Cardiology Flashcards
A teen receiving research protocol chemotherapy, including high dose steroids, develops acute HTN. She has no other symptoms, but BP is co sistantly 140/90. In addition to assessment of fluid status what is the best initial management?
Administer oral diuretic QID
10-day old infant underwent a Norwood procedure for HLH syndrome 4 days ago. He is now being weaned from the vent. The plan is to begin dexamethazone this evening and extubate in the AM. Feedings were started yesterday. Today his abdomen is slightly more distended and full. What is the best initial study to perform?
Abdominal Radiograph
What medication would you anticipate prescribing for a 5 month old infant with an unrepaired VSD and CHF that is already taking furosemide at home?
Aldactone
Most concerning complication of Kawasaki disease is what?
Coronary Artery aneurysm
What education do you need to provide to patients and family that are prescribed beta blockers for prolonged QT syndrome?
Avoid other medications which can prolong QT interval
What is the common radiological finding in a child with total anomalous pulmonary Venus return (TAPVR)?
Snowman sign ⛄️
A child 2 days post op of VSD repair has been unable to be weaned from the vent. An ECHO suggests pulmonary HTN. Best management includes:
Nitric oxide inhalation through ventilation circuit
An otherwise healthy 2 month old has SOB prior to feeding at home and arrives to the ER for concerns of resp.distress. She is tachypneic, with O2 sats of 96%. The cardiac monitor notes a narrow complex irregular rhythm with a HR of 240and a palpable pulse. What is the most important inital management?
Documenting the rhythm of the EKG
A 3 year old arrives to the ER with low grade fever, lethargy, and hypotension who is suspected to have myocarditis
What diagnostic test should be performed immediately?
ECHO
When performing an assessment on a 3 year old what would be a cause for concern?
A.) Brachial femoral lag as both are palpated simultaneously
B.) Heart sounds heard loudest on the left side of chest
C.) PMI noted at the mid clavicle line
D.) Split S2 ascultated on inspiration
A.) Brachial femoral lag as both are palpated simultaneously
In the acute post op phase following cardiac surgery measures to reduce pulmonary arterial pressure will include what measures?
Maintaining alkalosis and administration of nitric oxide
A child who had open heart surgery two weeks ago is suspected to have post op pericardiotomy syndrome. In addition to fever what other findings would you anticipate?
Muffled heart sounds, hypotension, jugular vein distention
What cardiac finding is most commonly seen on and ECHO of a patient with Marfan syndrome?
Mitral valve prolapse
4 year old is being scheduled for an adenoidectomy. A history what would warrant an ECHO prior to the procedure?
Right ventricular hypertrophy
An infant with unrepaired tetrology of fallot is admitted for emesis. Urgent surgical intervention is warranted for what finding?
Hypercyanotic spells
School aged child with upper respiratory symptoms for several days presents with complaints of midsternal chest pain. Physical exam shows JVD, muffled heart sounds, and a friction rub on ascultatuon. EKG demonstrates PR segment depression. What is the most likely diagnosis?
Pericarditis
What is the medical management of a 2 year old previously undiagnosed uncomplicated coarctation of the aortic has normal growth and development with stenosis is located just distal of the left subclavian artery?
Monitoring upper extremity blood pressures for hypertension.
A school aged child presents with fever for 5 days and nonraised reddened flat lesions on soles and palms and raised tender lesions with pale centers on finger and toe pads (Janeway lesions). What is the most likely etiology?
Endocarditis
An adolescent male presents with a history of occasional chest pain, SOB, and dizziness during exercise. His EKG is abnormal with evidence of left ventricular hypertrophy and QT segment changes. Family history reveals his grandpa died at 35 of unknown causes. What heart condition on the differential list would be of highest concern?
Hypertrophic cardiomyopathy
A child with congenital heart disease fell while playing and presents with a humerus fracture that is closed. Physical exam reveals mild bradycardia and moderate pain. Which medication would likely be the cause of bradycardia for this child?
Propranolol (inderal)
Critical congenital heart disease screening is completed for a 1 day old infant. Subsequent hyperoxia tests were performed. Physical exam reveals increased irritability and decreased bilateral femoral pulses. After obtaining vascular access what medication should be started?
Alprostadil
A two day old with dysmorphic features, 22Q11.2 deletions, is diagnosed with an interrupted aortic arch. There is need for further evaluation for what?
Immune dysfunction
An echo for a child who underwent patch closure for VSD demonstrates a small patch leak. What education does the patient and family need regarding this finding?
Antibiotics are needed prior to dental procedures to reduce the risk of infective endocarditis.
What physical assessment finding is consistent with a diagnosis of coarctation of the aorta in an asymptomatic school aged child?
Right upper extremity hypertension and weak femoral pulses
A newborn female whose weight and length are between 2 and 10 percentile, respectively for gestational age has significant pedal edema, a low hairline and skin fold at the nape of the neck. What diagnostic study would be performed?
ECHO
An infant presents with irritability, poor feeding, and a heart rate of 290 bpm. Following stabilization what anticipatory guidance should be provided to the caregiver of this infant?
Infant will likely outgrow the problem by age 1 year
What murmur is holosystolic, diastolic, increases intensity with standing, is harsh and is often accompanied by other genetic disorders?
Pathologic (bad)
