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Pediatrics > Cardiology > Flashcards

Cardiology Flashcards

1
Q

x ray findings CHD

A

cardiomegaly
overcirculation- prominence of pulmonary vasculature
characteristic shapes

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2
Q

CXR transposition of the great arteries

A

egg on a string

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3
Q

CXR T of F

A

boot shaped heart

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4
Q

Differential pulses (weak LE)

A

coarctation of the aorta

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5
Q

Bounding pulse = run-off lesions

A

L-R PDA

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6
Q

weak pulses

A

cardiogenic shock

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7
Q

pulsus paradoxus

A

an exaggerated SBP drop with inspiration → tamponade or bad asthma

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8
Q

pulsus alternans

A

altering pulse strength → LV mechanical dysfunction

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9
Q

sound of closing of mitral and tricuspid valves

A

S1

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10
Q

sound of closing of aortic (A2)and pulmonic (P2) valves

A

S2

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11
Q

sound heard in diastole ,related to rapid ventricular filling , can be normal, or abnormal -accentuated with dilated ventricles

A

S3

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12
Q

sound late in diastole just before S1 – always bad

A

S4

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13
Q

Heart murmurs which occur in the absence of anatomic or physiologic abnormalities of the heart or circulation

A

innocent or benign murmur

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14
Q

when would you hear ejection click

A

AS or PS

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15
Q

when would you hear mid systolic click

A

MVP

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16
Q

when would you hear loud S2

A

pulmonary HTN

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17
Q

when would you hear a single S2

A

one semilunar valve (truncus), anterior aorta (TGA), pulmonary HTN

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18
Q

when would you hear a fixed, split S2

A

ASD, PS

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19
Q

when would you hear a gallop

A

may be due to cardiac dysfunction/ volume overload

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20
Q

Functional murmur: heard first days of life, LLSB , 1-2/6 , gone by 2-3 weeks of life

A

Newborn

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21
Q

Functional murmur often in newborn period from branching PA. Heard in axillae and back short, high pitched 1-2/6

A

peripheral pulmonary arterial stenosis

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22
Q

Functional murmur: most common murmur of early childhood. Heard ages 2-7yrs. Musical, vibratory, mid to lower LSB, 1-3/6. loudest when patient supine

A

Still murmur

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23
Q

when would you hear muffled heart sounds or a rub

A

pericardial effusion ± tamponade

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24
Q

Functional murmur: most common innocent murmur in older children, ages 3 yrs and up. ULSB, soft ejection murmur , 1-2/6.

A

Pulmonary ejection murmur

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25
Q

Functional murmur: heard after age 2, infraclavicular R>L, Continuous musical hum. Best heard sitting. Comes from turbulence at confluence of subclavian and jugular vein

A

Venous hum

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26
Q

Functional murmur: older child and adolescent. Rt supraclavicular area, harsh, 2-3/6

A

Innominate or carotid bruits

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27
Q

syncope in kids is usually due to

A

Vasovagal or neurocardiogenic factors

circulation, cardiac disease less common

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28
Q

common origin of chest pain in kids

A

musculoskeletal

rarely cardiac in origin

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29
Q

most common rhythm disturbance in kids

A

PAC Some conducted, some non-conducted. Slight not-quite compensatory pause before next beat. Benign

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30
Q

less common rhythm disturbance in kids…wide QRS, no compensatory pause, typically benign unless they come several in a row

A

PVC

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31
Q

Supraventricular tachycardia ddx

A

re-entrant tachycardia (wolff-parkinson-white)

prolonged QTc syndrome

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32
Q

How do you stop re-entrant tachycardia

A

Adenosine

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33
Q

how do you manage re-entrant tachycardia

A

beta blockers

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34
Q

this heart block is associated with a prolonged PR

A

first degree

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34
Q

what can maternal lupus cause

A

congenital heart block (3rd degree)

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34
Q

this heart block happens when not all P waves are conducted

A

second degree

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34
Q

heart disease in children is commonly

A

congenital heart disease due to structural abnormalities

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37
Q

most common CHD presenting in the first week of life

A

transposition of the great arteries

38
Q

Acyanotic kid, what kind of shunt?

A

Left to Right shunt or

Obstruction to outflow

39
Q

most common CHD presenting beyond infancy

A

tetralogy of fallot

39
Q

Pulm flow in decreased in what type of shunt

A

right to left

40
Q

Cyanotic kid, what kind of shunt?

A

Right to Left shunt or

Parallel circuit

41
Q

Acyanotic kid, what kind of shunt?

