Cardiology

Question 1

What does the absence of femoral pulses in an infant indicate?

Answer 1

Coarctation of Aorta

Question 2

What are heaves a sign of?

Answer 2

Ventricular volume overload

Question 3

What do precordial thrills or suprastrenal thrills indicate?

Answer 3

Aortic stenosis

Question 4

What is the significance of 3rd and 4th heart sounds in children?

Answer 4

3rd: Can be normal in some
4th: always abnormal

Question 5

Name 4 things to describe when detailing a murmur

Answer 5

Timing (systolic/diastolic?)

Duration (ejection/pansystolic?)

Site (where is loudest)

Radiation

Question 6

Give 3 indicators that a murmur is innocent

Answer 6

Asymptomatic
No thrill/heave
Soft systolic

Question 7

Give 3 acyanotic congenital heart lesions

Answer 7

• VSD
• ASD
• Coarctation of aorta

Question 8

Give 3 cyanotic congenital heart lesions

Answer 8

• Tetralogy of Fallot
• Tricuspid atresia
• Pulmonary atresia

Question 9

Give 3 general causes of cyanosis in children

Answer 9

• Respiratory
• Seizure
• CNS depression e.g. drugs

Question 10

Give 2 heart conditions associated with Down’s syndrome

Answer 10

Atrioventricular septal defect

Tetralogy of Fallot

Question 11

Give 2 heart conditions associated with Turner’s syndrome

Answer 11

Aortic stenosis

Coarctation of aorta

Question 12

What is meant by a secundum ASD?

Answer 12

Middle part of atrial septum is affected

Question 13

What is meant by a primum ASD?

Answer 13

lower part of septum is affected

Question 14

How does an atrial septal defect usually present in children?

Answer 14

Asymptomatic with incidental murmur

Question 15

What is the treatment of secundum ASD?

Answer 15

Transcatheter device closure

Surgical repair

Question 16

How are small ventricular septal defects usually managed?

Answer 16

Most close spontaneously

Question 17

How are large/unstable ventricular septal defects usually managed?

Answer 17

Repaired in 1st 6 months of life surgically

Question 18

Give 3 management options if children show signs of heart failure

Answer 18

• Diuretics
• ACEI
• NG feeds

Question 19

Which 2 conditions are associated with a patent ductus arteriosus?

Answer 19

Prematurity

Maternal rubella

Question 20

Give 2 clinical signs of a patent ductus arteriosus

Answer 20

Bounding femoral pulses

Subclavicular murmur

Question 21

How is a patent ductus arteriosus managed in preterm infants?

Answer 21

NSAIDS

Surgical ligation

Question 22

How is a patent ductus arteriosus managed in older children?

Answer 22

Device occlusion by cardiac catheterisation

Question 23

How may neonates with coarctation present?

Answer 23

Collapse
Cardiac failure
Absent femoral pulses

Question 24

What is transposition of the great arteries?

Answer 24

Two separate circulations: mixing occurs at atrial level and arterial duct

Question 25

In transposition of the great arteries, what is given to open the arterial duct?

Answer 25

Prostaglandin

Question 26

What is the definitive treatment of transposition of the great arteries?

Answer 26

Arterial switch

Question 27

What are the 4 components of tetralogy of Fallot?

Answer 27

• VSD
• Overriding aorta
• RV hypertrophy
• RV outflow tract obstruction

Question 28

What is the most likely causative agent in infective endocarditis?

Answer 28

Strep. viridian’s

Question 29

Give 4 features of infective endocarditis

Answer 29

Weight loss
Malaise
Arthralgia
Haematuria

Question 30

What is the treatment of infective endocarditis?

Answer 30

IV ABX for at least 6 weeks