Cardiology

Question 1

mention Cyanotic CHD

Answer 1

1. F4
2. Tricuspid Atresia
3. TAPVR
4. TGA
5. Truncus arteriosus

first 3 (TAPVR with obstruction) is associated with Lung Oligemia

Question 2

what is CHD associated with Down $ (Trisomy 21)

Answer 2

1. ECD
2. VSD

Question 3

what is CHD associated with Edward $ (Trisomy 18)

Answer 3

1. VSD
2. ASD
3. PDA

Question 4

what is CHD associated with Patau $ (Trisomy 13)

Answer 4

1. VSD
2. Dextrocardia

Question 5

what is CHD associated with Congenital rubella

Answer 5

PDA

Question 6

what is CHD associated with Turner $ (45,X0)

Answer 6

1. Coarctation of Aorta
2. Bicuspid AV

Question 7

what is CHD associated with Noonan $

Answer 7

PS

Question 8

what is CHD associated with Allagile $

Answer 8

PS

Question 9

what is CHD associated with IDM

Answer 9

HOCM

Question 10

what is CHD associated with William $

Answer 10

Supravalvular AS

Question 11

what is CHD associated with DiGeorge $

Answer 11

Arch of Aorta anomalies (F4)

Question 12

what is CHD associated with SLE

Answer 12

Congenital Heart block

Question 13

what is CHD associated with Marfan syndrome

Answer 13

1. MVP
2. MR
3. AR
4. Aortic root dilatation

Question 14

Enumerate CCC of Eisenmenger $

Answer 14

1. Hypoxia & Cyanosis
2. CCC of PH++ ( 2ry polycythemia - Cor pulmonale - Thromboembolisms)
3. Paradoxical emboli

Question 15

mention manifestations of Eisenmenger $

Answer 15

1. Permanant cyanosis after 10y
2. Blue clubbing
3. disappearance of murmur
4. paradoxical emboli
5. signs of PH++

Question 16

TGA finding on X-ray

Answer 16

egg on a string sign

Question 17

risk of CHD recurrence

Answer 17

after 1 affected sibling → 2 ~ 6%
after 2 affected siblings → 20 ~ 30 %

Question 18

Aspirin may cause any CHD except

Answer 18

PDA

Question 19

PVC is present in all CHD except

Answer 19

F4

Question 20

enumerate signs of PH++

Answer 20

1. RVH
2. Visible and palpable pulsations over P2
3. Loud S2
4. functional PS

Question 21

Regarding VSD

Answer 21

• Presentation is usually early with loud murmur
• < 10% require surgical closure

Question 22

M/C site of VSD

Answer 22

perimembranous

Question 23

first presenting symptom in VSD

Answer 23

pulmonary venous congestion

Question 24

in VSD, if the murmur was low then it became loud

Answer 24

it indicates closure

Question 25

in VSD, if the murmur was loud then it became low

Answer 25

it indicates Eisenmenger $

Question 26

indications of surgical closure of VSD

Answer 26

1. Membranous; regardless of size 2. Large muscular 3. small muscular if causing severe symptoms / ccc 4. increasing pulmonary pressure 5. if it doesn't show any sign of closure by 5 years (to prevent eisenmenger)

Question 27

natural history of VSD

Answer 27

◼ Small: most will closely spontaneously within the first few years of life. ◼ Chest infection and congestive heart failure (CHF). Symptoms of HF may later resolve due to development of pulmonary hypertension. ◼ Pulmonary hypertension: in children with a large left to right shunt, increased pulmonary flow and pulmonary hypertension will lead to irreversible damage of the pulmonary capillary vascular bed (pulmonary vascular disease (PVD)). ◼ Eisenminger syndrome: Advanced pulmonary vascular disease with cyanosis due to intracardiac right to left shunting, commonly after the first 10years of life. ◼ Acquired pulmonary stenosis ◼ Infective endocarditis

Question 28

how to differentiate between functional PS murmur in ASD and true PS

Answer 28

* ASD → Wide fixed splitting * PS → Wide variable

Question 29

most common location of ASD

Answer 29

ostium secondum ( fossa ovalis)

Question 30

type of ASD in AVSD

Answer 30

ostium primum

Question 31

type of growth retardation in PDA

Answer 31

disproportionate

Question 32

in case of a preterm, PDA closes spontaneously after

Answer 32

3 months

Question 33

to differentiate between cardiac and pulmonary causes of cyanosis

Answer 33

hyperoxia test

Question 34

type of VSD in F4

Answer 34

wide membranous (non-functioning)

Question 35

M/C cyanotic heart disease

Answer 35

F4

Question 36

M/C type of PS in F4

Answer 36

subvalvular (occur after 6 months)

Question 37

what is the management of Tet spells

Answer 37

1. Squatting position 2. Oxygen 3. Morphine SC 4. IV Propranolol 0.1 mg/kg 5. NAHCO3 6. phenylephrine

Question 38

prognosis of F4 depends on

Answer 38

degree of RVOT obstruction & efficacy of surgical intervention

Question 39

M/C cyanotic heart disease in neonates

Answer 39

TGA

Question 40

2nd M/C Cyanotic heart disease

Answer 40

TGA

Question 41

degree of cyanosis in TGA depends on

Answer 41

degree of inter-circular mixing

Question 42

regarding TGA

Answer 42

incidence of coronary artery insufficiency after the switch operation is **low.**