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Cardiology Flashcards

1
Q

What is the most common cause of CHF in kids

A

Ventral Septal Defect

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2
Q

In a VSD (ventral septal defect) what does the size of the defect tell you about the murmur

A

Small Hole: Loud Murmur

Large Hole: Quiet Murmur

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3
Q

In a small hole in VSD, what shunt results

A

Left to Right Shunt

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4
Q

In a large hole in VSD, what happens with stroke volume

A

Increased SV across Pulmonary Outflow Tract

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5
Q

What type of murmur is heard in VSD

A

Systolic crescendo-decrescendo murmur (especially in large VSD)

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6
Q

Sx of VSD

A

Poor Weight Gain, Small size for age, Dyspnea on feeding, Frequent URI
Prominent RV impulse, palpable pulmonary artery pulsation

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7
Q

What do you see in CXR in VSD

A

Cardiomegaly and increased pulmonary vascular markings

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8
Q

What do you see on EKG in VSD

A

Large QRS in leads I and II

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9
Q

Tx for VSD

A

Most resolve spontaneously

With a large VSD + HF: Diuretics, Digoxin, and Ace-I before surgery

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10
Q

When do sx start with ASD (Atrial Septal Defect)

A

Adulthood

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11
Q

If sx do start in childhood what do you see with ASD

A

Recurrent URI, Failure to thrive, exertional dyspnea, atrial arrhythmias, syncope

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12
Q

What murmur do you hear with ASD

A

Systolic crescendo-decrescendo at pulmonic area

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13
Q

What do you see in CXR with ASD

A

Cardiomegaly

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14
Q

What do you see on EKG in ASD

A

RBBB, RVH, RAE

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15
Q

Tx for ASD

A

Spontaneous Closure

Surgery

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16
Q

What is the Ductus Arteriosus

A

Fetal circulation component that links pulmonary artery with descending aorta
Closes a couple hours/days after delivery

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17
Q

Sx with Patent Ductus Arteriosus

A

Poor Feeding, Weight loss, frequent URI, pulmonary congestion, pulmonary HTN

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18
Q

What results with a Patent Ductus Arteriosus

A

Right to Left Shunt

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19
Q

What kind of murmur is heard with Patent Ductus Arteriosus

A

Machine-Like Murmur, Continuous at 2nd intercostal space through systole and diastole

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20
Q

What do you see on EKG with Patent Ductus Arteriosus

A

LVH and LAE

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21
Q

Tx for Patent Ductus Arteriosus

A

Prostaglandin Inhibitor: Indomethacin

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22
Q

What is Coarctation of the Aorta

A

Congenital narrowing of descending aorta

23
Q

What is commonly seen along with Coarctation of the Aorta

A

Bicuspid Aortic Valve

24
Q

Sx of Coarctation of the Aorta

A

Higher BP in upper extremeties compared to lower extremities
Dealyed/Weak femoral pulses
Shock, failure to thrive, secondary HTN
Bilateral Claudication

25
What murmur is heard with Coarctation of Aorta
Systolic murmur that radiates to back/scapula/chest
26
Dx of Coarctation of Aorta
Angiogram is gold standard CXR: Rib notching EKG: LVH
27
Tx of Coarctation of Aorta
Baloon Angioplasty | Prostalgandins
28
What are the 4 main characteristics of Tetralogy of Fallot
1. Right outflow obstruction 2. RVH 3. Overriding aorta: Portion of aorta lined up over septum 4. Large VSD
29
What results with Tetralogy of Fallot
Right to Left Shunt
30
Sx of Tetralogy of Fallot
Blue Baby Syndrome | Tet-Spells: Older kids with cyanosis squat to relieve sx
31
What kind of murmur is heard with Tetralogy of Fallot
Harsh holosystolic murmur at left sternal border
32
Tx of Tetralogy of Fallot
Surgery: Blalock-Taussig Shunt | Prostaglandins to keep ductus arteriosus open
33
What is Kawasaki Disease
A vasculitis
34
What ethnic group is Kawasaki Disease found in most
Asians
35
What is the Dx criteria for Kawasaki Disease
``` Warm CREAM (Fever + 4) Conjunctivitis: Bilateral, non-exudative Rash: Polymorphous Extremity Changes: Erythema and Edema Adenopathy: Cervical Mucous Membranes: Strawberry tongue, cracked lips and oral cavity ```
36
What are complications from Kawasaki Disease
MI, Coronary Arterities, Aneurysms, Myocarditis, Pericarditis, Valvular heart disease
37
Tx for Kawasaki Disease
IVIG + High Dose ASA
38
What is Acute Rheumatic Fever
When Group A Strep (Strep Throat) is not treated and complicates. It's an autoimmune reaction to Group A Strep
39
Diagnostic criteria for Acute Rheumatic Fever
Recent Strep + 2 Major OR | Recent Strep + 1 Major and 2 Minor
40
What is the Major and Minor Criteria for Acute Rheumatic Fever
``` Major JONES J: Joints, Migratory Polyarthritis O: Active Carditis N: Subcutaneous Nodules E: Erythema Marginatum S: Sydenham's Chorea (movement disorder) ``` Minor: Fever, Elevated CRP/ESR, Arthralgia, Prolonged PR Interval
41
Tx for Acute Rheumatic Fever
Penicillin for Strep (need to give prophylactic until age 18yrs) ASA and NSAIDS, Corticosteroids for severe cases Consider valve replacement
42
What is the leading cause of sudden cardiac death in young people
Hypertrophic Cardiomyopathy
43
Sx with Hypertrophic Cardiomyopathy
Asymptomatic | Anginga, Syncope, Palpitations, Exercise Intolerance, Left precordial bulge
44
Dx of Hypertrophic Cardiomyopathy
Echo: Asymmetrical Septal Hypertrophy Diastolic function is always abnormal Stress Test: Evaluates LV outflow obstruction Cath: Ballerina slipper configuration of LV
45
Tx of Hypertrophic Cardiomyopathy
Restrict atheltics Beta Blocker or Verapamil for LV outflow obstruction Surgical myectomy of septum
46
What is the most common Glycogen Storage Disease of the Heart
Pompe Disease: Acid Maltase Absent
47
Sx of Glycogen Storage Disease of Heart
Newborn will be well Generalized muscle weakness, large tongue, cardiomegaly without murmur Developmental/Growth Delays will be noted by 6 months, feeding problems, cardiac failure
48
Tx of Glycogen Storage Disease of Heart
Enzyme Replacement, however most kids die by 1 yr
49
What are two main components to syncope in kids
Hypotension and Bradycardia
50
Dx of syncope
Head-up Tilt Table Testing | Classify as Vasodepressor (Hypotensive) or Cardioinhibitory (Bradycardia) or both
51
Tx for Syncope
``` Usually self-limited Prevent hypovolemia by managing salt and fluid intake Fludrocortison Vagolytics: Disopyramide SSRI to help with sx ```
52
**Tx for Hypertrophic Cardiomyopathy**
Restrict from competitive exercise Beta Blockers or Verapamil for LV outflow obstruction Surgical myectomy of septum if very sx Mitral valve repair/valve replacement
53
**Tetralogy of Fallot Dx**
CXR: RV Hypertrophy, Concave pulmonary artery segment, aortic knob to right of trachea, decreased pulmonary vascular markings EKG: QRS axis rightward Echo: RV wall thickening, overriding aorta, large VSD Cardiac Cath: Right to Left Shunt. Low pulmonary artery pressure
54
**Dx of Mitral Regurgitation**
Blowing holosystolicc murmur located at Apex, radiates to left axilla

Pediatrics (12 decks)

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