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ITT > Cardiac > Flashcards

Cardiac Flashcards

1
Q

Physiological causes of cyanosis in a neonate

A
  • R to L ventricular shunt (tetralogy of Fallout)
  • R to L partial shunt (severe pulmonary stenosis)
  • Complex mixing ( single ventricle disease)
  • Transposition physiology (transposition of the great arteries)
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2
Q

Determinants of arterial O2 saturation (5)

A

1- Pulmonary venous oxygen saturation (V/Q)
2- Pulmonary to systemic flow ratio (Qp:Qs)
3- Systemic blood flow (slow flow=longer extraction)
4- Hgb
5- Total body O2 consumption (VO2)

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3
Q

What is Eisenmenger syndrome

A
  • condition presenting in older children as a result of pulmonary hypertension secondary to a chronic ASD (30%) VSD (33%) or PDA (14%) “ communication between systemic and pulmonary blood flow”
  • features: fingernail clubbing, syncope, heart failure
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4
Q

Which CHD will present with significant pulmonary edema on CXR

A

Total anomalous pulmonary venous connection

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5
Q

Total anomalous pulmonary venous connection

A
  • 4 pulmonary veins fail to connect to LA

4 types

  • supracardiac
  • cardiac
  • infraacardiac
  • mixed
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6
Q

cause of higher pre ductal vs post ductal saturations

A
  • **Severe PPHN (PVR too high, blood preferentially circulating through PDA)
  • Aortic coarctation
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7
Q

cause of lower pre ductal vs pre ductal saturations

A

Transposition of great arteries ( high PVR = blood flowing through LV into pulmonary artery crosses PDA and mixes with oxygenated blood)

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8
Q

Possible causes of a right displaced aorta

A

ToF

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9
Q

snowman

A

TAPVR

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10
Q

egg on a string

A

Tans-position of the great arteries

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11
Q

approach to cadiomypathy

A
  • reversible cause? (infection/structure)

- manage (after-load reduction (milrinone, ace, BB) , HR control, diuresis)

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12
Q

what cardiac pathology should you consider in viral infections

A

myocarditis 7-28% of sudden death in peds if survive can lead to cardiomyopathy

presentation
ecg (tachy with low voltage QRS)
fever
heart block
tachycardia (persistant not responding to conventional therapy)
resp distress
older children ( exercise intolerance, abdominal pn)

management
diuretics, anticoagulant, steroids, IVIG, after-load reduction

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13
Q

definition of htn in ped

A

BP > 95th percentile for age, gender and height

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14
Q

hypertensive emergency vs urgency

A

emergency: severely elevated BP + end-organ damage

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15
Q

S/S HTN in peds

A

HTN’ive encephalopathy

DLOC
HA
nausea
Vomiting

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16
Q

DDX for hypertensive enceph

A 
acute neuro event 
renal disease
hepatorenal syndrome
steroid OD 
AMI
LV failure with pulmonary edema
microangiopathic hemolytic anemia
Dissecting AA
coarctation
17
Q

Tx for HTN’ve crisis

A
  • Labetolol 0.25 mg/kg bolus then 0.25-3 mg/kg/hr
    Recommended reduction MAP by 20-25% over 6-8hrs) (below 95th preventive
    -*** signs of ICP osmolar therapy is paramount prior to BP reduction
  • AAA drop BP faster
    -     try to get an art line, 2 lines
18
Q

size of heart on CXR

A

50-60% of chest

19
Q

SVT TX

A
  • ice
  • adenosine (.1 mg/kg, .2 mg/kg)
  • cardioversion (.5J/kg - 1J-2J) (+ sedation ketamine)
20
Q

consideration for pacemakers

A
  • bicarb in setting of arrythmia
21
Q

common arrhythmia complication cardiac surgery

A

JET

junctional ectopic tachycardia

22
Q

common cause of bradycardia in peds

A

hypothermia

23
Q

Post cardiac arrest goal

A
  • PaO2 > 60 < 300
  • PaCO2 35-40
  • tight glycemic control
  • norothermia
  • BP > 5th percentile
24
Q

high lying UV on CXR

A

above diaphragm lateral film is easier to view diaphragm

25
Q

UA on CXR

A

T 6-9 lateral and/or AP (will dip down)

26
Q

boot

A

tetralogy of fallout

27
Q

lab indicator of R heart failure

A

LFTs

28
Q

hallmark sign of CHD

A
  • “happy tachypnea” tachypnea without dyspnea
  • Differential cyanosis ( Pre> Post) (**PPHN may cause this if PDA with high PVR)
  • murmur
  • failed hyperoxia
29
Q

what CHD will present with tachypnea and dyspnea (result of pulmonary edema)

A

TGA

30
Q

higher post than pre sat

A

TGA with PDA (sometimes with low coarc)

ITT (17 decks)

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