Cardiology

Question 1

Types of VSDs

Answer 1

Perimembranous
- next to tricuspid valve

Muscular/ Trabecular
- Surrounded by muscle

Question 2

Risk factors for VSD

Answer 2

Down’s syndrome

Turner syndrome

Foetal alcohol syndrome

Question 2

Mumur in VSD

Answer 2

Pansystolic murmur
- Loudest in tricupid region

Systolic thrill

Question 3

An _______ murmur can be heard in large VSDs due to an increased flow over mitral valve

Answer 3

Apical mid-diastolic murmur

Question 4

ECG findings in VSD

Answer 4

In large VSD

- Biventricular hypertrophy

Question 5

Management of small VSDs (<3mm)

Answer 5

Monitoring

• Echo
• ECG
• Auscultation

Preventing endocarditis

• Dentition
• Avoiding needles.

Question 6

Large VSDs management

Answer 6

Surgery from 3-6 months
- Transvenous catheter closure

Heart failure

• Diuretics
• Captopril

Question 7

_______ is a type of ASD involving deficiency of the foramen ovale and surrounding septum

Answer 7

Secundum

- Most common ASD

Question 8

________ is a type of ASD involving deficiency in the AV septum

Answer 8

Atrial ventricular septal defect/ Primum

Question 9

Presentation of ASDs

Answer 9

Recurrent chest infections/ wheeze

Murmurs

Question 10

Murmurs in ASD

Answer 10

Ejection systolic
- left upper sternal edge (pulmonary)

Fixed, widely split S2

Apical pansystolic mumur
- AVSD (AV regurgitation)

Question 11

Chest X-ray findings of ASD

Answer 11

Cardiomegaly

Pulmonary artery hypertrophy

Increased pulmonary vascular markings

Question 12

ECG findings for ASDs

Answer 12

Secundum

• Right axis deviation- due to RV enlargement
• pRBBB

Partial AVSD
- Superior axis= negative deflection in aVF

Question 13

Management of ASD

Answer 13

Secundum
- Occlusion devise

Partial AVSD
- Surgery

Question 14

Ductus arteriosis is expected to close up ______ after birth

Answer 14

1 months

Question 15

Eisenmenger syndrome

Answer 15

Right to left shunt that occurs due to increased pulmonary vascular resistance
- Decompensation after left-to-right shunt

Question 16

A ________ pulse can be seen in a patent ductus arteriosus due to an increased _______

Answer 16

Collapsing/ bounding pulse

Increase pulse pressure

Question 17

Murmur in PDA

Answer 17

Crescendo-decrescendo murmur in S2

- Upper left sternal edge

Question 18

What investigation provides definite diagnosis for PDA

Answer 18

Echocardiogram

Question 19

What investigation provides definite diagnosis for PDA

Answer 19

Echocardiogram

Question 20

Indications of surgical closure of PDA

Answer 20

Age > 1

Symptomatic

Heart failure

Question 20

Indications of surgical closure of PDA

Answer 20

Age > 1

Symptomatic

Heart failure

Question 21

7 S’s of innocent mumurs

Answer 21

Soft
Symptomless
Systolic
Short
Situation dependent (quieter when standing)
Normal S1 and S2

Normal special tests

Question 22

Risk factors for innocent murmurs

Answer 22

Febrile illness

Anaemia

Question 23

A mitral regurgitation murmur is heard in the _____ area and is a _______ murmur

Answer 23

Mitral area (5th IC space, mid-clavicular) Pan systolic murmur

Question 24

A tricuspid regurgitation murmur is heard in the _____ area and is a _______ murmur

Answer 24

Lower left sternal edge (5th IC, sternal border) Pansystolic murmur

Question 25

An aortic stenosis murmur is heard in the _____ area and is a _______ murmur

Answer 25

2nd IC space, right sternal border Ejection systolic

Question 26

A pulmonary stenosis murmur is heard in the _____ area and is a _______ murmur

Answer 26

2nd IC space, left sternal edge Ejection systolic

Question 27

A hypertrophic obstructive cardiomyopathic murmur is heard in the _____ area and is a _______ murmur

Answer 27

4th IC space, left sternal edge Ejection systolic mumur

Question 28

Causes of cyanotic heart disease

Answer 28

Right to left shunts - Transposition of great arteries (always cyanotic) - Severe VSD and ASD - PDA

Question 29

Causes of cyanotic heart disease

Answer 29

Right to left shunts - Transposition of great arteries (always cyanotic) - Severe VSD and ASD - PDA

Question 30

________ and ______ are compensatory mechanism for the transposition of the great arteries

Answer 30

Patent PDA VSD/ ASD - Oxygenated blood to be shunted back into systemic circulation

Question 31

Management of transposition of the great arteries

Answer 31

Prostaglandin infusion - Keeps PDA potent Balloon septostomy - Catheter in foramen ovale = creates a large ASD Definite treatment - Arterial switch

Question 32

Coarctation of the aorta is associated with _______

Answer 32

Turner syndrome

Question 33

Presentation of coarctation of aorta

Answer 33

Tachypnoea Poor feeding/ weight gain Grey/floppy - Weak femoral pulses - Underdeveloped left arm - Underdeveloped legs Left ventricular heave

Question 34

Murmur heard in coarctation of the aorta

Answer 34

Systolic murmur in the left infraclavicular area

Question 35

Management of coarctation of aorta

Answer 35

Prostaglandins - PDA open Surgical correction of coarctation

Question 36

Aortic stenosis presents with a _______ pulse and _______ pulse pressure

Answer 36

Slow rising pulse Narrow pulse pressure

Question 37

Blood findings of a congential cyanotic heart disease

Answer 37

Significant hypoxia Metabolic acidosis (due to hypoxia)

Question 38

Investigations for congenital heart disease

Answer 38

Bloods - VBG: oxygen, acid-base status ECG Echo Chest Xray (heart size)