Cardiology

Question 1

What are the signs and symptoms of congestive HF

Answer 1

Symptoms: Dyspnea, diaphoresis, poor feeding, recurrent infections
Signs: FTT, tachypnea, murmur, cardiomegaly, hepatomegaly, rales

Question 2

Symptoms of congenital heart disease (CHD)

Major

Answer 2

Central cyanosis, systolic murmur (fixed S2, fixed position, >3/6, papberal thrill, DIASTOLIC murmur, CHF (dyspnea, tachycardia, tachypnea, poor feeding, diaphoresis)

Question 3

Symptoms of congenital heart disease (CHD)

Minor

Answer 3

Systolic murmur

Question 4

Ascultation for valves: 
A- valve 
P-valve
T- valve 
M- valve

Answer 4

A- valve: R 2nd intercostalspace
P-valve: L 2nd intercostal space
T- valve: R 4th intercostal space
M- valve: L 4th intercostal space

Question 5

What is the normal heart rate in a newborn + RR

Answer 5

110-160 beats/min, SBP: 70-90, RR: 30-50

Tachycardia > 160, bradi 60

Question 6

How do you diagnose rheumatic fever:

Answer 6

Jones criteria: 2 major and 1 minor, or 1 major + 2 minor + evidence of preceding GAS ( increased ASOT/strep antibody/strep a throat culture/recent scarlet fever/DNAse )
Major criteria:
- Sydenham´s chorea
- Pancarditis
- Migratory polyarthritis 
- Subcutaneous nodules 
- Erythema marginatum 

Minor: inc CRP, fever, polyarthralgia, prolonged PR interval, RH history

Question 7

What is sydenham´s chorea

Answer 7

involuntary movements of tongue, hands, clumsiness after 3-6 months of strep infection

Question 8

Erythema marginatum

Answer 8

non-pruritic, blanching macules in bathing suit distribution (trunk-thighs)

Question 9

Pancarditits (50%)

Answer 9

endocarditis, myocarditits, pericarditis = diastoloc murmur, pericardial rub, tamponade

Question 10

Migratory polyarthritits (80%)

Answer 10

Red, tender, swollen joints (knee, ankle, wrist) lasting

Question 11

Whats is rheumatic fever

Answer 11

An abnormal immune response to a preceding infection with a group A beta-hemolytic streptococcus. The disease mainly affects children aged 5-15 years. 2-6 w following a pharyngeal infection, polyarthritis, mild fever and malais develop.

Question 12

Treatment of rehumatic fever

Answer 12

Bed rest, NSAIDS (high dose, monitor serum levels)If the fever and inflammation do not resolve rapidly, corticosteroids will be required.
Symptomatic HF: ACEI and diuretics
Anti-strep: AB if persitent infection

Question 13

Prophylaxis against rheumatic fever

Answer 13

monthly injections of benzathine penicillin–> 18-21 years old or lifelong.

Question 14

Features of heart failure in infants ?

Answer 14

Poor feeding 
Sweating 
Tachycardia 
Tachypnea 
Gallop rhythm 
Cardiomegaly 
Hepatomegaly