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Residência Pediatria > Cardio > Flashcards

Cardio Flashcards

Heart failure

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1
Q

IC: Sindrome que resulta de ___ ventricular; sobrecarga de ____ ou ____; combinados ou ____

A

disfuncao; volume; pressao; isolados

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2
Q

Heart output proportional to its:

A

Filling volume

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3
Q

Heart output inversely proportional to:

A

Resistance against wich it pumps

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4
Q

Systemic oxigen transport is calculated as…

A

Product of cardiac output and systemic o2 content

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5
Q

Cardiac output is calculated as…

A

Product of heart rate and stroke volume

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6
Q

Stroke volume dependes on…

A

PRE-load; AFTER-load; contractility

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7
Q

High-output heart hailure is…

A

Mantained or increased cardiac output with decreased systemic O2 content or increased demands

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8
Q

Increased sympathetic tone increases secretion of…

A

epinephrine and noradrenaline; in turn this increases cardiac output

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9
Q

Wich receptors increases HR and myocardical contractility?

A

B-adrenergic receptors

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10
Q

A-adrenergic receptors causes vaso____

A

constriction

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11
Q

Chronic exposure to catecholamines leads to…

A

a decrease in B-adrenergic receptors; Downeregulation

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12
Q

Edema is very frequent in infants with HF (T/F)

A

False; generally absent; may be passed off as normal weight gain

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13
Q

Many children may pressent abdominal symptoms of HF (T/F)

A

True; abd pain;nausea; anorexia can be quite common

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14
Q

Cardiomegaly is invariably noted in HF (T/F)

A

True

Measured on a PA chest x-ray

0.42-0.50 NV

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15
Q

Common rhythm in HF

A

Gallop (S3)

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16
Q

Holosystolic murmur might signal

A

advanced dilation; mitral and/or tricuspid regurgitation

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17
Q

Large left to right shunts may have ______ at the X-ray

A

Exaggeration of the pulmonary arterial vessels

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18
Q

Fluffy perihialr purmonary markings indicate:

A

Venous congestion

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19
Q

Standard technique for assessing ventricular function:

A

Ecocardiography

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20
Q

Ventricular function can be quantitated by meassuring: (USG)(2)

A

Fractional shortening and ejection fraction

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21
Q

Fractional shortening:

A

[(End-Diastolic - End-Systolic)/End-Diastolic]*100; Normal 28-42

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22
Q

Normal Ejection fraction:

A

55-65%

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23
Q

Usefulness of magnetic resonance angiography in HF: (5)

A

Quantifying L&R V function; volume; mass; coronary anatomy; valvular regurgitatino

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24
Q

Hyponatremia in HF is often the result of…

A

renal water retention

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25
Q

Increased ventricular tension causes the release of…

A

B-type natriuretic peptide; it might indicate HF or volume overload

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26
Q

Pulmonary embolism or hypertension can cause BNP release (T/F)

A

TRUE

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27
Q

Noncardiac causes of elevated BNP (10)

A

Isquemic or hemorragic brain lesion; renal; liver; paraneo; COPD; Sepsis; Burns; Anemia; Metabolic and hormonal abnormalities

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28
Q

Possitive pressure ventilation may be required in:

A

Pulmonary edema; reduces o2 consuption by eliminating work of breathing

29
Q

Infants with HF fail to trhive due to:

A

increased metabolic demands and decreased caloric intake

30
Q

Caloric density above 0.8cal/ml may cause:

A

Diarreia or renal overload

31
Q

Gastroesophageal reflux may appear in…

A

Cardiac enlargement

32
Q

Low sodium formulas for infants are routinely used (TF)

A

False; there preparations are often poorly tolerated and may cause hyponatremia

33
Q

First mode of therapy for congestive HF

A

Diuretics

34
Q

Most commonly used diuretic in pediatric HF

A

Furosemide

35
Q

Diuretic that inhibits reabsorption of Na and CL in the “distal” tubules and the “loop”

