Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PANCE 2.0 > Cardiology #5 (Pediatric Cardiology) > Flashcards

Cardiology #5 (Pediatric Cardiology) Flashcards

1
Q

What is the MC innocent (physiologic) murmur?

A

Still Murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the pathophysiology of a still murmur?

A

Thought to be due to vibration of the valve leaflets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Explain a still murmur

A

Musical, vibratory noisy, twanging, low-pitched early to mid-systolic ejection murmur that is best heart in the inferior aspect of the left lower sternal border and apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When does a still murmur present?

A

MC heard from 2 months to preadolescence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a patent foramen ovale?

A

Covered but not sealed open communication between the right and left atria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Even though most patients with a patent foramen ovale are asymptomatic, what are some symptoms they MAY have?

A

Strokes from paradoxical embolism (stroke with no other underlying cause AKA cryptogenic stroke)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Best test to diagnose patent foramen ovale

A

Echocardiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What should be done for a patent foramen ovale?

A
  • Percutaneous device closure surgically

- If the patient has cryptogenic strokes, give antiplatelet or anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is an atrial septal defect?

A

Abnormal opening in the atrial septum between the right and left atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MC type of atrial septal defect

A

Ostium secundum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some symptoms in infants and young adults with an ASD?

A
  • Recurrent respiratory infection
  • Failure to thrive
  • Exertional dyspnea
  • Easy fatiguability
  • Syncope
  • Heart Failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

However, in young adults, like patent Foramen ovale, patients with an ASD may have?

A

Paradoxical emboli (stroke from venous clots) later in life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Explain the murmur of a patient with ASD

A
  • Systolic ejection crescendo-decrescendo flow murmur at the pulmonic area (LUSB)
  • Wide, fixed split S2 that does not vary with inspiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Best test to make diagnosis of ASD

A

Echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

However, what diagnostic is the gold standard/definitive for ASD?

A

Cardiac catheterization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Management for an ASD

A

Small (< 5mm): may be observed. Most close spontaneously in first year of life
If > 1 cm or symptomatic, percutaneous trans catheter closure between 2-4 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a patent ductus arteriosus?

A

Persistent communication between the descending thoracic aorta and the main pulmonary artery after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are some risk factors for PDA?

A

Prematurity
Females
Fetal hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Explain the pathophysiology of a PDA

A

-Continued prostaglandin E1 production and low arterial oxygen content promotes patency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Symptoms of a patient with a PDA

A

-Most asymptomatic
-Poor feeding
-Wide pulse pressures (bounding peripheral pulses)
-loud S2
Frequent lower respiratory tract infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Explain the murmur of PDA

A

Continuous machine-like murmur loudest at pulmonic area (LUSB)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Best initial test for PDA

A

Echocardiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Definitive diagnostic for PDA

A

-Cardiac catheterization

24
Q

First line medical treatment for PDA

A

NSAIDs (IV Indomethacin, Ibuprofen)

25
Q

How do NSAIDs work in regards to prostaglandins

A

They inhibit prostaglandin synthesis

26
Q

What should be done if there is no closure with Indomethacin?

A

Surgical correction before 1-3 years of age

27
Q

Coarctation of the aorta is congenital narrowing of the aortic lumen at what site?

A

Descending aorta

28
Q

Coarctation of the aorta is more common in

A

Males

29
Q

Symptoms of coarctation of the aorta

A
  • Bilateral claudication
  • Dyspnea on Exertion
  • Syncope
  • Failure to thrive in infants, poor feeding 1-2 weeks after birth
  • Upper extremity systolic hypertension with lower extremity hypotension
  • Diminished or delayed lower extremity pulses
30
Q

What kind of murmur is present with coarctation of the aorta?

A

Systolic murmur radiating to the back, scapula, or chest

31
Q

What is the confirmatory test for coarctation of the aorta?

