A

connect IVC to PA (Fontan)

51
Q

Finding in tricuspid atresia that distinguishes it from other cyanotic lesions?

A

only cyanotic lesion to cause LVH

52
Q

Common murmur to transposition and tricuspid atresia?

A

no murmur/ single S2

53
Q

Truncus arteriosus murmur

A

single S2
systolic ejection
diastolic murmur at mitral valve

54
Q

Murmur of TAPVC

A

pulmonary ejection murmur at LSB

55
Q

Repair of TAPVC

A

anastomose PV to LA

56
Q

CXR appearance of TAPVC

A

snowman appearance (enlarged heart)

57
Q

ECG findings in TAPVC

A

RVH

58
Q

1 acquired heart disease in US? worldwide?

A

US: Kawasakii
World: ARF

59
Q 
Infective Endocarditis
#1 and #2 most common predisposing factors
A

80% have structural disease and 50% are post op

60
Q

List some classic symptoms of endocarditis

A 
janeway and olsers nodes (oslers = ouch)
roth spots= white retinal lesions 
nailbed hemorrhages 
murmur 
hematuria 
spenlomegaly
61
Q

What are vegetations made of in endocarditis?

A

platelets, fibrin

62
Q

Two most common bacteria seen in endocarditis?

A

strep viridans

staph aureus

63
Q

Most important step in diagnosing endocarditis?

A 
#1 blood cultures 
also... transesophageal echo for vegetations
64
Q

When are abx needed to px against endocarditis during procedures?

A

structural lesions
6 months post op after a cardiac procedure
lifelong if any residual lesion following cardiac surgery

65
Q

How long are IV abx given after dx of endocarditis?

A

4-6 weeks

66
Q

Signs and symptoms of pericarditis?

A
  • friction rub
  • pain when supine
  • distant heart sounds
  • pulsus paradoxus
67
Q

Severe outcome of pericarditis?

A

tamponade

68
Q

1 cause pericarditis?

A

viral

CX, echo, adeno, flu, para, EBV

69
Q

Three non infectious causes pericarditis

A

lupus
uremis
post pericardotomy (1/3 cases)

70
Q

2 bacterial causes of endocarditis

A

staph aureus

strep pnuemo

71
Q

ECG changes assc with pericarditis

A

low voltage QRS

alterations in ST

72
Q

Myocarditis:

most serious outcome

A

causes 20% of SCD in atheletes

73
Q

Infectious Etiologies for myocarditis

A

coxsackie
cadida, crypto
trypanosoma cruzi
coryne, strep pyo, staph a, TB

74
Q

Autoimmune/ inflammatory causes of myocarditis

A
  • SLE
  • RF
  • Sarcoid
  • Kawasaki
75
Q

What does echo show in case of myocarditis?

A

global ventricular dysfunction

76
Q

Causes of dilated cardiomyopathy + which is most common?

A 
#1 idiopathic 
also:
beriberi 
mitochondrial abnormality 
carnitine def 
viral myocarditis 
....etc
77
Q

MCC SCD in athletes?

A

AD HCM

78
Q

Describe murmur assc with HCM

A

harsh systolic murmur worsened with valsalva

caused by LVOT obstruction by anterior mitral leaflet

79
Q

Causes of restrictive CM

A

amyloidosis
gauchers
fabrys
hemochromatosis/ hemosiderinosis

80
Q

MC peds dysrhythmia

A

SVT

81
Q

Causes of SVT

A

AVRT/AVNRT

82
Q

Describe WPW

A

AVRT with delta wave (long PR, upsloping QRS)

83
Q

Treatment of SVT

A

vagal maneuvers
adenosine
SCD

84
Q

Describe the types of heart block

A

type 1: long PR
type 2-I: progressively longer PR –> dropped beat
type 2-II: dropped beat
type 3: no conduction from A –> V

*type 2-I= wenke

85
Q

Treatment of heart block

A

pacing

86
Q

Causes of heart block

A

post surgical
SLE in mother
endocarditis

87
Q

Long QT syndrome risk

A

torsades –> death

88
Q

Treatment long QT syndrome

A

BBers/ pacing

89
Q

Two hereditary syndromes causing Long QT

A

AR, Jervell Lange Nielson = long QT + deaf

AD, Romano Ward= long QT only

90
Q

Most common cardiac related cause of chest pain

A

pericarditis

91
Q

Cause chest pain in marfans

A

aortic dissection

Pediatrics (12 decks)

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