Cardiology

Question 1

Truncus Arteriosus

Answer 1

Presents at birth
Mild cyanosis
Ejection systolic murmur at left sternal edge
Can cause heart failure
Need surgery

Question 2

Transposition of the Great Vessels

Answer 2

Presents on day 1/2
Severe cyanosis
No murmur
Loud single S2
CXR - egg on its side
PG infusion to maintain patency of duct, emergency cardiac catheterisation, switch procedure

Question 3

Tricuspid atresia

Answer 3

Presents day 1/2 (closure of duct)
Severe cyanosis
Ejection systolic murmur at left sternal edge
Can cause heart failure
CXR - boot shaped heart
PG and surgery

Question 4

Tetralogy of Fallot

Answer 4

VSD, Pulmonary stenosis, RVH, overriding aorta
Presents at 6-12 months
Intermittent hypoxic spells
Ejection systolic murmur at left sternal edge, radiating to the back, single heart sound, clubbing
CXR - boot shaped heart, uptilted vertex
Get them to squat with hypoxic spells, sodium bicarb, propanolol, surgery

Question 5

VSD

Answer 5

Present at 2-3 months with failure to thrive, sweaty during feeds
Loud pansystolic murmur at left sternal border. Quiet or loud P2
Complicated by CCF
75% resolve spontaneously

Question 6

ASD

Answer 6

Asymptomatic
Soft mid-systolic murmur and splitting of S2
Complicated by mitral incompetence and endocarditis
75% resolve spontaneously

Question 7

AVSD

Answer 7

Trisomy 21

Question 8

PDA

Answer 8

Occurs in premature babies
Presents at birth with increased ventilation requirements
Continuous murmur heart beneath the left clavicle
NSAIDs to promote duct closure. May need coil at 1yr

Question 9

Coarctation of the aorta

Answer 9

Turner’s syndrome
Often asymptomatic
Hypertension in upper limbs with hypotension in lower limbs
PG and surgery

Question 10

Kawasaki Disease

Diagnosis

Answer 10

WARM CREAM
Warm - temp >38.5 for 5 days
Cervical lymphadenopathy
Rash - polymorphous
Erythema and oedema ± peeling
Adenopathy
Mucous membranes (strawberry tongue)

Question 11

Kawasaki Disease

Management

Answer 11

Admit to hospital
IV fluids
IV IG and aspirin
CRP and platelets
Echocardiogram
Regular paeds review