A

Echocardiogram

32
Q

Gold standard diagnostic for coarctation of the aorta

A

Angiography

33
Q

What does a CXR show in coarctation of the aorta?

A 
Posterior rib notching
3 sign (narrowed aorta looks like the number 3)
34
Q

What is the treatment for coarctation of the aorta

A
  • Corrective surgery or trans catheter based intervention (balloon angioplasty with or without stent placement) in early childhood
  • Prostaglandin E1 (Alprostadil) preoperatively to maintain PDA to reduce symptoms and improve lower extremity blood flow
35
Q

What are the 4 components of Tetralogy of Fallot?

A
  • Pulmonary stenosis
  • Right ventricular hypertrophy (RVH)
  • Overriding aorta
  • VSD

PROVe

36
Q

What is the MC cyanotic congenital heart disease?

A

Tetralogy of Fallot

37
Q

What chromosome deletion is associated with tetralogy of Fallot?

A

Chromosome 22 deletion

38
Q

Symptoms of Tetralogy of Fallot

A
  • Cyanosis (MC Presentation in infants)
  • Tet Spells: paroxysms of cyanosis relieved with squatting (in infants, knees to chest helps)
  • Digital clubbing, cyanosis
39
Q

What kind of murmur is heard with Tetralogy of Fallot?

A

harsh systolic murmur at left mid to upper sternal border (VSD), right ventricular heave (RVH)

40
Q

Test of choice for Tetralogy of Fallot

A

Echocardiogram

41
Q

What does a CXR for Tetralogy of Fallot show?

A

Boot-shaped heart (prominent right ventricle)

42
Q

Treatment for Tetralogy of Fallot

A
  • Surgical repair in first 4-12 months of life

- Prostaglandin infusion prior to surgery to maintain PDA

43
Q

True or False: If a patient has Tetralogy of Fallot, he or she should receive prophylaxis for bacterial endocarditis?

A

True

44
Q

What is the pathophysiology of transposition of the great arteries?

A

Discordance between the aorta and pulmonary trunk (aorta arises from right ventricle and the pulmonary trunk arises from left ventricle)

45
Q

What is the MC type of ToGA?

A

Dextro-TGA: this leads to two parallel circuits. Deoxygenated blood gets sent back into circulation and oxygenated blood gets sent back up to the lungs.

46
Q

Prior to surgical correction of TGA, what is survival dependent on?

A

Shunts between right and left circulations (PDA, ASD, VSD)

47
Q

Symptoms of TGA

A

-Severe cyanosis and tachypnea within the first 30 days of life (not affected by exertion)

48
Q

Although cardiac catheterization is the gold standard diagnostic for TGA, what is the primary means of diagnosis? What does a CXR show?

A

Echocardiogram

CXR: egg on string appearance. Heart appears as egg on side with the narrowed superior mediastinum appearing as the string.

49
Q

Treatment for TGA

A

Arterial switch operation

Prostaglandin E1 to maintain PDA

50
Q

MC type of congenital heart disease in childhood

A

VSD

51
Q

MC type of VSD

A

Perimembranous (Hole in the LV near tricuspid valve)

52
Q

Symptoms of a VSD

A
  • Excessive sweating or fatigue
  • Lack of adequate growth
  • Frequent respiratory infections
53
Q

What kind of murmur is associated with a VSD?

A

High-pitched harsh holosystolic murmur best heard at LLSB

54
Q

What is the BEST diagnostic for a VSD?

A

Echocardiogram usually preferred over catheterization

55
Q

Treatment for VSD is defined by size. Explain

A

Small: Observation. Most close within 12 months

Symptomatic or Large: Patch closure by 2 years of age

56
Q

What is Eisenmenger Syndrome?

A

Right-to-left shunt occurring with VSD

  • -This occurs when a left-to-right shunt switches and becomes a right-to-left shunt. Cyanosis occurs.
  • -Pulmonary hypertension and cyanotic heart disease occur simultaneously

PANCE 2.0 (62 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions