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Pediatrics Board Exam > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Which cardiac medication is contraindicated in infants <1 yo?

A

Verapamil; causes cardiac arrest

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2
Q

Tx coarctation of aorta. Lifetime risk of what condition, even after surgical correction?

A

Tx by maintaining PDA with PGE gtt. Risk of HTN lifelong

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3
Q

5 Ts of cyanotic congenital heart disease

A

Transposition, tricuspid atresia, TOF, TAPVR, and Truncus arteriosus

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4
Q

Infant with formula mixed with well water. At risk for what?

A

Methemoglobinemia

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5
Q

Snowman XR

A

TAPVR

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6
Q

Full term baby with cyanosis, pulmonary edema, normal sized heart

A

Think TAPVR

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7
Q

Most common cyanotic condition overall

A

TOF

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8
Q

Most common cyanotic condition in newborns

A

Transposition of the great arteries

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9
Q

Tx tet spell

A

Squat/knee to chest. Phenylephrine, morphine, oxygen, propranolol

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10
Q

1 week old infant with signs of CHF, thready pulses, tachypneic, and EKG with aortic stenosis. Tx?

A

PGE1 (not dobutamine)

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11
Q

Best study to confirm dx of endocarditis

A

Blood culture

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12
Q

Most likely organism in subacute bacterial endocarditis

A

Strep viridans

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13
Q

When is dental abx ppx indicated in congenital heart disease?

A
  1. Unrepaired cyanotic heart disease; 2. Repaired with residual defect near prosthetic device 3. Any hardware placement in previous 6 months
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14
Q

MCC myocarditis

A

Coxsackie group B virus

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15
Q

Natural history of myocarditis

A

1/3 die or require transplant, 1/3 have dilated cardiomyopathy, 1/3 recover

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16
Q

Water bottle Xray

A

Pericardial effusion

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17
Q

Most common bacterial cause of pericarditis

A

Staph aureus

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18
Q

Most important study to order when pericarditis or pericardial effusion suspected

A

CXR; confirm with ECHO if stable

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19
Q

Barely palpable peripheral pulses on inspiration

A

Pericarditis

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20
Q

EKG findings in myocarditis

A

ST depression

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21
Q

EKG findings in pericarditis

A

diffuse ST elevation

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22
Q

Child with tachycardia not responding to fluids

A

Think CHF

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23
Q

Hyperoxia test

A

If pO2 150, cardiac UNLIKELY

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24
Q

Tx of TAPVR

A

emergent surgery

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25
Wall to wall heart on CXR
Ebsteins anomaly of the tricuspid valve
26
Systolic ejection click, murmur at RUSB, radiates to neck
Aortic stenosis
27
Most common congenital heart anomaly
Bicuspid aortic valve
28
Large VSDs have a risk of developing what if not closed by 1 year of age?
Pulmonary HTN
29
How do you treat HTN in coarctation?
Propranolol
30
In what 2 circumstances are PACs NOT benign?
Children on digoxin, and children less than 1 year old. At risk of progressing to atrial flutter.
31
Stable patient with HR 220. Next step?
EKG
32
Unstable patient with HR 220. Next step?
Adenosine (or cardioversion if not available)
33
What cardiac medication is contraindicated in WPW?
Digoxin
34
Treatment of Vtach
amiodarone, cardioversion
35
Treatment of Atrial flutter
Amiodarone, sotalol, DC cardioversion
36
Prolonged PR interval, no dropped beats
1st degree heart block
37
Progressive prolongation of PR followed by dropped beat
2nd degree heart block- Mobitz type 1
38
Prolonged PR with dropped beat
2nd degree heart block- Mobitz type 2
39
Unrelated P and QRS waves
3rd degree heart block
40
Hypocalcemia abnormality on EKG; Hypercalcemia?
Shortened ST; Prolonged ST
41
Shorthand rule for QT
For HR 70-100; QT should be less than half of the R-R interval.
42
Preterm baby with respiratory distress at 1 week of age, bounding pulses, widened pulse pressure, and systolic murmur below the clavicles. Tx?
PDA --> Tx with indomethacin
43
6 week old with heart failure, harsh holosystolic murmur heard at LLSB
VSD
44
Which antibodies associated in neonate with heart block?
Anti-Ro and Anti-La
45
What is a contraindication for surgery in VSD?
Irreversible pulmonary hypertension
46
Patient with Vtach, symptomatic with poor perfusion but palpable pulses. Initial management?
Synchronized cardioversion. If stable, can try adenosine first.
47
Pulseless vtach. Initial management?
Defibrillation and CPR
48
Systolic ejection murmur at LUSB, wide fixed split S2
TAPVR or ASD
49
Egg-shaped heart with narrow mediastinum on CXR
Transposition of the great arteries
50
What screening to do in child on statin?
LFTs, can cause myositis also
51
What age are lipid lowering medications prescribed? LDL indications?
Over 10 yo; LDL>190 OR LDL>160 + 2 risk factors
52
Appears like coarctation of aorta, but also with fever and elevated ESR
Takayasu Arteritis
53
Tx Rheumatic fever
Benzathin PCN G; Then lifelong every month, or PCN V daily for ppx
54
Tx digoxin toxicity (heart block, SVT/VT, nausea and vomiting)?
Activated charcoal; Atropine for arrythmias; Digoxin immune Fab
55
Tx mild to moderate CHF in myocarditis
Digoxin, lasix, captopril
56
Holosystolic or systolic ejection murmur that gets louder when supine. Tx?
Hypertrophic cardiomyopathy. Tx Beta blockers, surgery
57
Supravalvular aortic stenosis and coronary osteal stenosis are associated with what syndrome? What gene defect?
William's Syndrome; elastin gene defect (also: cocktail personality)
58
Cyanotic newborn that does not respond to oxygen, with no respiratory distress. What are some of the most likely diagnoses?
TGA, pulmonary atresia, Ebstein malformation
59
Cyanotic newborn that does not respond to oxygen, with no respiratory distress. PaO2 is normal to high, although pulse ox readings may not correlate.
Methemoglobinemia
60
A late systolic murmur preceded by a click at the apex
Mitral valve prolapse
61
A high-pitched early diastolic murmur beginning with the aortic component of the second heart sound
Aortic valve prolapse
62
crescendo-decrescendo systolic ejection murmur heard best at the left upper sternal border associated with a widely split and fixed S 2
Atrial septal defect
63
A holosystolic apical high-pitched blowing murmur radiating to the left axilla and back
Mitral regurgitation
64
History of syncope associated with a murmur that varies with positional changes. Also with fever, malaise, and arthralgia. Mass in left atrium. Dx?
Myxoma
65
Newborn with grade II/VI systolic murmur heard best at the left upper sternal border, radiating into the posterior lung fields and axillae
Peripheral pulmonary stenosis

Pediatrics Board Exam (23 decks)

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