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PEDIATRIC BRS > Cardio > Flashcards

Cardio Flashcards

1
Q

inadequate oxygen delivery by the myocardium to meet metabolic demands of the body

A

CHF

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2
Q

3 compensatory mechanisms that cause CHF

A

hypo perfusion of end organs, increased renin angiotensis system, catecholamine release

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3
Q

what may cause high output CHF

A

anemia

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4
Q

rapid infusion of IV fluids in premature infants may cause

A

CHF

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5
Q

these drugs increase the efficiency of myocardial contractions and relieve tachycardia

A

digoxin (cardiac glycosides)

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6
Q

drugs that reduce Intravascular volume by maximizing sodium loss

A

Loop diuretics

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7
Q

treatment of CHF secondary to CHD

A

surgical repair

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8
Q

murmurs caused by turbulent flow that are not caused by structural heart disease and have no hemodynamic significance

A

innocent heart murmurs

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9
Q

3 types of innocent heart murmurs

A

Stills murmur, pulmonic systolic murmur, venous hum

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10
Q

This is the type of innocent heart murmur heard at the mid left sternal board in ages 2-7, loudest supine and with excersize

A

Stil’s murmur

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11
Q

this innocent heart murmur is heard at the upper left sternal board, peaks early in systole, blowing high pitched, loudest supine and with exersice

A

Pulmonic systolic murmur

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12
Q

innocent heart murmur heard neck and below clavicles at any age, continuous and heard only sitting or standing, not heard SUPINE or with neck flexion or extension

A

Venous hum

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13
Q

type of ASD in lower portion of atrial septum w/ possible mitral regurg and common in DOWN syndrome

A

ostium primum

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14
Q

ASD defect in middle portion of atrial septum and most common overall ASD

A

ostium secundum

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15
Q

type of high ASD where right plum vein drain into the right atrium or SVC

A

sinus venosus

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16
Q

what may children with an osmium primum defect w/ mitral regurg develop?

A

CHF

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17
Q

physical findings include Increased right ventricular impulse, fixed S2 split w/ diastolic rumble and lower left sternal border

A

ASD

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18
Q

VSD pathophysiology

A

Bc of decreased pulmonary resistance and increased systemic resistance blood flows from the left ventricle into the right ventricle

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19
Q

as the size of the VSD decreases the intensity of the murmur _______?

A

increases

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20
Q

holosystolic murmur heard at apex

A

VSD

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21
Q

Eisenmenger syndrome

A

when PVR is greater than systemic resistance resulting in a switch from left to right to RIGHT TO LEFT shunt

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22
Q

large VSDs w/ pulmonary hypertension are closed at what age?

A

3-6 months

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23
Q

small vsd’s are closed at what age?

A

2-6 years

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24
Q

continuous machine like murmur at the upper left sternal border w/ widened pulse pressure

A

PDA

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25
Q

what is used to close a PDA?

A

indomethacin

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26
Q

narrowing of aortic arch below subclavian artery

A

coarctation of the aorta

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27
Q

patient w/ severe coarctation may depend on what anomaly for perfusion of lower thoracic and descending aorta?

A

right to left shunt through PDA

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28
Q

hypertension in right arm and reduced blood pressure in lower extremity

A

PDA

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29
Q

what else may someone w/ coarctation have?

A

bicuspid aortic valve

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30
Q

in coarctation of the aorta does the femoral pulse precede the radial pulse?

A

no, femoral pulse is DELAYED.

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31
Q

treatment of coarctation in neonate

A

IV prostaglandin E (to keep pda open) and inotropic medication (dopamine)

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32
Q

what is the therapy of choice in recurrent cocarctation?

A

balloon angioplasty

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33
Q

ross procedure

A

aortic stenotic valve is replaced w/ pulmonary valve

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34
Q

why does severe aortic stenosis cause left ventricular hypoplasia in the neonate?

A

impaired fetal left ventricular development w/ myocardial ischemia

35
Q

aortic stenosis symptoms in older children

A

chest pain, syncope and sudden death

36
Q

high aortic valve pressure gradient

A

> 50-70

37
Q

high pulmonary valve pressure gradient

A

> 35-40

38
Q

what can be seen on chest x ray with patent ductus arterioles

A

cardiomegaly w/ increased pulmonary vascular marking

39
Q

ejection click w/ systolic ejection murmur at base that radiates to the upper right sternal border and carotids

A

aortic stenosis

40
Q

vasomotor instability and vasoconstriction causes

A

peripheral cyanosis

41
Q

5 cardiac causes of central cyanosis

A

tetralogy of fallout, transposition of great arteries, tricuspid atresia, truncus arterioles and total anomalous pulmonary venous connection

42
Q

tetralogy of flow components

A

Pulmonary stenosis, right ventricular hypertrophy, overiding aorta, VSD,

43
Q

boot shaped heart

A

tetrallogy of fallow

44
Q

what may a child w/ tetralogy of fallot do?

