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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
What is the most common cardiac defect associated with Down Syndrome?
Complete Atrioventricular (AV) septal defect
26
What is the treatment for transposition of the great vessels (arteries)?
Balloon atrial septostomy (make an ASD to allow flow between the 2 separate circulations)
27
What is the most likely cardiac abnormalities associated with IV drug abuse?
1. tricuspid regurgitation | 2. septic pulmonary embolism
28
... 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
Venous hum (benign)
29
... 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
Patent ductus arteriosus (PDA)
30
What is a normal finding on EKG in a 2 month old suggestive of the normal right ventricular predominance in that age?
Rs pattern- taller R wave and smaller s wave in the QRS complex of right precordial leads
31
A patient with a non-pruritic, erythematous, serpiginous macular lesions with pale centers on trunk and extremities in setting of rheumatic fever has ...
erythema marginatum
32
What is the most common cardiac abnormality associated with Turner syndrome?
non-stenotic bicuspid aortic valve
33
what congenital heart defects often does not become symptomatic until 2nd decade of life and results in right ventricular hypertrophy?
ASD | atrial septal defect- fixed A2
34
What is the initial treatment for stable patient with ventricular tachycardia (EKG showing wide QRS tachycardia with atrioventricular dissociation)?
IV amiodarone
35
What is the most common side effect of ACE inhibitors?
cough | subsides after decreasing dose or change to different antihypertensive
36
What is a possible medication treatment for neurocardiogenic syncope?
Fludrocortisone | if more fluids and salt in diet does not help
37
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?
Pericarditis with pericardial effusion | pulsus paradoxus- BP variation with breathing
38
What is disorder/ disease is associated with rib notching?
Coarctation of aorta
39
What is the most likely etiology of low pitched extra heart sound?
S3 due to large amount of blood filling dilated Left ventricule
40
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?
Ebstein anomaly | usually due to lithium
41
... 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
PR interval
42
What is a congenital heart defect that was results in a left axis deviation?
tricuspid atresia
43
What is the best initial step in management for patient with ventricular tachycardia with pulse but unstable (altered mental status)?
Synchronized cardioversion
44
What is the treatment for stable SVT (supraventricular tachycardia)?
vagal maneuver/ bag of ice/ adenosine
45
What is a complication in prolonged VSD resulting in increased pulmonary vascular resistance leading to right to left shunting?
Eisenmenger syndrome
46
What is a complication in prolonged VSD resulting in increased pulmonary vascular resistance leading to right to left shunting?
Eisenmenger syndrome
47
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?
Total anomalous pulmonary venous return (with obstruction of pulmonary venous return)
48
What is the treatment for patent ductus arteriosus (PDA- bounding pulses, apical impulse, continuous machine like murmur at left 2nd intercostal space)?
Ibuprofen or Indomethacin
49
What maneuvers increase venous return and what is result on hypertrophic cardiomyopathy murmur versus aortic stenosis murmur?
Squatting HCM- decreased murmur (separation of obstruction) AS- increased murmur
50
What maneuvers decrease venous return and what is result on hypertrophic cardiomyopathy murmur versus aortic stenosis murmur?
Standing and Valsalva HCM- increased murmur AS- decreased murmur
51
What is the most likely murmur associated with Anorexia?
Mitral valve prolapse | apical systolic murmur with a midsystolic apical click
52
What is the most likely diagnosis for patient developing sudden chest pain, SOB, fatigue and low grade fever 1-6 weeks after cardiac surgery?
Pericarditis
53
What cardiac defect is associated with congenital syphilis?
PDA (patent ductus arteriosus)
54
Is anemia alone an indication for transfusion in a sickle cell disease patient?
No
55
What cardiac abnormality is associated with Noonan's syndrome?
pulmonary valve stenosis
56
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?
ASD (atrial septal defect)
57
What is the cardiac abnormality associated with Williams Syndrome?
Supravalvular aortic stenosis
58
What is the medical treatment for prolonged QT syndrome?
beta blocker (nadolol)
59
What cardiac defect is associated with CXR showing snowman sign (large supracardiac shadow lying just above the cardiac shadow)?
total anomalous pulmonary venous return (TAPVR)
60
What is the next step in management for bradyarrhythmia associated with hyperkalemia?
Calcium gluconate (stablize myocardium)
61
What is the most likely diagnosis for patient with positive family history of sudden death, pulsus bisferiens (double peaked pulse), and LVH on EKG?
hypertrophic cardiomyopathy (HCM)

Peds Boards 2021 (22 decks)

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