Cardio

Question 1

Widened, split s2

Answer 1

ASD

Question 2

LLSB holosystolic murmur

Answer 2

VSD

Question 3

Cardiac apex diastolic rumble

Answer 3

Mitral stenosis

If also LLSB holosystolic murmur present, then due to incr flow across mitral valve usually (due to VSD)

Question 4

LUSB Harsh systolic ejection murmur

Answer 4

Pulmonary stenosis (usually TOF)

Question 5

Mid systolic click

+- late systolic murmur

Answer 5

Mitral valve prolapse

Question 6

Transfusion associated circulatory overload Sx

Answer 6

Respiratory distress (tachycardia, incr bp, work of breathing)
Pulmonary edema (rales, bilateral crackles)

Question 7

TACO Tx (transfusion associated ,, ,,)

Answer 7

Furosemide (decrease load for heart)
Respiratory support

Anemic pts especially susceptible (e.g. on nothing else but cows milk)

Question 8

Signs of circulatory overload

Answer 8

Diffuse crackles
S3 gallop
JVD

Question 9

Obstructive sleep apnoea (paediatric) cardiac sx

Answer 9

Systemic hypertension!

(Other sx: tonsillar hypertrophy, BED WETTING! Daytime napping

Question 10

Kawasaki disease Tx

Answer 10

IVIG within 10 days of symptoms (prevent coronary artery) + ASA
Acute phase (2 weeks): high dose ASA (anti inflammatory effect)
Subacute phase (months): low dose ASA (anti platelet effect)

If fever returns 1 day to 36 hours- IVIG again
Still unresponsive- steroids