Cardiology

Question 1

cyanosis of arms but not legs is indicative of what lesion?

Answer 1

TGA

Question 2

bounding pulses?

Answer 2

large PDA (or aortic valve insufficiency)

Question 3

systolic ejection click?

Answer 3

bicupsid aortic valve, aortic stenosis

Question 4

midsystolic click?

Answer 4

mitral valve prolapse

Question 5

what should you be thinking about with the following EKG values: 1.) +I and +aVF? 2.) +I and - aVF? 3.) -I and + aVF?

Answer 5

1.) nothing - normal. 2.) LAD (tri atresia, AV septal defects, LVH). 3.) RAD (RVH, PS, ASD, RBBB, TOF, pulm htn)

Question 6

how to find RR on EKG?

Answer 6

count big boxes and divide 300 by # of boxes

Question 7

normal PR interval?

Answer 7

3-5 small squares (120-200ms)

Question 8

normal QRS duration?

Answer 8

<100ms (1/2 big square)

Question 9

what overdose can lead to prolonged QT?

Answer 9

tricyclic

Question 10

what EKG finding does RA enlargement cause?

Answer 10

peaked P waves in II and V1

Question 11

what P wave finding indcated LA hypertrophy?

Answer 11

notched in II or negative in V1

Question 12

what is the drug of choice for a patient with WPW who develops atrial flutter?

Answer 12

procanimide (shock if unstable)

Question 13

what is the best treatment for atrial flutter?

Answer 13

synchronized cardioversion (can also use beta blocker, dig or diltiazem)

Question 14

what should you think about in a patient with new a fib?

Answer 14

hyperthyroidism

Question 15

what disease should you think about in a patient with multiple types of PVCs?

Answer 15

tuberous sclerosis (cardiac tumor causing the pVCs)

Question 16

what side effect can adenosine cause?

Answer 16

bronchoconstriction

Question 17

side effect of procanimide?

Answer 17

lupus, blood disorders

Question 18

side effects of quinidine?

Answer 18

torsades, autoimmune ITP, hearing loss, psychosis, tinnitus

Question 19

side effects of amiodarone?/

Answer 19

gray skin, thyroid, liver damage, pulmonary fibrosis

Question 20

what type, muscular or membranous, of VSD is commonly detected after age 1?

Answer 20

membranous (the muscular ones usually close by age 1)

Question 21

how do VSDs present?

Answer 21

heart failure at age 2 months

Question 22

heart sound finding in older children with ostium secundum ASDs (mid septal)

Answer 22

widely split S2 with no variation

Question 23

is the mumur for aortic regurgitation systolic or diastolic?

Answer 23

diastolic

Question 24

causes of aortic regurgitation?

Answer 24

congenital aortic stenosis, marfan, rheumatic fever, endocarditis

Question 25

most common cause of mitral regurgitation?

Answer 25

worldwide: rheumatic fever; US: mitral valve prolapse (late systolic murmur often with click at the apex)

Question 26

where can you hear the murmur for PS?

Answer 26

LUSB, radiates to clavicle and back; has a systolic ejection click along LSB

Question 27

what genetic syndromes are associated with pulmonic stenosis?

Answer 27

alagille and noonan

Question 28

murmur for aortic stenosis?

Answer 28

crescendo=decrescendo, harsh systolic murmur with suprasternal notch thrill

Question 29

how is HOCM inherited?

Answer 29

AD (murmur gets louder with standing, softer with squatting)

Question 30

what should you test for in someone with an interrupted aortic arch?

Answer 30

digeorge

Question 31

what cyanotic heart lesion most commonly presents within first few days?

Answer 31

d-TGA (2 parallel circulations)

Question 32

how does EKG differ in tricupsid atresia vs TOF/TGA?

Answer 32

tri atresia will have LVH/left axis vs the others will have right axis and RVH

Question 33

how do infants with TAPVR present?

Answer 33

FTT and tachypnea (xray will have “snowman” on it_

Question 34

what genetic syndrome do you test for with truncus arteriosus?

Answer 34

digeorge

Question 35

how do kids with HLHS present?

Answer 35

poor perfusion, CHF within first days to weeks

Question 36

what GI finding is common with asplenia or polysplenia?

Answer 36

malrotation

Question 37

what will you see on barium swallow with vascular ring?

Answer 37

posterior indentation of esophagus

Question 38

what is the most common arch abnormality that causes significant symptoms?

Answer 38

double aortic arch (persistence of both 4th arches)

Question 39

what symptoms will an infant have with ALCAPA

Answer 39

poor feeding, tachypnea, crying as if in pain, heart failure from MI or ischemia (also consider diagnosis in suddent death of athlete)

Question 40

what is kussmaul sign?

Answer 40

rise in venous jugular pressure with inspiration (because blood can’t get into heart secondary to tamponade)

Question 41

what is pulsus paradoxus?

Answer 41

drop in aortic pressure >10-15 during inspiration during tamponade

Question 42

do you see kussmaul sign more in tamponade or constrictive pericarditisi?

Answer 42

pericardititis

Question 43

what are common causes of constrictive pericarditis?

Answer 43

radiation, TB or bacterial pericarditis

Question 44

other than hyperkalemia, what side effect can occur with spironolactone?

Answer 44

gynecomastia

Question 45

what conditions require antibiotic prophylaxis for dental procedures?

Answer 45

prosthetic valves, previous history of endocarditis, unrepaired cyanotic heart disease, completely repaired congenital disease with prosthetic material or device for 6 months post-op, cardiac transplant recipients with valvulopathy

Question 46

what are the 5 major jones criteria?

Answer 46

carditis, chorea, subcutaneous nodules, polyarthritis, erythema marginatum

Question 47

what positive test must you have for RF?

Answer 47

elevated or risingASO titer, positive throat culture

Question 48

how do you treat RF?

Answer 48

penicillin, aspirin - then will need prophylaxis for 5 years or until age 21