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3a Child Health > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What are switched in transposition of the great arteries?

A

Pulmonary artery and aorta - the aorta arises from the RV and PA from the LV

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1
Q

What does survival in transposition of the great arteries depend upon?

A

A shunt being also present - PDA, ASD, VSD. If there is no shunt, there is no mixing of systemic and peripheral circulations

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2
Q

Describe the presentation of transposition of the great arteries

A

Cyanosis at birth/ within 24 hours, tachycardia, respiratory distress, sweating, poor feeding and weight gain

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3
Q

What does the CXR show for transposition of the great arteries?

A

Eggs on a string - narrow mediastinum and cardiomegaly

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4
Q

What is the gold standard diagnosis for transposition of the great arteries?

A

ECHO

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5
Q

What is given to maintain the ductus arteriosus?

A

Prostaglandin infusion

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6
Q

Name 3 causes of infective endocarditis

A

Strep viridans (dental work), staph aureus (IV DU), staph epidermis (prosthetic heart valves)

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7
Q

What does FROM JANE stand for in IE?

A

Fever, Roth spots, Osler nodes, Murmur (new), Janeway lesions, anaemia, nails (splinter haemorrhages) and emboli

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8
Q

What is the gold standard diagnosis for IE?

A

Echo shows vegetation on the pulmonary valve

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9
Q

Describe the treatments for IE dependent on cause

A

IV ben pen for strep, IV fluclox for staph aureus and IV amox for unknown

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10
Q

What is rheumatic fever?

A

A type 2 hypersensitivity reaction that can occur 2-4 weeks after strep pyogenes infection (tonsilitis)

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11
Q

What is an atrial septal defect?

A

A hole in the septum between the two atria connecting left and right sides causing a left to right shunt

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12
Q

What is the most common form of ASD?

A

ostium secondum

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13
Q

What is the murmur of ASD?

A

Mid systolic crescendo-decrescendo murmur loudest at the upper left sternal border

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14
Q

What is a ventricular septal defect?

A

A hole in the septum between the two ventricles

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15
Q

What is often underlying in VSD?

A

A genetic condition such as Downs or Turners

16
Q

What is the murmur of VSD?

A

Pansystolic murmur heard loudest at the left lower sternal border in the 3rd and 4th intercostal spaces

17
Q

Name the 4 co-existing pathologies of tetralogy of fallot

A

Pulmonary Valve Stenosis, Right Ventricular Hypertrophy, Overriding Aorta and VSD

18
Q

What is the overall direction of the Tetralogy of Fallot shunt?

A

right to left

19
Q

What are tet spells?

A

Periods where the shunt worsens when pulmonary vascular resistance increases or systemic decreases causing a cyanotic episode

20
Q

What is shown on CXR for T of F?

A

Boot shaped heart

21
Q

What is the gold standard management for T of F?

A

total surgical repair via open heart surgery

22
Q

What is PDA?

A

Persistent connection between aorta and pulmonary artery which normally closes permanently within 2-3 weeks

23
Q

How does PDA present?

A

SOB, difficulty feeding, poor weight gain, tachypnoea, lower RTI

24
Q

What is the murmur of PDA?

A

Continuous machinery murmur crescendo-decrescendo

25
Q

What can be given in PDA to inhibit prostaglandin?

A

Indomethacin

26
Q

What is Eisenmenger Syndrome?

A

Blood flows from the right side of the heart to the left across a structural heart lesion, bypassing the lungs causing by PDA, ASD, VSD

27
Q

What is aortic valve stenosis?

A

Narrow aortic valve restricting blood flow from LV to aorta. The aortic valve normally has 3 leaflets called the aortic sinuses of Valsalva

28
Q

What is the presentation of AVS?

A

Mild can be asymptomatic
More significant - fatigue, SOB, dizziness, fainting, worse on exertion

29
Q

What is the murmur of AVS?

A

Ejection systolic loudest at the aortic area with an ejection click

30
Q

What is the presentation of heart failure?

A

Sweating, SOB, poor weight gain and feeding, tachypnoea, hepatomegaly, cardiomegaly, tachycardia, gallop rhythm and older children can present with adult signs such as raised JVP, oedema and paroxysmal nocturnal dyspnoea

31
Q

What is the most common abnormal rhythm in children?

A

supraventricular tachycardia

32
Q

What does ECG of SVT show?

A

Narrow complex tachycardia of 250-300 bpm

33
Q

What is the treatment for SVT?

A

Carotid sinus massage, IV adenosine and maintenance with solatol or flecanide

34
Q

What is Wolff Parkinson White?

A

Pre-excitation syndrome due to abnormal re-entry circuit of the AV node accessory pathway (Bundle of Kent)

35
Q

What does the ECG of Wolff Parkinson White show?

A

Short PR interval and delta wave

36
Q

What is the definitive management of Wolff Parkinson White?

A

Catheter ablation of the extra pathway

37
Q

What is long QT syndrome?

A

Autosomal dominant - causes blackouts and palpitations

38
Q

What is the most common cardiac defect in babies of diabetic mothers?

A

Transposition of the great arteries

3a Child Health (14 decks)

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