Cardiology

Question 1

Failed CCHD screen

Answer 1

SpO2 < 90% in R hand or either foot

> 3% discrepancy x 3 between R hand and either foot

Question 2

Murmur
Vibratory
Venous

Answer 2

Innocent

Question 3

Murmur
3rd heart sounds disappears when sitting up

Answer 3

Normal

Question 4

Fixed split 2nd heart sound

Answer 4

ASD

Question 5

Cause of murmur in ASD

Answer 5

Increase in flow through the PV and sometimes PA branches

Question 6

Murmur
Blowing/harsh
Holosystolic
LLSB

Answer 6

VSD

Question 7

Systolic ejection click
Varies with respiration

Answer 7

Pulmonary stensosis

Question 8

Systolic ejection click
Does NOT vary with respiration

Answer 8

Aortic stenosis

Question 9

Continuous machine-like murmur
Bounding femoral pulses

Answer 9

PDA

Question 10

Superior QRS axis
Down syndrome

Answer 10

AV canal defect

Question 11

Vibratory murmur
Louder in spine

Answer 11

Still’s murmur

Question 12

Murmur disappears with pressure on the jugular vein

Continuous murmur heard in 1st and 2nd R intercostal spaces that varies in intensity just by changes in neck position

Answer 12

Venous hum

Question 13

LVH without Left axis deviation

Answer 13

Hypertrophic cardiomyopathy

Question 14

Left axis deviation without LVH

Answer 14

Tricuspid atresia
AV canal defects

Question 15

Causes of differential cyanosis

Answer 15

TGA + Aortic obstruction (CoA or iAA) or pulmonary hypertension

Question 16

3 causes of severe cyanosis in immediate newborn period

Answer 16

TGA
Pulmonary atresia
Ebstein malformation

Question 17

Main side effects of prostaglandin E1

Answer 17

Fever
Apnea

Question 18

Cyanotic heart disease without murmur

Answer 18

TGA
Tricuspid atresia
Pulmonary atresia
TAPVR

Question 19

4 components of Tetralogy of Fallot

Answer 19

Pulmonary stenosis
Overriding aorta
VSD
RVH with right axis deviation on EKG

Question 20

Boot shaped heart on CXR
Single 2nd heart sound
Decreased pulmonary vascularity

Answer 20

Tetralogy of Fallot

Question 21

Complications after coarctation repair

Answer 21

Recurrence
Hypertension

Question 22

Complications of tetralogy repair

Answer 22

Arrhythmia
Syncope

Question 23

Management for Tet spells

Answer 23

Squatting
Morphine
Phenylephrine
Propranolol
Volume expansion

Question 24

Inability to hear previous murmur
CHD

Answer 24

Tet spell

Question 25

Most common congenital heart lesion

Answer 25

Transition of Great arteries

Question 26

Single 2nd best sound Increased pulmonary vascularitis

Answer 26

Transposition of great arteries

Question 27

Genetic condition Conotruncal defect VSD

Answer 27

22q11 deletion

Question 28

Genetic condition AV canal defect VSD

Answer 28

Down syndrome

Question 29

Genetic condition Aortic root dilation and dissection Mitral valve prolapse

Answer 29

Marfan syndrome

Question 30

Genetic condition Supravalvular aortic stenosis

Answer 30

William syndrome

Question 31

Genetic condition Supravalvular pulmonic stenosis

Answer 31

Noonan syndrome

Question 32

Genetic syndrome Coarctation of aorta

Answer 32

Turner syndrome

Question 33

Most common symptomatic arrhythmia in children

Answer 33

Supraventricular tachycardia

Question 34

Prolonged QT Treatment

Answer 34

QTc > 460 Propranolol

Question 35

Most likely cause if Vtach + loss of consciousness

Answer 35

Torsades de pointes

Question 36

Diagnosis of Rheumatic fever

Answer 36

Recent group A strep infection 2 major criteria Or 1 major + 2 minor criteria

Question 37

Major (Jones) criteria for rheumatic fever

Answer 37

Polyarthritis Carditis Subcutaneous nodules Erythema marginatum Sydenham chorea

Question 38

Minor (Jones) criteria for rheumatic fever

Answer 38

Arthralgia Fever Elevated acute phase reactants Prolonged PR interval

Question 39

Most common murmur in rheumatic fever

Answer 39

Mitral valve regurgitation

Question 40

Tender nodules on pads of fingers/toes

Answer 40

Osler nodes

Question 41

Non-tender red nodules on palms/soles

Answer 41

Janeway lesions

Question 42

Best study to diagnose endocarditis

Answer 42

Blood culture

Question 43

Most common cause is acute bacterial endocarditis in children

Answer 43

Staph aureus

Question 44

Treatment for staph aureus endocarditis

Answer 44

Vancomycin + beta lactamase resistant antibiotic (nafcillin, oxaxillin, cefazolin) 2-8 weeks

Question 45

Criteria for antibiotic prophylaxis for endocarditis

Answer 45

Unrepaired cyanotic heart disease Heart disease surgically correct with hardware and other devices within the previous 6 months Any residual defect near a prosthetic cardiac device Prosthetic cardiac valve Previous infective endocarditis Cyanotic CHD Repaired CHD Cardiac transplant

Question 46

Timing of antibiotic prophylaxis for endocarditis

Answer 46

PO amoxicillin (50mg/kg or adult 2g) 60 minutes prior to the procedure

Question 47

Most common cause of myocarditis

Answer 47

Coxsackie group B virus

Question 48

Most common bacterial cause of pericarditis

Answer 48

Staph aureus

Question 49

Most important study to order when pericarditis or effusion is suspected

Answer 49

CXR

Question 50

Harsh crunch-like systolic sound over the precordium

Answer 50

Pneuomediastinum

Question 51

Harsh crunch like systolic sound over the precordium

Answer 51

Pneumomediastinum Hamman sign

Question 52

Anterior filling defect in esophagus on lateral projection

Answer 52

Pulmonary sling