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Peds Boards 2021 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What are the ECHO findings associated with dilated cardiomyopathy (like due to myocarditis after viral illness)?

A

Dilated left ventricle with decreased contractility

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2
Q

What is the most appropriate treatment for patient with prolonged QTc (symptoms of syncopal episodes induced by exercise, fright or sudden startle)?

A

Beta Blocker (Propranolol)

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3
Q

… is characterized as apical displacement of the tricuspid valve leaflets associated with tricuspid insufficiency and dilated right atrium which is ECHO finding in neonates of mother’s on lithium

A

Ebstein Anomaly

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4
Q

What is a complication of significant right to left shunting in a patient with unrepaired Tetralogy of Fallot?

A

brain abscess and cerebral thrombosis

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5
Q

What is the most likely cause of sudden death in a patient after direct precordial trauma (punched in chest with fist, hit in chest with hockey puck, etc)?

A

Ventricular fibrillation

syndrome called Commotio cordis

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6
Q

What is the most common cardiac abnormality associated with Fetal Alcohol Syndrome?

A

VSD (pan-systolic harsh murmur over the left lower sternal border)

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7
Q

What are the 3 indications for antibiotic prophylaxis to prevent endocarditis during dental procedure?

A
  1. prosthetic valve
  2. previous hx of endocarditis
  3. unrepaired cyanotic heart disease
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8
Q

What is the most likely diagnosis for patient presenting with chorea, hypotonia, emotional lability, facial grimacing, jerking trunk/ extremities worsened by stress, milkmaid grip with handshake and pronation and spooning of hands as arms are raised above head (pronator sign)?

A

Sydenham chorea

sequelae of rheumatic fever due to group A strep infection

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9
Q

What is the most likely diagnosis for patient with conjunctivitis (sparing limbus), erythematous mouth and pharynx, strawberry tongue, cracked lips, generalized rash, unilateral cervical lymphadenopathy, and redness/ swelling of hands in feet in setting of 5 or more days of fever?

A

Kawasaki Disease

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10
Q

An EKG showing short PR interval (less than 0.12 seconds) and widened QRS with a slow upstroke of QRS is consistent with …. in …. syndrome

A

Delta Wave; Wolff-Parkinson-White Syndrome

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11
Q

What is the recommend antibiotic regimen for endocarditis prophylaxis prior to dental procedure when indicated?

A

Amoxicillin 50 mg/kg (max 2 grams) once 30-60 minutes prior to procedure
(not if prosthetic procedure was more than 6 months ago)

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12
Q

What is the most likely cause of a systolic murmur heard best at the LUSB radiating to lung fields and axillae?

A

Peripheral Pulmonary Artery Stenosis

functional in newborns

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13
Q

What age is an inverted T wave in the right precordial leads (V4R and T1) normal?

A

1 week of life to late childhood/ early adolescence

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14
Q

What is the most likely diagnosis for patient with brief syncopal episode without tonic-clonic seizure in setting of prolonged standing following a prodrome of nausea, blurry/ tunnel vision while in warm/ clammy temperature?

A

Vasovagal syncope
(if diagnosis not clear, tile table test)
(tx: increased fluid and dietary salt)

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15
Q

What are the 4 components of Tetralogy of Fallot?

A
  1. VSD
  2. RV outflow tract obstruction
  3. overriding aorta
  4. RV hypertrophy
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16
Q

What are the 5 components of the Jones Criteria for rheumatic fever?

A
  1. carditis
  2. erythema marginatum
  3. subcutaneous nodules
  4. polyarthritis
  5. chorea
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17
Q

What are the 4 minor criteria for Rheumatic Fever?

A
  1. arthalgia
  2. elevated ESR or CRP
  3. prolonged PR interval on EKG
  4. fever
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18
Q

What is the most common cyanotic heart defect that presents itself within the first days of life?

A

Transposition of the great vessels (arteries)

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19
Q

What is the most common cyanotic heart defect?

A

Tetralogy of Fallot

presents usually after 1 month of life, will squat to relieve tet spells

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20
Q

What is a possible non cardiac complication of Kawasaki disease?

A

Gallbladder hydrops (RUQ mass with enlarged/ overdistended balloon shape on abdominal ultrasound)

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21
Q

What is the main treatment for dilated cardiomyopathy?

A

Diuretics (decrease preload) and ACE inhibitors (decrease afterload)

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22
Q

What heart defects respond to the use of prostaglandin E1 (PGE) to maintain a patent ductus arteriosus?

A
  1. critical coarctation of aorta
  2. tricuspid atresia
  3. pulmonary atresia
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23
Q

What is the clinical presentation associated with Wolff-Parkinson- White syndrome?

A

Supraventricular tachycardia

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24
Q

What is a cause of drug induced lupus?

A

Procainamide

tx discontinue medication and symptoms resolve

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25
Q

What is the most common cardiac defect associated with Down Syndrome?

A

Complete Atrioventricular (AV) septal defect

26
Q

What is the treatment for transposition of the great vessels (arteries)?

A

Balloon atrial septostomy (make an ASD to allow flow between the 2 separate circulations)

27
Q

What is the most likely cardiac abnormalities associated with IV drug abuse?

