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CPR II Week 3 > Cardiac Clinical Medicine Part 6: Pediatrics > Flashcards

Cardiac Clinical Medicine Part 6: Pediatrics Flashcards

1
Q

When a baby takes their first breath what embryological structures close?

A

1) Foramen ovale
2) Ductus arteriosus
3) Ductus venosus

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2
Q

What chromosomal abnormalities can cause structural defects?

A

1) Trisomy 21
2) Trisomy 18
3) DiGeorge syndrome
4) Turner syndrome

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3
Q

What structural defects are common with Down syndrome?

A

VSD, ASD, AVSD, PDA

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4
Q

What do L to R shunts result in?

What are examples?

A

1) Congestive HF

2) ASD, VSD, PDA

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5
Q

What do R to L shunts result in?

What are examples?

A

1) Cyanosis

2) Pulmonary atresia and tricuspid atresia

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6
Q

What is enlarged due to overfilling in atrial septal defect?

Due to over-circulation, what can result?

In what pediatric population do we want to watch for it?

What type of shunt does it cause?

What heart sound is notable of ASD?

A

1) RA and RV
2) Pulmonary HTN
3) Trisomy 21
4) L to R
5) Wide fixed split S2

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7
Q

What is the most common of all cases of isolated CHD?

A

VSD

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8
Q

What type of shunt is ventricular septal defect?

How are they characterized if they are smaller?

What can they cause if they are large?

Where is the holosystolic murmur heard?

A

1) L to R
2) Loud and harsh
3) CHF
4) LLSB

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9
Q

Patent ductus arteriosus is problematic if it stays open in premature infants because?

What is used to treat PDA in premature infants?

What is used to treat in term babies?

If the baby is symptomatic then what treatment is preferred?

What type of shunt is it?

Where is the murmur heard?

How is the murmur described in systole and diastole?

A

1) Floods lungs leading to CHF
2) Indomethacin
3) Coil embolization
4) Surgical ligation
5) L to R
6) LUSB
7) Crescendo in systole and decrescendo into diastole

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10
Q

What does tricuspid atresia results in structurally?

What blood flow is restricted?

What type of shunt is it?

It results in early onset?

A

1) Only a single useful ventricle (LV)
2) Pulmonary blood flow
3) R to L
4) Cyanosis or CHF

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11
Q

What type of shunt is pulmonary atresia?

It is ductal dependent until flow can be established through?

A

1) R to L at ASD

2) Pulmonary valve

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12
Q

A patient presents with feeling faint with exertion, SOB with exertion, and fatigue with activity. Which stenosis is most likely?

A

Aortic stenosis

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13
Q

What is done for treatment/management of aortic stenosis when they are old enough?

Where is the systolic ejection murmur heard?

A

1) Prosthetic valve

2) RUSB and radiates to carotids

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14
Q

What is the current standard of care for pulmonary stenosis?

While is it usually asymptomatic, it may have sx of?

Where is it best heard at?

A

1) Balloon valvuloplasty
2) Pulmonary congestion
3) LUSB and radiates to axilla

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15
Q

What is defective in Ebstein’s anomaly?

Where can a systolic thrill be heard with tetralogy of Fallot?

A

1) Tricuspid valve

2) LUSB

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16
Q

What are the 4 types of innocent murmurs?

A

1) Stills
2) Venous hum
3) Pulmonary flow
4) Carotid bruit

17
Q

Which innocent murmur has a mid-frequency sound and is heard along the LUSB?

A

Pulmonic flow murmur

18
Q

Which innocent murmur has a low pitched, “musical” sound and is heard along LSB or between apex and LLSB?

A

Still’s murmur

19
Q

Which innocent murmur has a high frequency, is loudest when sitting/standing (goes away when supine), and is heard around clavicle?

A

Venous hum

20
Q

Which innocent murmur is heard in older children and has decreased intensity with hyperextension of the shoulders?

A

Carotid bruit

21
Q

What atrial arrhythmias occur in newborns?

A

1) AV reentrant tachycardia
2) Atrial flutter
3) Premature Atrial Contractions

22
Q

Which atrial arrhythmia is associated with cocaine abuse in moms?

A

Atrial flutter

23
Q

What causes increased precordial activity?

A

Increased RV or LV stroke volume

24
Q

What is a thrill caused by?

In what murmur grades is it seen?

A

1) Blood flowing from high pressure to lower pressure

2) Grade IV and above

25
Q

S1 occurs when what valve closes?

Due to?

A

1) AV valves (tricuspid and mitral)

2) Ventricular systole

26
Q

S2 occurs when what valve closes?

Due to?

A

1) Semilunar valves (pulmonic and aortic)

2) Ventricular diastole

27
Q

A fixed split S2 is usually indicative of?

A

ASD

28
Q

If S1 and S2 are obscured then what murmur is heard?

What defect is most commonly seen in this scenario?

A

1) Holosystolic murmur

2) VSD

29
Q

When is a physiologic split heard on S2?

When is a fixed split heard?

A

1) Upon inspiration

2) ASD

30
Q

What are the 6 components of describing a murmur?

A

1) Grade 1-6 (Grade 4: associated with a thrill)
2) Timing (early, middle, late, or holosystolic)
3) Character (harsh, whooping, honking, blowing, musical, vibratory)
4) Location of highest intensity
5) Change with position of patient
6) Radiation

31
Q

What part of the stethoscope should you use to listen to diastolic murmurs?

Why?

What does it mean if heard on its own?

A

1) Bell
2) Lower pitched rumbling
3) Never normal on its own

32
Q

What is the only sound in diastole that does not warrant a referral to cardiology?

A

Venous hums

33
Q

What causes a harsh, crescendo-decrescendo systolic murmur heard best at the apex and left sternal border?

When does it increase in intensity?

A

1) Hypertrophic cardiomyopathy

2) When patient stands or with the Valsalva maneuver

34
Q

How is S2 described in ASD?

A

Widely split and fixed

35
Q

What happens to still’s murmurs during inspiration, sittin up, or standing?

A

Decreased intensity

36
Q

What are the 5 cyanotic congenital heart defects?

A

One big trunk: Truncus arteriosus

Two interchanged vessels: Transposition of Great vessels

Three: Tricuspid atresia

Four: Tetralogy of Fallot

Five words: Total Anomalous Pulmonary Venous Return

37
Q

What are the 7 lesions looked out for when screening for critical congenital heart disease by using oxygen saturation?

A

1) Hypoplastic left heart syndrome
2) Pulmonary atresia
3) Tetralogy of Fallot
4) Total anomalous venous return
5) Transposition of the great arteries
6) Tricuspid atresia
7) Truncus arteriosus

CPR II Week 3 (11 decks)

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