Cardiac

Question 1

Most common congenital anamoly

Answer 1

VSD

Question 2

Trimester that cardiac anamolies occur

Answer 2

1st

Question 3

Characteristics of pathological murmurs

Answer 3

Significant history of congenital anamoly
Loud and harsh
Diastolic murmur
Holosystolic murmur
Heart murmur with loud s2, diminished fem pulses, ejection click, cyanosis

Question 4

murmur that is short, systolic and musical

Answer 4

still’s murmur (innocent)

Question 5

soft blowing murmur that is vibratory and located at lower left sternal border that is louder supine and decreases or disappears with valsalva

Answer 5

still’s murmur

Question 6

most common ages for still’s murmur

Answer 6

3-8 years

Question 7

Murmur that is from mildly turbulent flow in the right side of the heart

Answer 7

Pulmonary flow murmur (innocent)

Question 8

short systolic ejection located at the upper left sternal border and most commonly occurs in late childhood and early adolescents

Answer 8

Pulmonary flow murmur (innocent)

Question 9

Louder with expiration, normal split s2, thin body habitus, straight back syndrome, increased cardiac output, increases with supine position, increased with fever/anemia. Best heard in supine position with exhalation and intensifies with exercise

Answer 9

Pulmonary flow murmur (innocent)

Question 10

systolic ejection that goes away by 6 months

Answer 10

Peripheral pulmonic stenosis murmur (innocent)

Question 11

Peripheral pulmonic stenosis murmur assc symptoms that do not go away by 6 months

Answer 11

Williams syndrome and congenital rubella

Question 12

Systolic ejection that his high pitched and harsh

Answer 12

Supraclavicular bruit (innocent)

Question 13

Where are Supraclavicular bruits heard best

Answer 13

supraclavicular fossa on the right more than the left

Question 14

Murmur that does not radiate too far

Answer 14

Supraclavicular bruit (innocent)

Question 15

Murmur not heard below clavicle

Answer 15

Supraclavicular bruit (innocent)

Question 16

Murmur that is not affected by sitting or lying

Answer 16

Supraclavicular bruit (innocent)

Question 17

Murmur that is louder in diastole

Answer 17

Venous hum (innocent)

Question 18

Murmur that disappears with change in head position, digital pressure, and lying supine

Answer 18

Venous hum (innocent)

Question 19

Murmur that is continuous (louder in diastole) and loudest when sitting or standing

Answer 19

Venous hum (innocent)

Question 20

Murmur that disappears with laying down and turning the head

Answer 20

Venous hum (innocent)

Question 21

Wide fixed split s2 with 3/6 systolic ejection murmur at USB 2nd intervostal space

Answer 21

ASD

Question 22

2-4/6 holosytolic murmur at LLSB. Thrill present if 4/6 or greater

Answer 22

VSD

Question 23

Think if preterm inflant weighing less than 1500g

Answer 23

PDA

Question 24

Murmur that is machine like in quality with systolic and diastolic murmur

Answer 24

PDA

Question 25

Single S1 or very slightly spilt S2

Answer 25

TPA

Question 26

Egg on a string x-ray

Answer 26

TPA

Question 27

Tetrology of fallot patho

Answer 27

Right pulmonary outflow tract obstruction Right ventricular hypertrophy VSD Overiding aorta

Question 28

Boot shape on xray

Answer 28

ToF

Question 29

Loud harsh ejection murmur with thrill

Answer 29

ToF

Question 30

Tricuspid valve patho

Answer 30

Absent tricuspid valve and underdeveloped right ventricle

Question 31

Single S1

Answer 31

Tricuspid atresia

Question 32

Pulmonary atresia patho

Answer 32

no pulmonary valve and underdeveloped right ventricle

Question 33

Thrill at right upper sternal border

Answer 33

aortic stenosis

Question 34

ejection click and harsh systolic ejection murmur at aortic area with radiation to neck

