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My Neo Board Quickfacts > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Most common type of TAPVR

A

supra cardiac

PV enters into vertical vein, azygous, or SVC

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2
Q

Most common cause of complete vascular ring

A

DOUBLE aortic arch (40%)

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3
Q

Embryonic cause of double aortic arch

A

right and left 4th branchial arches

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4
Q

Causes of complete vascular ring

A

Double aortic arch (40%)
Right aortic arch + PDA/ligementum arteriosus (30%)
Aberrant right subclavian artery (20%)
Anomalous innominate artery (10%)
(rare - aberrant left pulmonary artery)

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5
Q

NO synthesase converts ____ into NO in the _______

A

Nitric oxide synthase coverts L-ARGININE into nitric oxide in the ENDOTHELIAL CELLS lining the pulmonary blood vessels

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6
Q

Nitric oxide diffuses into ______activates ________, leading to _______ production

A

Nitric oxide diffuses
into PULMONARY VASCULAR SMOOTH MUSCLE,
activates GUANYL CYCLASE,
leading to cGMP production

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7
Q

Mediators of ductal CONSTRICTION

A

oxygen
prostaglandin F2
acetylcholine
bradykinin

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8
Q

Mediators of ductal DILATION

A

PGE -1
PGE - 2
hypoxia
acidosis

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9
Q

Timeline of ductal closure (functional and anatomic)

A

Term:
functional 48 hrs
anatomic 2-4 wks

Preterm: functional- days to weeks

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10
Q

Reverse differential cyanosis causes

A

D-TGA + PDA + (one of the following):
- PPHN
- coarctation
- interrupted AA

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11
Q

Most common type of VSD

A

Perimembranous VSD(70%) can extend into:

  • trabecular region (most common)
  • inlet (eg AV canal)
  • Infudibular region (eg ToF)
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12
Q

Fetal oxygen saturation in the Umbilical vein

A

*70% - Umbilical Vein
65% - LEFT Atrium, LEFT Ventricle (UV +PV)
65% - PRE-Ductal (to head/upper body)
———
40% SVC (lowest coming from brain)
45% IVC
55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)

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13
Q

Fetal oxygen saturation LA/LV

A

70% - Umbilical Vein
*65% - LEFT Atrium, LEFT Ventricle (UV +PV)
65% - PRE-Ductal (to head/upper body)
———
40% SVC (lowest coming from brain)
45% IVC
55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)

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14
Q

Fetal oxygen saturation to head/upper body

A

70% - Umbilical Vein
65% - LEFT Atrium, LEFT Ventricle (UV +PV)
*65% - PRE-Ductal (to head/upper body)
———
40% SVC (lowest coming from brain)
45% IVC
55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)

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15
Q

Fetal oxygen saturation in IVC and SVC

A

70% - Umbilical Vein
65% - LEFT Atrium, LEFT Ventricle (UV +PV)
65% - PRE-Ductal (to head/upper body)
———
*40% SVC (lowest coming from brain)
*45% IVC
55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)

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16
Q

Fetal oxygen saturation in RA/RV

A

70% - Umbilical Vein
65% - LEFT Atrium, LEFT Ventricle (UV +PV)
65% - PRE-Ductal (to head/upper body)
———
40% SVC (lowest coming from brain)
45% IVC
*55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)

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17
Q

Blood flow to lungs
2nd trimester
3rd trimester
>38 weeks gestation

A

2T - 7-15%
3T - ~35% (pulmonary vessel growth)
>38w - 20% (pulmonary vessels become sensitive to hyperemic environment and constrict)

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18
Q

Percentage of fetal blood flow to the placenta

A

45%

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19
Q

Percentage of fetal blood flow that crosses the PDA

A

60%

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20
Q

Percentage of total fetal blood flow from RV and LV

A

RV - 66%
LV - 34%

Head/upper body ~20%
Lower body ~70%

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21
Q

Fetal blood flow to coronaries (%)

A

3%

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22
Q

First degree heart block a/w :

A

(PR interval prolonged 2/2 delay in AV node)

myocarditis
digoxin toxicity
hypERkalemia
hypOthyroid
congenital heart disease

(tx not usually needed)

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23
Q

Two equations for Cardiac Output

A

CO = HR x Stroke Volume

CO = Systemic BP / Total PVR

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24
Q

Most common type of cardiac lesion in Tri21

A

endocardial cushion defect

ECG - superior axis deviation (this lesion causes superior displacement of the AV node)