A

squat ( tet spells) increases venous return to heart and SVR decreasing the right to left shunt

45
Q

graft imposed between subclavian and ipsilateral plum artery to improve pulm growth w/ tetralogy of fallot

A

blalock taussig shunt

46
Q

definitive management of tetralogy of fallot

A

complete surgical repair at 4-8 months.

47
Q

results in pulmonic and systemic circulations in parallel rather than in series

A

transposition of the great arteries

48
Q

what do patients need to survive w/ transposition of the great arteries?

A

shunting blood through a patent foramen ovale, ASD, VSD or

49
Q

acute management of a TET spell

A
  1. squat position
  2. IV fluid bolus
  3. oxygen
  4. morphine (stops agitation
  5. propranolol
  6. Sodium bicarb
  7. transfusion for anemia
  8. surgery
50
Q

central cyanosis, SINGLE s2, no murmur

A

transposition

51
Q

2 initial managements of transposition of great vessels

A

PGE and emergent balloon atrial septostomy (rashkind procedure)

52
Q

what does the rash kind procedure do?

A

increases the size of the ASD or PFO

53
Q

condition in which an ASD or PRO is always present and a plate of tissue is on the floor of the right atrium?

A

tricuspid atresia

54
Q

the only cause of cyanosis in the newborn period that results in LAD and LVH

A

tricuspid atresia

55
Q

fontan procedure

A

treatment of tricuspid atresia where flow from inferior vena cava is directed into pulmonary arteries

56
Q

most common acquired heart disease in children in US , asian males

A

kawasaki disease

57
Q

kawasaki disease symptoms

A

5 day fever, bilateral conjunctivitis, oropharyngeal changes, cervical adenopathy, rash, red, cracked swollen lips, erythematous palms and soles.

58
Q

causes of infective endocarditis?

A

strep viridans and staph introduced during an invasive proedure

59
Q

what can be seen on valves during infective endocarditits?

A

vegetations

60
Q

roth spots, janeway lesions and osier nodes are seen in?

A

bacterial endocarditis

61
Q

most sensitive way to detect vegetations in infetive endocarditis?

A

transesophageal echocardiography

62
Q

most common bacterial causes of pericarditis?

A

staph aureus and strep pneumo

63
Q

chest pain most intense while supine and relieved when sitting upright, pericardial friction rub, distant heart sounds and pulses paradoxes , hepatomegaly

A

pericarditis

64
Q

management of pericarditis?

A
  1. antibiotics, 2. antiinflam, 3. drainage
65
Q

common cause of death in young athletes

A

myocarditis

66
Q

elevated ESR, CK MB fraction and C reactive protein

A

lab results for myocarditis

67
Q

identification of organism of myocarditis?

A

PCR or viral serology of endomyocardial biopsy specimens

68
Q

type of cardiomyopathy that is autosomal dominant w/ asymmetric septal hypertrophy

A

hypertrophic cardiomyopathy

69
Q

most common cause of death in young athletes?

A

hypertrophic cardiomyopathy

70
Q

valsalva and standing will increase or decrease the ejection murmur of cardiomyopathy?

A

increase

71
Q

type of cardiomyopathy seen w/ amyloidosis and inherited infiltrative disorders?

A

restrictive cardiomyopathy

72
Q

type of cardiomyopathy seen w/ carnitine and nutrition deficiency or mitochondrial abnormalities?

A

dilated cardiomyopathy

73
Q

neonatal heart rate greater than 250?

A

SVT

74
Q

delta wave on EKG?

A

WPW (sudden cardiac death)

75
Q

SVT management?

A

vagal maneuvars, ice pack, carotid massage, IV ADENOSINE, chronic digoxin and propanolol, radio frequency catheter ablation

76
Q

babies born to SLE moms typically have what kind of AV block?

A

third degree

77
Q

prolongation of PR interval?

A

1st degree AV block

78
Q

second degree type 1 block

A

wenkebock, progressive prolongation of PR interval

79
Q

second degree type 2 block

A

more than one PR interval but no prolongation

80
Q

treatment of AV block?

A

pacemaker

81
Q

autosomal recessive syndrome associated w/ deafness and long QT?

A

jervel, lange, neilsen

82
Q

autosomal recessive syndrome w/ long QT and no deafness?

A

Romano ward syndrome

83
Q

causes an enlarged heart in older children w/ supra cardiac drainage “snow man appearance” w/ RVH and RAE

A

TAPVC

PEDIATRIC BRS (9 decks)

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