A

Left to Right shunt or

Obstruction to outflow

42
Q

Pulm flow in increased in what type of shunt

A

Left to Right shunt – blood flows to chamber with lower pressure

42
Q

VSD cyanotic or noncyanotic

A

noncyanotic

43
Q

PDA cyanotic or noncyanotic

A

noncyanotic

44
Q

pulmonic stenosis cyanotic or noncyanotic

A

noncyanotic

45
Q

ASD cyanotic or noncyanotic

A

noncyanotic

46
Q

aortic coarctation cyanotic or noncyanotic

A

noncyanotic

48
Q

ASD treatment

A

Most will close on their own, but if its present after 2 years old, need to close. ASDs may be closed either by device placement during catheterization or surgically

50
Q

Kid comes in:
Easy fatigueability
Acyanotic, RV lift, normal pulses
Persistently split second heart sound (S2)
Pulmonary ejection murmur
Diastolic flow murmur over tricuspid valve

51
Q

ASD treatment

A

Most will close on their own, but if its present after 2 years old, need to close. ASDs may be closed either by device placement during catheterization or surgically

52
Q

kid comes in:
Congestive heart failure
Poor growth
Shortness of breath/Increased respiratory effort
Easy fatigue
Recurrent respiratory infections
Patients with small defects can be asymptomatic

52
Q

how do we keep a PDA open

A

prostaglandins

53
Q

Kid comes in with “bounding” precordial activity and a yolosystolic murmur, harsh
LLSB, +/- thrill

54
Q

what is usually the first sign of AS

A

murmur
Ejection click
Basilar ejection murmur
Precordial or suprasternal thrill

55
Q 
AV valve insufficiency
Heart Failure over 6-8 weeks
Poor growth
Trisomy 21
What shunt is this most likely?
56
Q

most common form of AS

A

you have a bicuspid aortic valve rather than a tricuspid valve

56
Q

associated defect with CoA

A

bicuspid aortic valve

58
Q

treatment for AS (mild does not require tx)

A

All treatment is palliative
Balloon valve angioplasty
Surgery , valve replacement

59
Q

TOF cyanotic or acyanotic

59
Q

tricuspid atresia cyanotic or acyanotic

60
Q

Narrowing near where the ductus enters the aorta

61
Q

TAPVR cyanotic or acyanotic

62
Q

Older kid comes in with hypertension, absent or weak femoral pulses, leg cramps, chronic pulmonary congestion, headaches, epistaxis. Also, hear a blowing systolic murmur in the left axilla

63
Q

truncus arteriosis cyanotic or acyanotic

64
Q

DORV cyanotic or acyanotic

65
Q

hypoplastic left heart syndome cyanotic or acyanotic

66
Q

pulmonary atresia cyanotic or acyanotic

67
Q

DORV cyanotic or acyanotic

68
Q

what type of murmur with TGA

68
Q

TOF- four defects

A

large VSD
Pulmonary stenosis
Right ventricular hypertrophy
An overriding aorta (moves toward the midline)

68
Q

most common cyanotic lesion

68
Q

a hallmark of severe TOF

A

hypoxemic spells (tet spells)

73
Q 
Sudden onset or deepening of cyanosis
Sudden onset of dyspnea
Alterations of consciousness
Decrease in intensity of systolic murmur
WHATS HAPPENING?
74
Q

TOF treatment

A

PGE1 (prostaglandin to keep PDA open)
Create an emergency systemic to pulmonary shunt
Complete surgical repair

77
Q

treatment TGA

A 
Ballon septostomy
Create ASD
Prostaglandin infusion
Ductal dependent
Surgical Correction
78
Q

this type of defect presents in older child w/ murmur, exercise intolerance, or HTN (in CoA)
Not cyanotic

A

Non-ductal dependent

  • m/m AS
  • m/m CaO
  • m/m PS
79
Q

study of choice to evaluate heart failure

80
Q

most common type of cardiomyopathy

81
Q

this disease will present with narrowed pulse pressure

A

cardiomyopathy

82
Q

infectious causes of cardiomyopathy

A

echovirus, coxsackie B

83
Q

treatment cardiomyopathy

A

diuretics, inotropic meds, afterload reducers

84
Q

most common cause of pericarditis

85
Q

most common bacterial cause of pericarditis

A

Staph A, strep pneumo

86
Q

best test for pericarditis

87
Q

this infection is typically a complication of CHD and surgery. It is subacute and slowly progressive

A

Endocarditis

88
Q

most common acquired heart disease

89
Q

Onset: 1 – 3 weeks following group A beta-hemolytic strep throat / pharynx infection

A

acute rheumatic fever

90
Q

what does the Jones criteria tell us

A

helps determine if its rheumatic fever

91
Q

treatment for acute rheumatic fever

A

PCN G
aspirin
corticosteroids

92
Q

what is our main concern with kawasaki disease

A

Coronary artery dilation

93
Q

treating kawasaki

A

IVIG and high dose ASA

Pediatrics (15 decks)

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