Answer 34

aortic stenosis

Question 35

systolic ejection murmur that begins early in systole after the click

Answer 35

aortic stenosis

Question 36

Systolic murmur loudest at LUSB grade 2-5/6 associated with a click

Answer 36

Pulmonic stenosis

Question 37

Click decreases with inspiration and increased with expiration

Answer 37

Pulmonic stenosis

Question 38

Trhill at the LUSB that radiates to back and sides

Answer 38

Pulmonic stenosis

Question 39

Bruit at LUSB

Answer 39

Coarctation of aorta

Question 40

Coarctation gender affected

Answer 40

Male to female 2:1

Question 41

Grade 2-3/6 systolic ejection murmur with radiation to left interscapular area

Answer 41

Pulmonic stenosis

Question 42

Murmurs associated with Charge

Answer 42

VSD/ASD

Question 43

Murmurs associated with DiGeorge

Answer 43

Aortic arch anomalies, tet

Question 44

Murmurs associated with Downs

Answer 44

AV canal, atrioventricular septal defects, VSD

Question 45

Murmurs associated with Marfans

Answer 45

Aortic root dissection, MVP

Question 46

Murmurs associated with Noonan's

Answer 46

PS, ASD

Question 47

Murmurs associated with Turners

Answer 47

Coarction of aorta

Question 48

Murmurs associated with Williams

Answer 48

Supravalvular Aortic Stenosis

Question 49

CHF S&S

Answer 49

``` inc respiratory rate Poor feeding dec exercise tolerance chronic cough tachycardia Hepatosplenomegaly Pallor Mottling Puffy eye lids Weak peripheral pulses Wheezes and rales ```

Question 50

Fever lasting 5 or more days

Answer 50

Kawasaki

Question 51

Kawasaki symptoms

Answer 51

Fever >5 days Polymorphous rash Hands and feet erythematous and swollen Cervical lymphadenopathy

Question 52

Acute phase reactants in kawasaki

Answer 52

ESR CRp

Question 53

Kawasaki treatment

Answer 53

IV gamma globulin (IGG) | ASA

Question 54

may have biventricular outflow tract obstruction in infancy and older children may be asymptomatic

Answer 54

HCM

Question 55

Murmur that increases as patient stands from squating

Answer 55

HCM

Question 56

Rheumatic fever labs

Answer 56

ASO (antistreptolysin O titers) | DNAse B and antihyaluronidase titers

Question 57

Rheumatif fever treatment

Answer 57

Anti inflammatory therapy with ASA for arthritis without carditis Naproxen 25-30 mg/kg/day in 3 doses Taper naproxen over 4-6 weeks until all signs of inflammation are done Sed rate must return to normal

Question 58

Prevention of ARC

Answer 58

Benzathine Pen G | Pen V 250mg bid

Question 59

Chest pain, respiratory distress, CHF, or tamponade, precordial knock or rub (shoes on snow sound)

Answer 59

Pericarditis

Question 60

Exercise intolerance, fatigue, jugular distention, lower extremity edema, hepatomegaly, poor distal pulses, dimished heart tones, and pulsus paradoxus

Answer 60

Pericarditis

Question 61

Common bacterial agents of endocarditits

Answer 61

S viridians, S aureus

Question 62

Fever, tachy, dysrhythmia, cardiogenic shock, hx of recent cardiac surgery or indwelling catheter. Petechiae, septic embolii, petechiae and purpura, Osler's nodes (tips, pain). Janeway lesions (proximal palms and soles)

Answer 62

Endocarditis

Question 63

Physiologic splitting of s2

Answer 63

normal variant!

Question 64

Management of kid with bp >95%ile

Answer 64

repeat bp in 1 week

Question 65

Heard best at the right upper sternal border

Answer 65

venous hum

Question 66

Decreased femoral pulses

Answer 66

coarctation of the aorta

Question 67

Wide pulse pressure with low diastolic bp

Answer 67

aortic regurgitation

Question 68

most common cause of myocarditits

Answer 68

viral/coxsackie b

Question 69

Describe aortic stenosis

Answer 69

thrill at rusb, ejection click, harsh systolic murmur with radiation to neck

Question 70

Describe pulmonic stenosis

Answer 70

lusb with a clock click decreases w inspiratiom, incr with expiration thrill at LUSB radiating to back and sides

Question 71

describe peripheral pulmonic stenosis murmur

Answer 71

systolic ejection disappears by 6 months heard in chest/axillae

Question 72

describe a pulmonary flow murmur

Answer 72

short systolic ejection louder with expiration Upper LSB, LSB, transmits to the back all ages, straight back, thin body Increases with supine position, cardiac out put fever, anemia Soft blowing, no click or thrill

Question 73

Describe a still's murmur

Answer 73

short systolic musical soft blowing vibrating, buzzing twangy string sound LLSB louder when supine, disppears with valsalva Common in 3-8 year olds

Question 74

S+S of secondary htn

Answer 74

increased bp >95% on at least 3 occasions

Question 75

Describe coartation of the aorta

Answer 75

Bruit at LUSB 2-3/6 systolic ejection murmur with rad to L interscapular area Can have bicuspid aortic valve Decreases pulse/BP in lower extremities

Question 76

Characteristics of a VSD

Answer 76

2-4/6 holosystolic murmur at LLSB Throll if 4/6 LVH, LAH can occur

Question 77

characteristics of asd

Answer 77

wide fixed split s2 2nd intercostal space RVH

Question 78

describe a pda

Answer 78

machine like murmur common in preterm infants can have hypertrophy

Question 79

describe hcm

Answer 79

murmur increases when child stands | assc with sudden cardiac death