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Laughing Pedi > Cardiology > Flashcards

Cardiology Flashcards

0
Q

medium to high pitched grade 1-2 mid-systolic murmur, soft ejection at birth to one week until 3-4 months

A

neonatal PPS from small pulmonary arteries - innocent

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1
Q

Murmur axillae and back, birth 2-3 months, grade 1-2

A

Pulmonary branch stenosis

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2
Q

low pitched 1-3 mid systolic vibratory musical buzzing murmur loudest when child is lying down but goes away if standing, from 1-10 yrs with vibration in LVOT

A

Still’s - innocent

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3
Q

Continuous grade 1-3/6 murmur, heard best at clavicle from 2-10 yrs, increased when upright, abolished by head turn or jugular compression

A

Venous hum - innocent

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4
Q

widely split S2

A

ASD

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5
Q

loud single S2

A

pulmonary htn

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6
Q

3 Pansystolic murmurs

A

VSD, TR, MR

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7
Q

Harsh murmurs (3)

A

VSD, valve stenosis, outflow tract obstruction

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8
Q

systolic clicks (3)

A

aortic or pulmonic stenosis, MVP

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9
Q

% w DS w/ CHD? and types?

A

40-50%, AV canal defect or primum ASD

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10
Q

Turner and CHD, % and types

A

30%, coarctation of Ao, bicuspic aortic, aortic stenosis, later w/ dissection/aneurysm

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11
Q

the high and common ASD?

A

Ostium secondum

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12
Q

Noonan % w/ CHD and type

A

80-90%, Pulm stenosis, ASD, HOCM! (Right heart)

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13
Q

William’s syndrome, %/CHD type

A

supravalvar aortic stenosis, Coarct (Left sided) 60%

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14
Q

22q11, %/type of CHD

A

Conotruncal 35%, interrupted aortic arch, truncus arteriosus, TOF

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15
Q

Alagille syndrome CHD %

A

95%, pulm art stenosis, TOF

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16
Q

CHD in Fetal alcohol

A

VSD, ASD, TOF

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17
Q

CHD and CHARGE?

A

ASD, VSD

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18
Q

De Lange and CHD?

A

TOF, VSD

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19
Q

Cri-du-chat and CHD?

A

Various CHD

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20
Q

CHD in fetal hydantoin?

A

ASD, VSD, Coarct

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21
Q

CHD and Infant of DM mother?

A

Hypertrophic cardiomyopathy, VSD, TGA

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22
Q

Laurence Moon Biedl and CHD?

A

TOF, VSD

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23
Q

Marfan and CHD?

A

Aortic root aneurysm, mitral prolapse

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24
Q

Rubella and CHD?

A

PDA, peripheral pulmonary stenosis

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25
Q

Rubinstein-Taybi and CHD?

A

PDA

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26
Q

Holt-Oram and CHD?

A

ASD, VSD

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27
Q

Treatment of hypercyanotic spell (5) (TET spell)

A

knee-chest, O2, sedation, fluids, phenylephrine

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28
Q

Prevention of hypercyanotic spells

A

no dehydration, treat iron def, B-blocker

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29
Q

most common cyanotic lesion in newborn?

A

TGA

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30
Q

BT shunt?

A

Aorto-pulmonary

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31
Q

EKG w/ q waves in 1, avl, V5, V6, ST elevation in V5, V6. Sweating, SOB w/ feeding?
Also has holosystolic murmur

A

Coronary problem: ALCAPA. Murmur from MR (from ischemia of papillary muscles)

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32
Q

what is ALCAPA

A

coronaries from pulm artery instead of Ao

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33
Q

Anomalous left coronary artery from right aortic (not left) aortic sinus? Causes what in teens?

A

sudden death! exertional chest pain/syncope

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34
Q

Test if vascular ring is suspected?

A

barium swallow or CT

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35
Q

Two most common bugs in infective endocarditis

A

Strep viridans,&raquo_space; Staph aureus

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36
Q

Dental prophylaxis for heart disease? which ones?

What tx?

A
  1. unrepaired cyanotic CHD (shunt/conduit)
  2. complete repair w/ prosthetic material in 6 mos
  3. repaired but residual defect at site of lesion or prosthetic
  4. transplant w/ valve issue

AMOX

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37
Q

Criteria for ARF?

A

JONES: joints (arthritis), carditis, nodules, erythema marginatum, Sydenham’s chorea are major

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38
Q

Tx of ARF?

A

Benzathine PCN G (IM)
no NSAIDS until dx established
ASA 100mg/kg/day in 4-6 divided doses
RArely steroids

39
Q

murmur in carditis in ARF?

A

regurgitation: Mitral or aortic

40
Q

dx req for Kawasaki?

A

Fever!

4/5

41
Q

% of coronary artery aneurysm in Kawasaki/

A

15-20%

42
Q

Diagnostic test in suspected pericarditis? Finding?

A

ECG: diffuse ST elevation segment and PR segment depression:

43
Q

% FH in HOCM?

A

30%

44
Q

acute tx of SVT

A

cardioversion if unstable
vagal maneuvers
Adenosine: 0.1mg/kg IV bolus. Can repeat and double. Max 12mg

45
Q

Drug never to use in baby <2y w/ arrhythmia?

A

Verapamil

46
Q

short PR interval, wide QRS, delta wave
Dx?
Complications?

