Cardio13

Question 1

What congenital heart condition causes Early cyanosis (“blue-babies”)?

Late cyanosis (“blue-kids”)?

Answer 1

Early = Right-to-Left shunts

Late = Left-to-Right shunts

Question 2

What are the Right-to-Left shunts?

Answer 2

Tetralogy of fallot
Transposition of great vessels
Persistent Truncus arteriosus
Tricuspid atresia
Total anomalous pulmonary venous return

“the 5 Ts”

Question 3

What are the Left-to-Right shunts?

Answer 3

Ventricular Septal Defect (VSD)
Atrial Septal Defect (ASD)
Patent Ductus Arteriosus (PDA)

Question 4

What is the most common cause of Early cyanosis?

Answer 4

Tetralogy of Fallot

Question 5

What is the most common congenital cardiac anomaly?

Answer 5

VSD

Question 6

What is the frequency of the Left-to-Right shunts?

Answer 6

VSD > ASD > PDA

Question 7

What syndrome is caused by uncorrected VSD, ASD, or PDA?

Answer 7

Eisenmenger’s syndrome

Question 8

What does uncorrected VSD, ASD, or PDA cause?

Answer 8

Compensatory pumonary vascular Hypertrophy, which results in Progressive Pulmonary Hypertension

Question 9

What happens in Eisenmenger’s syndrome as Pulmonary Resistance INcreases?

Answer 9

Shunt reverses from left-to-right to right-to-left

Causes:

• Late cyanosis
• Clubbing
• Polycythemia

Question 10

What causes Tetralogy of Fallot?

Answer 10

Anterosuperior displacement of the Infundibular Septum

Question 11

What are the 4 parts of tetralogy of Fallot?

Answer 11

“PROVe”

Pulmonary infundibular stenosis
Right Ventricle Hypertrophy
Overriding Aorta
Ventricular Septal Defect

Question 12

What is the preferred treatment for tetralogy of Fallot?

Answer 12

early, primary surgical correction

Question 13

Why does squatting relieve cyanotic symptoms in older Fallot’s patients?

Answer 13

Reduces blood flow to the legs
INcreases PVR
DEcreases the cyanotic right-to-left shunt across the VSD

Question 14

What is D-transporsition due to?

Answer 14

Failure of the aorticopulmonary septum to spiral.

Aorta leaves RV (anterior) and Pulmonary trunk leaves LV (posterior) –> Seperation of systemic and pulmonary circulations

Question 15

Infantile type Coarctation of the Aorta.

Answer 15

Aortic Stenosis proximal to insertion of Ductus Arteriosus (preductal)

“INfantile: IN close to the heart”

Question 16

What syndrome is Infantile type Coarctation of the Aorta associated with?

Answer 16

Turner syndrome

Question 17

Adult type Coarctation of the Aorta.

Answer 17

Stenosis is Distal to Ligamentum Arteriosum (Postductal)

“aDult: Distal to Ductus”

Question 18

What is Adult type Coarctation of the Aorta most commonly associated with?

Answer 18

Bicuspid Aortic Valve

Question 19

Describe Patent Ductus Arteriosus in fetal and neonatal stages.

Answer 19

In fetal period, shunt is normal (right-to-left)

Neonatal, Lung resistance DEcreases and shunt becomes left-to-right w/subsequent RVH and/or LVH and failure

Question 20

Patency of the ductus arteriosus is maintained by what?

Answer 20

PGE synthesis

Low O2 tension

Question 21

What medication closes the patent duct?

Answer 21

Endomethacin Ends patency of PDA

*PGE; kEEps it open

Question 22

When would you want to keep the ductus arteriosus patent?

Answer 22

Transposition of the great vessels

treat with PGE

Question 23

What is the murmur heard in PDA?

Answer 23

continous, machine-like murmur

Question 24

Congenital cardiac defect associations:

22q11 syndromes

Answer 24

Truncus Arteriosus

Tetralogy of Fallot

Question 25

Congenital cardiac defect associations:

Down Syndrome

Answer 25

ASD
VSD
AV Septal defect
*Endocardial cushion defect

Question 26

Congenital cardiac defect associations:

Congenital Rubella

Answer 26

Septal defects
PDA
Pulmonary Artery Stenosis

Question 27

Congenital cardiac defect associations:

Turner syndrome

Answer 27

Coarctation of Aorta (Preductal/Infantile)

Question 28

Congenital cardiac defect associations:

Marfan’s syndrome

Answer 28

Aortic insufficiency

Dissection (late complication)

Question 29

Congenital cardiac defect associations:

Infant of Diabetic Mother

Answer 29

Transposition of great vessels