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Paediatrics > cardio > Flashcards

cardio Flashcards

1
Q

common congenital cardiac lesions

A
  • ventricular septal defect
  • patent ductus arteriosus
  • atrial septal defect
  • pulmonary stenosis
  • aortic stenosis
  • coarctation of aorta
  • transposition of great arteries
  • tetralogy of fallot
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2
Q

drug factors affecting baby heart

A
  • alcohol
  • amphetamines
  • cocaine
  • ecstasy
  • phenytoin
  • lithium
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3
Q

infection factors affecting baby heart

A

Toxoplasma
Rubella
CMV
herpes

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4
Q

maternal factors affecting baby heart

A

DM

systemic lupus erythematosus

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5
Q

describe presence of congenital heart defects in downs syndrome

A
  • trisomy 21

- AVSD

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6
Q

history taking congenital heart defect

A
  • feeding
  • weight
  • development
  • cyanosis
  • tachypnoea
  • dyspnoea
  • exercise tolerance
  • chest pain
  • syncope
  • palpitations
  • joint problems
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7
Q

CHD examination

A
  • weight and height
  • dysmorphic features
  • cyanosis
  • clubbing
  • tacky/dyspnoea
  • pulses/ apex
  • heart sounds
  • murmurs
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8
Q

CHD investigations

A
  • blood pressure
  • O2 stats
  • arterial BGA
  • ECG
  • CXR
  • echo
  • catheter
  • angiography
  • MRI
  • exercise testing
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9
Q

methods for improving CHD if you can’t fix it

A
  • medication

- paliative procedure e.g. BT, balloon valvoplasty, prostaglandin infusion, pulmonary banding

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10
Q

common features of innocent murmurs

A
  • systolic murmur
  • no other signs of cardiac disease
  • soft murmur (grade 1-2/6)
  • vibratory, musical
  • localised
  • varies with position, respiration, exercise
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11
Q

describe stills murder

A
  • LV outflow murmur
  • age 2-7
  • soft systolic, twangy
  • apex @ left sternal border
  • increases in supine position and with exercise
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12
Q

describe pulmonary outflow murmur

A
  • age 8-10
  • soft systolic
  • vibratory
  • upper left sternal border (well localised, not radiating to back)
  • increases in supine position and with exercise
  • often children with narrow chest
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13
Q

describe carotid/ brachiocephal IC arterial bruits

A
  • age 2-10
  • 1-2/6 systolic
  • harsh
  • supraclavicular
  • radiates to neck
  • increases with exercise, decreases on turning head or extending neck
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14
Q

describe venous hum

A
  • age 3-8
  • soft indistinct
  • continuous murmur, sometimes with diastolic accentuation
  • supraclavicular
  • only in upright position, disappears when lying down or turning head
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15
Q

3 main types of ventricle septal defects

A
  • subaortic
  • perimembranous
  • muscular
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16
Q

clinical presentation ventricle septal defects

A
  • pansystolic murmur lower left sternal edge, sometimes with thrill
  • signs of cardiac failure if large
    eventually leads to biventricular hypertrophy and pulmonary hypertension
17
Q

methods for VSD closure

A
  • amplatzer or other occlusion device, trans-catheter

- patch closure (open heart surgery)

18
Q

clinical presentation of atrial septal defects

A
  • few clinical signs in early childhood
  • sometimes detected in adulthood with AF, HF or pulmonary hypertension
  • wide fixed splitting of 2nd heart sound, pulmonary flow murmur
19
Q

presentation mild pulmonary stenosis

A

asymptomatic

20
Q

presentation moderate and severe pulmonary stenosis

A

exertion dysponoea and fatigue

21
Q

presentation of severe aortic stenosis

A
  • reduced exercise tolerance
  • exertional chest pain
  • syncope
  • ejection systolic murmur upper right sternal border, radiation into carotids
22
Q

changes to fetal circulation at birth

A
  • pulmonary vascular resistance falls
  • pulmonary blood flow rises
  • systemic vascular resistance is increased
  • ductus arteriosus closes
  • foramen ovale closes
  • ductus venosus closes
23
Q

management of patent ductus arteriosus in newborns

A
  • fluid restriction + diuretics
  • prostaglandin inhibitors
  • surgical ligation
24
Q

what CHD is common in pre-term infants

A

patent ductus arteriosus

25
Q

management coarctation of aorta

A
  • re-open ductus arteriosus with prostaglandin E1 or E2
  • resection with end-end anastomosis
  • subclavian patch repair
  • balloon aortoplasty

Paediatrics (23 decks)

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