A

WPW

prob: SVT, life threatening afib w/ rapid ventricular rate/sudden death

47
Q

acute tx of ventricular tachycardia

A

cardiovert, amiodarone

48
Q

two causes of congenital heart block

A

mom w/ SLE aBs: anti-Ro/SSA, anti-La/SSB

L transposition of Great arteries

49
Q

most common wide QRS tachycardia in kids?

A

SVT with a bundle branch block

50
Q

long QTC?

A

> 470-480 (99%)

borderline is 440-470

51
Q

inheritance in long QT?

A

autosomal dominant usually if not assoc w/ deafness

52
Q

syncope without prodrome or with emotional / physical stress

EKG with tachycardia w/ polymorphic VT

A

long QT!

53
Q

hallmark arrhythmia in long QT syndrome?

A

torsades, polymorphic vtach

54
Q

recommendation if you see WPW in teen?
Any tests?
Management issue?

A

Do echo, because could be assoc w. CHD
Sports restriction
Not typically genetic/hi risk to other family members

55
Q

neonatal PACs cause what? Tx?

A

p buried in T, PAC causes bradycardia b/c it gets blocked. Benign. observe.

56
Q

CHD with sat in hand LESS than foot?

A

HAS to be TGA, with postductal saturation high, open ductus.

57
Q

valve prob assoc w/ coarctation and Ao

A

bicuspid aortic valve

58
Q

consider this in younger child w/ cardiomyopathy and systemic weakness

A

Becker! Less severe than Duchenne but with out of proportion cardiomyopathy, and sometimes initial presentation

59
Q

Most common CHD presenting in late teen with cyanosis?

A

Tetrology (pink tet) if mild pulm stenosis

60
Q

infant with cyanosis, no CHD and no resp distress. Well water

A

methemoglobinemia

61
Q 
normal sized heart
cyanosis
pulm edema
short systolic murmur, single S2
Full term baby
A

TAPVR

62
Q

normal sats on rt side of heart vs left?

A

right: 70s
Left: close to 100

63
Q

cyanosis on day 1-2, tachypnea, lack of increased vascular markings?

A

likely PDA closing, w/ ductal dependent lesion

64
Q 
asx till 3-5 mos
palpable right ventricular impulse
Single S2
RVH
boot heart
Dx?
A

TOF

65
Q

4 components of TOF?

A

Pulm stenosis
overriding aorta
VSD
RVH

66
Q

what often triggers hypercyanotic hypoxic episode?

Cause?

A

TET spell
often anemia triggered
incr R–>L shunting

67
Q

5 treatments for TET spell

A
  1. knee to chest
  2. morphine
  3. phenylephrine
  4. propanolol
  5. volume expansion
68
Q

precordial hyperactivity
loud S2 but NO murmur
very enlarged heart

A

Hypoplastic Left Heart: looks huge b/c all RV

69
Q

common presentation of hypoplastic left heart?

Tx?

A

10 d newborn with cardiogenic shock, tx: PGE1 to keep ductus open

70
Q

egg shaped heart
single S2
incr pulm vascularity on CXR
tachypnea and cyanosis in newborn

A

tga

71
Q

Single S2: Two disorders and how to distinguish?

A

TGA: increased pulm vascularity
TOF: no incr pulm vascularity

72
Q

generalized facial swelling, fatigue, wt loss, nt sweats, dusky color?

A

venous stasis from Superior Vena Cava syndrome

73
Q

managing Digoxin?

A

about borderline 1st degree heart block with PR of about 200. Not blood levels.

74
Q

diastolic murmur on right OR systolic ejection click at apex

Dx?

A

endocarditis

75
Q

tender lesions on pads of fingers / toes

A

Osler nodes

76
Q

nontender red nodules on palms, soles

A

janeway lesions

77
Q

best study to confirm endocarditis

A

blood culture (not echo)

78
Q

most common bug in acute bacterial endocarditis

A

S aureus

79
Q

most common bug in subacute endocarditis

A

strep viridans

80
Q

most common bug in viral myocarditis

A

coxsackie group B

81
Q

pulsus paradoxus, EKG w/ low volt, abnormal T wave, ST depression,
DX?
Tx?

A

myocarditis

No steroids

82
Q

pericardial friction rub but no change in sound w/ change in position, non-positional

A

purulent pericarditis

83
Q

Very good murmurs?

A

Vs: Very good, venous hum, vibratory, and Vascular (carotid bruit)

84
Q

pansystolic murmur left lower sternal border OR single loud S2 and hyperdynamic precordium

A

VSD

85
Q

Fetal alcohol causes what two heart defects

A

ASD, VSD

86
Q

bad systolic murmurs?

A

pan or late systolic

87
Q

“normal” third heart sound?

A

disappears when child sits up from lying

88
Q

Superior QRS axis (30-90 degrees) found in what?

A

AV canal (conduction goes around the large middle defect)

89
Q

two disorders causing left axis dev?

A

tricuspid atresia and AV Canal Defect

90
Q

two populations when PACs are not okay

A

<1y or children on digoxin

91
Q

Digoxin contraindicated when?

A

WPW

92
Q

SVT: beware of two drugs?

A

Verapamil in babies < 1yr: cardiac arrest

Digoxin: contraindicated in WPW

93
Q

major prognostic indicator with AV block?

A

if its a wide QRS complex in which case: risk of seizure and syncope

94
Q

left axis deviation : 2 causes and ddx them

A

Tricuspid atresia, endocardial cushion defect.

Tricuspid atresia is cyanotic. ECC is not.

Laughing Pedi (24 decks)

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