25
Q

Most common cause of hypertrophic cardiomyopathy

A

Noonan syndrome

26
Q

High lying UAC have fewer clinically obvious _______
than low lying UACs

A

fewer clinically obvious ISCHEMIC COMPLICATIONS

27
Q

congenital heart block typically diagnosed at _____ gestation

A

16-24 wks

*fewer than 1/3 of affected infants have a diagnosis of SLE

28
Q

mortality rate for fetus/newborn with congenital heart block from anti-SSA/Ro and anti-SSB/La antibodies

29
Q

Most common cyanotic lesion to present in the first week of life

A

D-TGA

(5-10% of all CHD)

30
Q

Treatment for a-flutter (med)

31
Q

Most common congenital heart lesion

32
Q

Recurrence rate for ToF in siblings of affected children

33
Q

At what embryonic week do endocardial cushions come together to create the intracardiac septa

A

week 5 : cardiogenesis (paired heart tubes)
tubes fuse and fold
week 6 : heart beat
week 7-8: septation

34
Q

PDA arises from what aortic arch

35
Q

What arises from the 6th aortic arch

A

PDA
Proximal pulmonary arteries

36
Q

Third aortic arch

A

carotid artery

37
Q

4th aortic arch

A

Left: part of the aortic arch

Right: right subclavian artery

38
Q

Organ that aids in clearance and metabolism of prostaglandins

A

Lungs - but only after pulmonary blood flow is increased after birth

39
Q

TTTS
- cardiac defects are are more prevalent in the _______ twin
- ______ fold increase in frequency of congenital heart defects
- most frequent defects are ______

A
  • more prevalent in RECIPIENT twin
  • 3 fold increase
  • VSD, ASD, Pulm stenosis
40
Q

Effect of treating hypotension w/ fluid bolus in preterm neonates

A

transient increase in BP (2-4 mmHg)

when compared with placebo, IVF bolus showed NO DIFFERENCE in BP or mortality

*majority of hypotensive preterm infants are euvolemic

41
Q

Extracardiac anomalies present _____% of the time w/ Truncus

A

20-40%

(a/w 22q11)

42
Q

Normal neonatal ECG findings
(that would be abnormal in adult)

A

(elevated right-sided forces as pulm pressures dropping)

QRS axis deviated to the right
upright T waves in V1 (right ventricular strain)
small QRS voltages in limb leads
small T wave voltages

43
Q

Tall peaked P waves in neonates

A

Abnormal –> Right atrial enlargement

45
Q

Cri du Chat chromosome

A

5th
- partial deletion short arm of Ch 5
- deleted portion is paternal 80% of de novo events

46
Q

Cri du chat cardiac

A

30%
VSD
PDA
ToF

47
Q

thumb hypoplasia
colobomas
microcephaly
high nasal bridge
large ears
short big toe

A

13q deletion

also:
CHD
increased risk of retinoblastoma (bilateral)
ptosis
cryptorchidism, hypospadius

48
Q

Greek warrior helmet

(broad beaked nose, high forehead, hypertelorism, supraorbital ridge continuous with nasal bridge)

A

Wolf Hirshorn
4p deletions syndrome

also: low set simple ear with pre auricular dimple

seizure, severe cognitive deficits
cardiac
GU - hypospad/cryptorchidism

49
Q

elfin facies
upturned nose
hypercalcemia
SUPRAvalvular aortic stenosis

A

Williams

“cocktail party personality”

50
Q

Most common chromosomal deletion in humans

A

22q11.2

1 in 4000 live births
AD

51
Q

Rubenstein-Taybi

A

16p13
- encodes cAMP regulated enhancer binding protein (CREB)
- sporadic
*1/4 submicroscopic deletion (some point mutations)

cardiac 25%
brad thumbs
broad first toes

52
Q

MC cyanotic heart defect identified in the first week of life

53
Q

central cyanosis occurs when deoxygenated Hgb exceeds _____ g/dL

54
Q

hypOcalcemia -> _________ QT interval

55
Q

cyanotic CHD
single S2
left superior axis on ECG

A

Tricuspid Atresia

(likely)

56
Q

MC heart defect in congenital rubella

A

PDA

(50% chance of cardiac defect)

57
Q

Williams heart defect

A

supravalvular sub aortic stenosis

My Neo Board Quickfacts (11 decks)

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