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Peds > Cardiology > Flashcards

Cardiology Flashcards

embryology is not included

1
Q

most congenital heart defects are a result of problems with ..

A

either septation, rotation, or migration

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2
Q

two classification of congenital heart dz

A
  1. acyanotic (left to right shunt)

2. cyanotic (right to left shunt)

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3
Q

2 broad categories of cyanotic CHD

A
  1. intra-cardiac defects and obstruction to pulmonary flow

2. admixture of pulmonary and systemic venous return

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4
Q

Physical findings for CHD

A

1.cyanosis (need 5 mg/dl of de ox blood
2. if anemic, it might be hidden
3. check both upper and lower extremities saturation
4. arterial pulse - absent, bounding, delayed
5-heart sound-S2 split or not, fixed split, murmurs

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5
Q

innocent murmur

A
  • Still’s murmur is a musical/vibratory systolic LSB, not in back, decreased w/expiration/standing
  • Physiologic peripheral pulmonic stenosis which is a soft harsh SEM best heard in axillae bilaterally and disappears by 12 MONTHS
  • venous hum
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6
Q

Phyisiologic peripheral pulmonic stenosis is a soft harsh SEM best heard in

A

axillae BILATERALLY

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7
Q

venous hum is a/w

A

innocent murmur

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8
Q

…is a musical/vibratory systolic LSB, not in back, decreased w/expiration/standing

A

Still’s murmur

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9
Q

List acyanotic CHD.

A

PDA, ASD, VSD, atrioventricular canal, coarctation of aorta

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10
Q

most common of all CHD

A

VSD

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11
Q

murmur in VSD

A

holosystolic @LLSB, loud if restrictive

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12
Q

PE findings in large VSDs

A

failure to thrive, tachypnea, GERD

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13
Q

most common defect in down syndrome

A

VSD

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14
Q

lab findings in VSD

A

ECG: LVH
CXR: cardiomegaly, increased pulmonary vascular markings
Echo: location, size. pressure gradient, other defects
Cath: if unclear of size and sx , indications for surgery

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15
Q

VSD medical managements

A

diuretic, ACE, digoxin

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16
Q

indication for surgery in VSD

A
  1. unmanageable HF
  2. failure to med mostly due to failure to thrive, URI, pneumonia
  3. shunt greater than 1.5-2 w/wo sx
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17
Q

most common type of ASD

A

secundum ASD

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18
Q

2nd most common CHD

A

ASD

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19
Q

risk of paradoxical emboli is a/w

A

ASD

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20
Q

sx of ASD

A

usually asx, fatigue, palpitation, exercise intolerance

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21
Q

never leave ASD open in … pts

A

young girls approaching puberty

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22
Q

development of eisnmenger’s is a risk for what CHD

A

ASD

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23
Q

synonyms of Atrioventricular Septal Defects (AVSD)

A

endocardial cushion defects, atrioventricular canal defects (AVCD)

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24
Q

types of AVSD

A
  1. complete : a.common AV valve b. primum ASD c. inlet VSD

2. Partial: MOST FREQUENT FORM = primum ASD +cleft anterior MV leaflet

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25
Q

most common prenatal dx of CHD

A

AVSD

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26
Q

AVSD is very common with …what trisomy

A

21 -down syndrome —usually the complete form

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27
Q

AVSD with Tetralogy almost unique to what trisomy

A

21-down syndrome

28
Q

complete AVSD usually results in

A

PA HTN, CHF

29
Q

complete AVSD vs Partial AVSD

A

Complete: Large ASD & Large VSD
Partial: Large ASD & no VSD

30
Q

repair of partial VSD at what age?

A

delayed until after 18-24 mos old

31
Q

problems a/w partial VSD

A

subaortic stenosis and LAVV regurgitation or stenosis

32
Q

PDA leads to enlarged …

A

RA, RV, LV

33
Q

PDA signs and sx

A

Continuous machinery murmur, wide pulse pressure, hyperdynamic precordium

34
Q

PDA closure approaches

A

medical: indomethacin, ibuprofen
catheter based: coil, device
surgical: left thoractomy

35
Q

three surgical method for closure of PDA

A
  1. clip-premees
  2. ligate-neonates, infants, young children
  3. divide and oversew-toddlers and older
36
Q

coarctation of aorta

A

juxtaductal just distal or at left subclavian artery

37
Q

signs and sx a/w coarctation of aorta

A

proximal hypertension-pressure differential

murmur- systolic, LUSB and left interscapular may be continuous

38
Q

murmur in coarctation of aorta

A

systolic, LUSB and left interscapular may be continuous

39
Q

coarctation of aorta is a/w what syndrome

A

turner’s syndrome

40
Q

presentation of coarctation of aorta in infants

A

irritability, tachypnea, poor feeding, FTT, CHF

41
Q

presentation of coarctation of aorta in older children and teens

A

HA, nosebleed, absent/diminished femoral pulses, unexplained HTN

42
Q

rib-notching is a/w

A

coarctation of aorta

43
Q

lab findings in coarctation of aorta

A

ECG: LVH
CXR: cardiomegaly, rib-notching (takes several years to develop)
Echo: useful but difficult to visualize but diagnostic
CT-angio/MRA : gold standard

44
Q

gold standard dx for coarctation of aorta

A

CT-angio/MRA

45
Q

tx of coarctation of aorta

A

surgical (stent is reserved for recurrent coarctations)

46
Q

cyanotic CHD

A

truncus arteriosus, transposition, tetralogy of fallot, TAPVR

47
Q

truncus arteriosus

A
  • common truncus-failure to septate into aorta and pulmonary artery
  • large VSD with right to left shunt
  • CHF with diastolic runoff
48
Q

DiGeorge syndrome is a/w

A

truncus arteriosus

49
Q

when to repair truncus arteriosus?

A

first 2 weeks of life

50
Q

transposition of great vessels (dTGA)

A

aorta and PA did not rotate

51
Q

transposition of great vessels (dTGA)

A

cyanotic, coronary anomalies,

PGE started BAS performed - need adequate mixing

52
Q

gold standard for dTGA repair

A

arterial switch operation-true anatomic repair done in first 2 weeks of life

53
Q

“egg on a string appearance “ on CXR is a/w

A

dTGA

54
Q

tetralogy of fallot

A
  1. Right Ventricular Outflow Tract obstruction -infundibular often with valvar and supravalvur stenosis
  2. VSD
  3. overriding aorta
  4. RVH
55
Q

when to fix TOF?

A

by 3-6 months or sooner if blue

56
Q

TAPVR

A

Total Anomalous Pulmonary Venous Connection

57
Q

most common cyanotic heart anomaly

A

TOF

58
Q

murmur in TOF

A

crescendo-decrescendo holosystolic at LSB radiating to back

59
Q

murmur in d-TGA

A

systolic if associated VSD

60
Q

cyanosis that alleviated with squatting is a/w

A

TOF

61
Q

differences btw arterial pulses and BP in UE and LE is pathognomonic for …

A

coarctation of aorta

62
Q

boot shaped heart (coeur en sabot) is a/w

A

TOF

63
Q

most common site of coarctation of aorta

A

ligamentum arteriosum

64
Q

wide fixed split SD is a/w

A

ASD

65
Q

loud S2 is a/w

A

dTGA

Peds (8 decks)

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