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Peds Rotation > Cardio > Flashcards

Cardio Flashcards

1
Q

What is the most common cyanotic congenital heart defect after infancy?

A

Tetralogy of Fallot

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2
Q

What are the four characteristics of Tetralogy of Fallot?

A

Pulmonary stenosis
RV hypertrophy
VSD
Overriding aorta

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3
Q

PE of Tetralogy of Fallot

A

Pulmonary stenosis
RV impulse at LLSB
Single S2
Tet spells

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4
Q

What is a tet spell?

A

Child turns blue when crying or feeding

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5
Q

EKG of Tetralogy of Fallot

A

Right axis deviation

Right ventricular hypertrophy

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6
Q

CXR of Tetralogy of Fallot

A

Boot shaped heart

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7
Q

Tx of Tetralogy of Fallot

A

Surgical repair

Subacute bacterial endocarditis prophylaxis for life

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8
Q

What is the most common congenital heart disorder?

A

VSD

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9
Q

What are the four types of VSD?

A

Infundibular
Perimembranous
Inlet
Muscular

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10
Q

What is the most common VSD?

A

Perimembranous

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11
Q

What is also associated with VSD?

A

Myocardial infarction

Down syndrome

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12
Q

Characteristics of VSD

A

Pansystolic murmur at LLSB
+/- LA and LV enlargement
Most spontaneously close

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13
Q

Tx of VSD

A 
Diuretics
ACE inhibitors
Cardiac glycosides
Transcatheter closure
Surgery
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14
Q

What is the most common ASD?

A

Secundum

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15
Q

Sx of ASD

A

Depend on size

  • Palpitations
  • Dyspnea
  • A Fib
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16
Q

PE of ASD

A

Fixed split S2

Systolic ejection murmur

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17
Q

EKG of ASD

A

RVH and RAD

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18
Q

CXR of ASD

A

Cardiomegaly
RAE
Large pulmonary artery

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19
Q

S/sx of PDA

A

Continuous machine-like murmur
Bounding pulses
Widened pulse pressure

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20
Q

Tx of PDA

A

Preterm-indomethacin
Term- closure device or coil embolization
-Surgical ligation

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21
Q

PE of coarctation of aorta

A 
Decreased femoral pulses
Systolic murmur
-Blowing
-Left axilla
-Left back
Low BP to anything distal, high BP to anything proximal
22
Q

Infant ECG/CXR of coarctation of aorta

A

Cardiomegaly
RVH
Pulmonary edema

23
Q

Older children ECG/CXR of coarctation of aorta

A

Mild cardiomegaly

LVH

24
Q

General ECG/CXR of coarctation of aorta

A

Rib notching

3 sign- dimpling of artery on angiography

25
Q

Tx of coarctation of aorta

A

Prostaglandin E1
+/- Emergency Balloon Angioplasty
Surgical repair

26
Q

Sx of HCM

A 
Asymptomatic
Dyspnea
Fatigue
Atypical chest pain
Syncope
Palpitations
Sudden cardiac death
27
Q

EKG of HCM

A

T-wave inversion can happen with LVH

28
Q

What decreases the HCM murmur?

A

Squatting

29
Q

Tx of HCM

A 
Beta blockers
Calcium channel blockers
Left ventricular mymectomy
Catheter septal ablation
ICD
30
Q

How is a definitive dx of acute rheumatic fever made?

A

Presence of 2 major Jones criteria or one major and two minor, along with evidence of an antecedent streptococcal infection

31
Q

What are the major Jones criteria?

A 
Polyarthritis
Carditis
Chorea
Erythema marginatum
Subcutaneous nodules
32
Q

What is the most common major manifestation of acute rheumatic fever?

A

Arthritis

33
Q

What are minor Jones criteria for acute rheumatic fever?

A 
Fever
Arthalgias
Previous rheumatic fever
Leukocytosis
Elevate ESR/CRP
Prolonged PR interval
34
Q

What is considered carditis for acute rheumatic fever?

A 
Tachycardia
New murmur
Pericarditis
Cardiomegaly
Signs of heart failure
35
Q

Erythema marginatum

A

A serpiginous, non-pruritc, evanescent rash
Uncommon
On the trunk
Brought out by warmth

36
Q

Tx of acute rheumatic fever

A

Benzathine PCN
Salicylates
Bed rest
Long-term PCN prophylaxis, preferably with IM benzathine PCN G, 1.2 million U every 28 days.

37
Q

Possible causes of syncope

A 
Neurocardiogenic
Micturition
Hair grooming
Cough
Carotid sinus
Cardiac syncope
Left ventricular outflow tract obstruction
Pulm HTN
Myocarditis
Tumor or mass
Coronary artery disease
Dysrhythmia
38
Q

Definition of syncope

A

The transient loss of consciousness and muscle tone that, by history, does not suggest other altered states of consciousness

39
Q

Definition of pre-syncope or near-syncope

A

Has many or all of the prodromal sx without loss of consciousness

40
Q

Syncopal prodrome

A

Consists of:

  • Dizziness
  • Lightheadedness
  • Nausea
  • Diaphoresis
  • Visual changes (blacking out)
  • Palpitations
41
Q

What is the second most common vasculitis of childhood?

A

Kawasaki disease

42
Q

When does Kawasaki disease most commonly occur?

A

Children younger than 5 years of age

43
Q

What are the three phases of Kawasaki disease?

A

Acute
Subacute
Convalescent

44
Q

What happens during the acute phase of Kawasaki disease?

A 
Sudden onset of high, hectic fever
Conjunctival erythema
Dry cracked lips
Strawberry tongue
Cervical LAD
Swelling of the hands and feet
45
Q

How long does the acute phase of Kawasaki disease last?

A

1-2 wks

46
Q

Criteria for cervical LAD in Kawasaki disease

A

> 1.5 cm in diameter

47
Q

Description of conjunctivitis in Kawasaki disease

A

Bilateral
Bulbar
Nonsuppurative

48
Q

How long does the subacute phase of Kawasaki disease last?

A

Until the fourth wk

49
Q

Characteristics of the subacute phase of Kawasaki disease

A

Gradual resolution of fever and other acute phase sx
Desquamation of the skin
Increased platelet count
Coronary artery aneurysms

50
Q

Labs and rads for Kawasaki disease

A

Blood and urine cultures
CXR
Inflammatory parameters (WBC, CRP, ESR) are elevated during acute phase
Platelet count elevated during subacute phase
Hepatobiliary function tests
Echo for coronary artery aneurysms

51
Q

How to diagnose Kawasaki disease

A

Fever for >5 days without identifiable source and presence of four of five other clinical criteria

52
Q

Tx of Kawasaki disease

A

IVIG

Aspirin in anti-inflammatory doses then in antithrombotic doses once fever is resolved

Peds Rotation (12 decks)

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