cardiac

Question 1

how do you determine whether a murmur is innocent?

Answer 1

10 S 
systolic
small area
sitting-standing positional 
symptomatic 
short small
sternal depression
soft
special test ECG and CXR are normal

Question 2

what would give you the indication of a pathological murmur?

Answer 2

pansystolic 
intensity greater than 3 
and location - upper left sternal edge 
travels to the back
harsh quality 
if there is an early or midsystolic click
abnormal second heart sound

Question 3

what are the causes of heart failure?

Answer 3

infection- myocarditis 
structural- cardiomyopathy 
septal defect
coarctation 
abnormal opening- large PDA
electrical- SVT

Question 4

causes of HTN

Answer 4

cardiac- coarctation
renal- reflux nephropathy secondary to UTI
catecholamines excess- neuroblastoma or pheaochromcytoma

Question 5

presenting with funny turns

Answer 5

arrhythmias= PR
QT prolongation
romano ward

Question 6

recurrent chest infections

Answer 6

ASD

vSD

Question 7

risk factors for congenital heart disease

Answer 7

chromosomal abnormalities 
downs
turners
crit-du-chat
williams 
noonans 
IUInection - rubella
maternal diabetes and SLE
drugs- anticonvulsants or excess alcohol

Question 8

heart disease in the older patient

Answer 8

congenital- 
familial hypercholseterolemia 
pompe disease
mucopolysacchaidoses 
mar fans
helpers danlos 
friedreich ataxia

Question 9

investigations in a child with heart disease

Answer 9

FBC= iron defiecncy anemia polyceythemia WBC 
UE= renal function HTN

arterial blood gas 
hyperopia nitrogen washout test 
CXR 
ECG
ECHO
cardiac catherisation

Question 10

blu baby !

Answer 10

ABC and call for senior help
establish IV access 
prostaglandin 
SE- hypotension, apnoea,convulsions 
correct acidosis and electrolyte abnormalilities 
keep warm 
prevent hypoglycaemia

Question 11

when would you give medical management

Answer 11

only if symptomatic
thiazides and spiralactone
ACE inh plus above
dopamine -if hypotensive

Question 12

how would you manage the child with HF

Answer 12

feeding
monitoring
ventilation
surgery if severe with failure to thrive and pulmonary vascular disease

Question 13

tetralogy of fallot

Answer 13

VSD
overriding aorta 
subpulmonary stensis 
right ventricular hypertrophy 
boot shaped heart 
cynaotic spells lead to squatting 
ECG look at lead one pure R wave and upright T pulmonary HTN