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Neonatal Board Questions > Cardiology > Flashcards

Cardiology Flashcards

1
Q

MC neonatal cardiac tumor

A

Rhabdomyoma

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2
Q

Rhabdomyoma associated with

A

Tuberous sclerosis

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3
Q

MC type of TAPVR

A

Supracardiac (pulmonary veins entering into the vertical vein, azygous vein or SVC)

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4
Q

Obstructive cause of TAPVR

A

Infracardiac or sub diaphragmatic

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5
Q

MCC complete vascular ring

A

Double aortic arch

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6
Q

What vessels does iNO work on?

A

Selectively dilates pulmonary blood vessels that are VENTILATED, resulting in improvement of V/Q matching

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7
Q

PACs result from

A

Depolarization originating within the atrium, before the SA node

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8
Q

Functional closure of PDA in full term infants

A

48 hours

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9
Q

Anatomic closure of PDA in full term infants

A

2-4 weeks

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10
Q

Differential cyanosis defined as

A

oxygen saturation >/= 5% or PaO2 >/=20mmHg

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11
Q

Reverse differential cyanosis defined as

A

Lower extremity oxygen saturation or PaO2 higher than upper extremity
(picture explanation here) https://www.utmb.edu/pedi_ed/CoreV2/CardiologyPart1/CardiologyPart18.html

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12
Q

Differential cyanosis associated with

A

PPHN or cyanotic heart disease

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13
Q

Reverse differential cyanosis seen in

A

D-TGA + PDA + Coarct, Interrupted aortic arch or PPHN

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14
Q

MC type of VSD

A

Perimembranous

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15
Q

Highest oxygen saturation in fetus

A

Umbilical vein (70%)

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16
Q

Lowest oxygen saturation in fetus

A

SVC (40%) because brain has highest oxygen extraction

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17
Q

PR interval prolonged

A

First degree AV block

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18
Q

Increasing PR interval until atrial impulse not conducted

A

Second degree AV block, Mobitz type 1, Wenckebach phenomenon

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19
Q

Abrupt atrial beat not conducted

A

Second degree AV block, Mobitz type 2

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20
Q

Which medication can lead to cyanide toxicity?

A

Nitroprusside

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21
Q

Inotrope forces Frank Starling curve in which direction?

A

Upward and leftward

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22
Q

Cardiac output =

A

Systemic BP / Total peripheral vascular resistance
OR
HR x Stroke volume

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23
Q

MC cyanotic heart lesion in first week of life

A

TGA

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24
Q

MC cardiac lesion in Trisomy 21

A

Endocardial cushion defect

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25
Q

EKG in Endocardial cushion defect

A

Superior axis deviation d/t superior displacement of the AV node

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26
Q

MC congenital herat lesion in VACTERL

A

VSD

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27
Q

High or low lying catheter associated with increased risk of ischemic complications?

A

Low

28
Q

High or low lying catheter associated with increased risk of HTN?

A

Equal risk

29
Q

MCC hypertension in neonate

A

Renovascular disease

MCC renal artery thrombosis from umbilical catheter placement

30
Q

MCC hypertrophic cardiomyopathy in neonates under 4

A

Noonan syndrome

31
Q

Infants with congenital heart block, are moms symptomatic?

A

No, less than 1/3 of mothers have a diagnosis of SLE and most are asymptomatic

32
Q

MC cardiovascular cause of hypertension in neonate

A

Coarctation of the aorta

33
Q

What are dilators of the PDA?

A

Acidosis, hypoxia, prostacyclin and PGE1

34
Q

What are constrictors of the PDA?

A

PGF2-alpha, acetylcholine, bradykinin, oxygen

35
Q

Initial treatment for stable infant with flutter?

A

Digoxin (to block the ventricular rate)

36
Q

Initial treatment for unstable infant with flutter?

A

Synchronized cardioversion or esophageal pacing followed by digoxin

37
Q

What week does cardiogenesis begin?

A

5th week

38
Q

What week does the heart begin to beat?

A

6th week

39
Q

What week does septation of the heart begin?

A

Between weeks 7 and 8

40
Q

Conotruncal defect is defined by

A

Normal development of the cardiac outflow tract is disrupted

41
Q

Examples of conotruncal defects

A 
Truncus arteriosus
TGA
TOF
DORV
DOLV
Interrupted aortic arch
42
Q

Ductus arteriosus arises from which arch?

A

Left 6th aortic arch

43
Q

Carotid artery arises from which arch?

A

3rd arch
“Make Some Impoetant Shtuff”
ICA from 3rd

44
Q

R subclavian artery arises from which arch?

A

R 4th arch

“Make Some Important Schtuff”

45
Q

Aortic arch arises from which arch?

A

L 4th arch

46
Q

Complications of untreated PDA

A

CHF, pulmonary hypertension, Endarteritis, ductal aneurysm

47
Q

MC form of intracranial injury after bypass

A

White matter injury

48
Q

Congenital heart defects most prevalent in which twin in TTTS?

A

Recipient twin

49
Q

Most frequent congenital heart defects in TTTS

A

VSD, ASD, pulmonary stenosis

50
Q

Epinephrine side effects and what mediated by

A

Hyperglycemia, lactic acidosis due to B2 receptor stimulation in liver
Tachycardia due to B2 receptor stimulation in heart

51
Q

Why does epinephrine preferentially increase SVR over PVR?

A

alpha 2 receptor mediated production of nitric oxide

52
Q

Why does prolonged use of Dopamine result in less effective inotropy?

A

Norepenephrine stores of the myocardium can become depleted after only 12 hours

53
Q

Does evidence support onefluid bolus for hypotension?

A

No- RCTs comparing placebo with fluid bolus found no difference in BP or short term outcomes such as mortality

54
Q

Dopamine effects on left ventricular output and superior vena caval flow

A

Reduces both

Alpha 1 stimulation –> inc vasc resistance

55
Q

Dobutamine effects on left ventricular output and superior vena caval flow

A

Increases both

56
Q

Epinephrine effects on left ventricular output

A

Increase

57
Q

Are PDAs clinically silent in first few days of life?

A

most are

58
Q

When MC time frame for pulmonary hemorrhage from PDA?

A

First 72 hours (as blood floods the lungs from decreased PVR)

59
Q

How does epinephrine work during a code?

A

Alpha 1 receptors increase PVR and decrease preferential blood flow to the dilated aorta and instead to coronary arteries

60
Q

What is MC cardiac defect in DiGeorge?

A

Conotruncal ie. TOF, Truncus arteriosus

61
Q

Bruit over anterior fontanelle seen in

A

anemia, meningitis, AVM

62
Q

Normal EKG findings in first few days of life

A

Rightward QRS axis, upright T waves in V1, small QRS voltage in limb leads, low voltage T waves

63
Q

What does Digoxin do to inotropy and chronotropy?

A

Positive inotrope

Negative chronotrope

64
Q

How does Digoxin work on inotropy?

A

Inhibition of sarcolemmal Na/K ATP –> increases intracellular Na and Ca

65
Q

How does Digoxin work on chronotropy?

A

Decreased due to prolonged SA conduction rate and increased refractory period through the AV node

Neonatal Board Questions (12 decks)

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