A
  1. tricuspid regurgitation

2. septic pulmonary embolism

28
Q

… is characterized by continuous murmur (systole and diastole) heard best at the 1st and 2nd right intercostal space that varies with changes in neck position or compression on jugular vein

A

Venous hum (benign)

29
Q

… is characterized as loud, harsh, machine like (or rumbling) heard best at 1st and 2nd left intercostal space that radiates along the left sternal border

A

Patent ductus arteriosus (PDA)

30
Q

What is a normal finding on EKG in a 2 month old suggestive of the normal right ventricular predominance in that age?

A

Rs pattern- taller R wave and smaller s wave in the QRS complex of right precordial leads

31
Q

A patient with a non-pruritic, erythematous, serpiginous macular lesions with pale centers on trunk and extremities in setting of rheumatic fever has …

A

erythema marginatum

32
Q

What is the most common cardiac abnormality associated with Turner syndrome?

A

non-stenotic bicuspid aortic valve

33
Q

what congenital heart defects often does not become symptomatic until 2nd decade of life and results in right ventricular hypertrophy?

A

ASD

atrial septal defect- fixed A2

34
Q

What is the initial treatment for stable patient with ventricular tachycardia (EKG showing wide QRS tachycardia with atrioventricular dissociation)?

A

IV amiodarone

35
Q

What is the most common side effect of ACE inhibitors?

A

cough

subsides after decreasing dose or change to different antihypertensive

36
Q

What is a possible medication treatment for neurocardiogenic syncope?

A

Fludrocortisone

if more fluids and salt in diet does not help

37
Q

What is the most likely diagnosis for pt presenting with sudden substernal chest pain radiating to upper back, EKG showing low voltage QRS, T- wave inversions, and ST elevation, subjective SOB and BP variation with inspiration and expiration?

A

Pericarditis with pericardial effusion

pulsus paradoxus- BP variation with breathing

38
Q

What is disorder/ disease is associated with rib notching?

A

Coarctation of aorta

39
Q

What is the most likely etiology of low pitched extra heart sound?

A

S3 due to large amount of blood filling dilated Left ventricule

40
Q

What is the most likely diagnosis for patient with cyanosis, ECHO showing tricuspid valve displaced toward apical right ventricle, CXR showing wall to wall (or box shaped) heart?

A

Ebstein anomaly

usually due to lithium

41
Q

… is the time it takes from cardiac impulse to travel from SA node through AV node and His bundle to onset of ventricular depolarization on EKG

A

PR interval

42
Q

What is a congenital heart defect that was results in a left axis deviation?

A

tricuspid atresia

43
Q

What is the best initial step in management for patient with ventricular tachycardia with pulse but unstable (altered mental status)?

A

Synchronized cardioversion

44
Q

What is the treatment for stable SVT (supraventricular tachycardia)?

A

vagal maneuver/ bag of ice/ adenosine

45
Q

What is a complication in prolonged VSD resulting in increased pulmonary vascular resistance leading to right to left shunting?

A

Eisenmenger syndrome

46
Q

What is a complication in prolonged VSD resulting in increased pulmonary vascular resistance leading to right to left shunting?

A

Eisenmenger syndrome

47
Q

What is the most likely diagnosis for patient presenting with cyanosis, acute worsening dyspnea, progressive interstitial and alveolar edema with ground glass appearance on CXR without cardiomegaly?

A

Total anomalous pulmonary venous return (with obstruction of pulmonary venous return)

48
Q

What is the treatment for patent ductus arteriosus (PDA- bounding pulses, apical impulse, continuous machine like murmur at left 2nd intercostal space)?

A

Ibuprofen or Indomethacin

49
Q

What maneuvers increase venous return and what is result on hypertrophic cardiomyopathy murmur versus aortic stenosis murmur?

A

Squatting
HCM- decreased murmur (separation of obstruction)
AS- increased murmur

50
Q

What maneuvers decrease venous return and what is result on hypertrophic cardiomyopathy murmur versus aortic stenosis murmur?

A

Standing and Valsalva
HCM- increased murmur
AS- decreased murmur

51
Q

What is the most likely murmur associated with Anorexia?

A

Mitral valve prolapse

apical systolic murmur with a midsystolic apical click

52
Q

What is the most likely diagnosis for patient developing sudden chest pain, SOB, fatigue and low grade fever 1-6 weeks after cardiac surgery?

A

Pericarditis

53
Q

What cardiac defect is associated with congenital syphilis?

A

PDA (patent ductus arteriosus)

54
Q

Is anemia alone an indication for transfusion in a sickle cell disease patient?

A

No

55
Q

What cardiac abnormality is associated with Noonan’s syndrome?

A

pulmonary valve stenosis

56
Q

What is the most likely etiology of a systolic ejection murmur heard best at left sternal border with normal S1 and widely split S2 that does not vary with respiration?

A

ASD (atrial septal defect)

57
Q

What is the cardiac abnormality associated with Williams Syndrome?

A

Supravalvular aortic stenosis

58
Q

What is the medical treatment for prolonged QT syndrome?

A

beta blocker (nadolol)

59
Q

What cardiac defect is associated with CXR showing snowman sign (large supracardiac shadow lying just above the cardiac shadow)?

A

total anomalous pulmonary venous return (TAPVR)

60
Q

What is the next step in management for bradyarrhythmia associated with hyperkalemia?

A

Calcium gluconate (stablize myocardium)

61
Q

What is the most likely diagnosis for patient with positive family history of sudden death, pulsus bisferiens (double peaked pulse), and LVH on EKG?

A

hypertrophic cardiomyopathy (HCM)

Peds Boards 2021 (22 decks)

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