A

Furosemide

36
Q

Diuretic that inhibits aldosterone

A

Spironolactone; enhances K retention; 2mg/kg/24h BID

37
Q

Diuretic with favorable effect on cardiac fibrosis

A

Spironolactone

38
Q

Children with cardiomyopathy may benefit more from ___load reducers

A

“AFTER”load; ACEI and ARB’s

39
Q

Children with mitral or aortic insufficiency may benefit more from ___load reducers

A

“AFTER”load; ACEI and ARB’s

40
Q

Adults with dilated cardiomyopathy in use of ACEI have reduced:

A

Mortality and morbidity; may have effects on cardiac remodeling

41
Q

Main effect of nitroprusside

A

Peripheral arterial vasodilation and afterload reduction; some venodilation

42
Q

High doses of nitroprusside may cause intoxication due to:

A

Thiocyanate poisoning; Cyanide is a byproduct of hepatic metabolization

43
Q

ACEIs may cause ___kalemia

A

“HYPER”

44
Q

Digoxin may reduce death among infants with _____ heart disease

A

Single-ventricle.

45
Q

Dopamine is a “predominantly _____ receptor agonist

A

B-adrenergic; it also has A-adrenergic effect at “higher” doses >15µ/kg/min

46
Q

Dopamine is more arrhytmogenic than pure B-agonists like Isoproterenol (T/F)

A

False; its also less chronotropic

47
Q

Fenoldopam is a ____ receptor agonist

A

Dopamine DA1; increases renal blood flow and urine output

48
Q

Dobutamine is a derivative of ____

A

Dopamine

49
Q

Main effects of Dobutamine (2)

A

Inotropic effect and moderate reduction in peripheral vascular resistance

50
Q

Isoproterenol is a pure _____ receptor agonist

A

B-adrenergic; marked chronotropic effect; effective in patients with slow HR. Often used after heart transplants.

51
Q

Epinephrine is a ____ receptor agonist

A

Mixed A-B adrenergic; usually reserver for patientes with cardiogenic shock and low BP

52
Q

Epinephrine increases afterload by:

A

increasing systemic vascular resistance; also increases risk of arrhytmia

53
Q

Milrinone is a ______ Inhibitor

A

Phosphodiesterase

54
Q

Milrinone is useful in patients with _____ cardiac output

A

Low; used mostly after open heart surgery

55
Q

Milirinone has ___tropic effect and ____ vasodilatory effects

A

“INO”; peripheral

56
Q

Carvelidol is a ____ receptor bloquer

A

A-B adrenergic; metoprolol is B-adrenergic selective

57
Q

B-blockers should be adminestered in acute fase of HF (T/F)

A

False; increases mortality

58
Q

Ivabradine lowers HR without _______ miocardial _____

A

Lowering; contractility

59
Q

Leading cause of sudden death in severe cardiomyopathy

A

Arrhytmias

60
Q

Main causes of cardiogenic shock (8)

A

Cardiac dysfunction before or after surgery; septicemia; severe burns; anaphylaxis; cardiomyopathy; infarction; CNS disorders

61
Q

Cardiogenic shock is characterized by:

A

low cardiac output that results in inadequate tissue perfusion

62
Q

Hight HR may reduce cardiac output by:

A

decreasing time for diastolic filling and increasing myocardial o2 demand

63
Q

Use of digoxin should be ____ during acute low cardiac output states

A

“Avoided”

64
Q

Milrinone combined with a B-adrenergic agonists has a _____ effect

A

synergistic

65
Q

Most common short term modality to support circulatory failure in children

A

ECMO

66
Q

Tools for preload meassurement(4)

A

CVP; PCWP; Left Atrial Pressure; Cardiac chamber size (USG)

67
Q

Parameters that measure contractility (4)

A

Cardiac output; BP; fractional shortening or EF (USG) mixed venous sato2

68
Q

Parameters that measure afterload (3)

A

BP; periferal perfusion; SVR (calculated from cardiac output and meanBP)

Residência Pediatria (13 decks)

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