Cardio

Question 1

Cyanotic heart defects

Answer 1

The 5 T’s that have right-to-left shunts

Truncus arteriosus = ONE arterial vessel overriding ventricles

Transposition of the great vessels = TWO arteries switched

Tricuspid atresia (THREE)

Tetralogy of Fallot (FOUR)

Total anomalous pulmonary venous return = FIVE words

Question 2

presents with severe cyanosis within the first few hours of life.

Answer 2

Transposition of great arteries

Question 3

Noncyanotic heart defects—

The 3 D’s

Answer 3

VSD

ASD

PDA

Question 4

Down syndrome heart defects

Answer 4

ASD

Endocardial cushion defects

Question 5

Congenital rubella heart defect

Answer 5

PDA

Question 6

Turner’s syndrome heart defect

Answer 6

Coarctation of the aorta

Question 7

Coronary artery aneurysms associated disease

Answer 7

Kawasaki disease

Question 8

Associated with maternal lithium use

Answer 8

Ebstein’s anomaly

Question 9

Neonatal lupus is associated with this heart problem

Answer 9

Congenital heart block

Question 10

Neonatal thyrotoxicosis effect

Answer 10

Heart failure

Question 11

Heart diseases of newborn associated with maternal diabetes

Answer 11

TGA

Asymmetric septal hyper trophy

Question 12

Suprvalvular aortic stenosis seen in

Answer 12

William’s disease

Question 13

most common cause of congenital heart disease.

Answer 13

VSD

Question 14

Small versus large VSD

Answer 14

Small
-harsh holosystolic murmur

Large
-frequent respiratory infections, dyspnea, FTT, and CHF

Question 15

Surgical indications of VSD

Answer 15

1. symptomatic patients who fail medical management

2. children

Question 16

VSD ECG

Answer 16

ECG: LVH and may show both LVH and RVH with larger VSD

Question 17

Heart defect that has a fixed, widely split S2

Answer 17

ASD

Question 18

Examination reveals a right ventricular heave; a wide and fixed, split S2; and a systolic ejection murmur at the left upper sternal border (from ↑ flow across the pulmonary valve). There may also be a mid-diastolic rumble at the left lower sternal border.

Answer 18

ASD

Question 19

ASD ECG ABD CXR findings

Answer 19

ECG may show RVH and right atrial enlargement. PR prolongation is common.
CXR reveals cardiomegaly and ↑ pulmonary vascular markings.

Question 20

Failure of the ductus arteriosus to close in the first few days of life, leading to an acyanotic left-to-right shunt from the aorta to the pulmonary artery. Risk factors include maternal first-trimester rubella infection, prematurity, and female gender

Answer 20

Patent ductus arteriosus

Question 21

In infants presenting in a shocklike state within the first few weeks of life, look for:

Answer 21

1. Sepsis
2. Inborn errors of metabolism
3. Ductal-dependent congenital heart disease, usually left-sided lesions (as the ductus is closing)
4. Congenital adrenal hyperplasia

Question 22

Examination reveals a continuous “machinery murmur” at the second left intercostal space at the sternal border, a loud S2, wide pulse pressure, and bounding peripheral pulses.

Answer 22

patent Ductus arteriosus

Question 23

Indomethacin is to ____ Pda

Answer 23

Come IN and CLOSE the door: give INdomethacin to CLOSE a PDA.

Question 24

Constriction of a portion of the aorta, leading to ↑ flow proximal to and ↓ flow distal to the coarctation.

Answer 24

Coarctation of the aorta

Question 25

Most common site of coarctation

Answer 25

Occurs just below the left subclavian artery in 98% of patients

Question 26

More than two-thirds of patients have a bicuspid aortic valve.

Answer 26

Coarctation

Question 27

Coarctation of the aorta

Answer 27

The condition is associated with Turner’s syndrome, berry aneurysms, and male gender.

Question 28

Heart defects that require a patent PDA for survival

Answer 28

transposition of the great vessels tetralogy of Fallot hypoplastic left heart Critical coarctation

Question 29

Differential cyanosis may be seen with lower O₂ saturation in the left arm and lower extremities (postductal areas) as compared to the right arm (preductal area).

Answer 29

Coarctation of the aorta

Question 30

CXR and ECG of coarctation

Answer 30

LVH on ECG the “3” sign on CXR due to pre- and postdilatation of the coarctation segment with aortic wall indentation "rib notching” due to collateral circulation through the intercostal arteries

Question 31

Without a septal defect (ASD or VSD) and a PDA, it is incompatible with life The most common cyanotic congenital heart lesion in the newborn

Answer 31

TGA

Question 32

Examination reveals tachypnea, progressive hypoxemia, and extreme cyanosis. Some patients have signs of CHF, and a single loud S2 is often present. There may not be a murmur if no VSD is present. If a VSD is present, a systolic murmur may be heard at the left sternal border.

Answer 32

TGA

Question 33

DiGeorge syndrome— CATCH 22

Answer 33

Cardiac abnormalities (transposition) Abnormal facies Thymic aplasia Cleft palate Hypocalcemia 22q11 deletion

Question 34

CXR may show a narrow heart base, absence of the main pulmonary artery segment, an “egg-shaped silhouette,” and ↑ pulmonary vascular markings

Answer 34

TGA

Question 35

__________ is the most common cyanotic heart disease of newborns __________ is the most common cyanotic heart disease of childhood

Answer 35

TGA | TOF

Question 36

Tetralogy of Fallot components

Answer 36

Consists of pulmonary stenosis, overriding aorta, RVH, and VSD

Question 37

Children often squat for relief during hypoxemic episodes called “tet spells,” which ↑ systemic vascular resistance.

Answer 37

TOF

Question 38

CXR shows a “boot-shaped” heart with ↓ pulmonary vascular markings. Remember that a VSD may result in ↑ pulmonary vascular markings. ECG shows right-axis deviation and RVH.

Answer 38

TOF

Question 39

Treat hypercyanotic “tet spells” with

Answer 39

O₂, propranolol, phenylephrine, the knee-chest position, fluids, and morphine.

Question 40

Infants with FTT will first fall off of the ______ curve, then the ______ curve, and finally the _______ curve.

Answer 40

Infants with FTT will first fall off of the weight curve, then the height curve, and finally the head circumference curve.

Question 41

Order of sexual development in a female

Answer 41

Thelarche Pubarche Growth spurt Menarche

Question 42

Precocious puberty in males | In females

Answer 42

8 | 9

Question 43

Delayed puberty boys | Girls

Answer 43

14 | 13

Question 44

Pattern of sexual development in males

Answer 44

Gonadarche Pubarche Adrenarche Growth spurt