Cardiology

Question 1

What is the MCC of chest pain in peds?

Answer 1

Musculoskeletal

Question 2

Chest pain red flags in peds?

Answer 2

pain on exertion, acutely worseings, pain + fever, cardiac or respiratory findings that need referral

Question 3

What are causes of musculoskeletal pain?

Answer 3

muscle strain, trauma/fx, slipping rib, precordial catch, costochondritis

Question 4

What are pulmonary/respiratory causes of chest pain?

Answer 4

asthma, PNA, pneumothorax, CF, pleurisy, PE, pulm HTN, acute chest syndrome (sickle cell)

Question 5

Other non-cardiac causes of chest pain?

Answer 5

reflux esophagitis, fibrocystic breasts, FB, mastitis, Pg, psychogenic

Question 6

What is hypertrophic obstructive cardiomyopathy (HOCM)?

Answer 6

autosomal dominant d/o,
systolic murmur worsening w/ change from lying to standing or w/ squat/Valsalva
procedures that reduce blood return to ventricles (reduce preload),
pain with exertion

Question 7

S/sx’s pericarditis?

Answer 7

fever, resp distress, sharp substernal pain–improves when sitting up, friction rub, JVD,

Question 8

S/sx’s of myocarditis?

Answer 8

pain, fever, vomiting, gallop, tachy, orthostasis, cardiomegaly

Question 9

What is the MCC pediatric arrhythmia?

Answer 9

supraventricular tachycardia

Question 10

What does “intensity” of a murmur describe?

Answer 10

the volume, grade I-VI, IV is palpable, VI is w/o stethoscope

Question 11

Which murmurs are abnormal?

Answer 11

diastolic, holosystolic, and continuous

Question 12

Which murmurs are innocent?

Answer 12

Still’s vibratory, venous hum, carotid bruit, systolic ejection, peripheral pulmonary stenosis

Question 13

What is the MC congenital heart defect?

Answer 13

ventricular septal defect VSD

Question 14

What are s/sx’s of VSD?

Answer 14

small=asx + murmur, large = 2-8wks old, fatigue, diaphoresis, labored breathing, poor growth, pansystolic murmur, LVH

Question 15

What are s/sx’s of endocarditis?

Answer 15

fever, chest pain, tachy, murmur, petechiae, arthritis, HSM, wt loss, bacteremia, hematuria, elevated inflammatory markers

Question 16

S/sx’s of Rheumatic fever (JCNES)?

Answer 16

Joints-polyarthritis (migratory), Carditis, Nodules, Erythema marginatum, Sydenham’s chorea…Minor criteria: arthralgia, prev rheumatic fever, fever, elevated ESR/CRP/WBCs, long PR interval

Question 17

What are the 4 defects of tetralogy of Fallot?

Answer 17

ventricular septal defect, pulmonary stenosis, Rt ventricular hypertrophy, overriding aorta

Question 18

What are s/sx’s of coarctation of the aorta?

Answer 18

absent femoral pulses, murumur, lethargy, poor feeding, hypertension, often w/PDA or VSD

Question 19

What are s/sx’s of tetralogy of Fallot?

Answer 19

cyanosis (Tet spells), poor feeding, failure to thrive, clubbing, scoliosis, hemoptysis, systolic murmurs, aortic ejection click