Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pediatrics > Cardiology > Flashcards

Cardiology Flashcards

(51 cards)

Start Studying
1
Q

Hallmarks of an innocent murmur

A 
The5 Ss
InnoSent:
1.  ASymptomatic
2. Soft blowing murmur
3. Only Systolic murmur (not diastolic)
4. Left Sternal edge
- Other: No thrill, no radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Symptoms of heart failure

A
  • Breathlessness
  • Sweating
  • Poor feeding
  • Recurrent chest infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most probable cause of HF during the first week of life?

A

Left heart obstruction

  • Coarctation of the aorta
  • Hypoplastic left heart syndrome
  • Aortic valve stenosis
  • Interruption of the aortic arch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The cyanotic heart diseases

A

The 5 Ts:

  1. Tetralogy of Fallot
  2. Transposition of great vessels
  3. Truncus arteriosis
  4. Total anomalous pulmonary venous return
  5. Tricuspid atresia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Types of ASD

A
  1. Secundum ASD - most common (80%)

2. Partial atrioventricular septal defect (AVSD) or primum ASD

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

Symptoms of ASD

A
  • None (commonly)
  • Recurrent chest infections/wheeze
  • Arrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Physical signs in ASD

A
  • Ejection systolic murmur, upper left sternal border - due to increased flow across the pulmonary valve
  • Fixed and widely split second heart sound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Physical signs of small VSD

A
  • Loud pansystolic murmur at the lower left sternal edge (loud murmur implies smaller defect)
  • Quiet pulmonary second sound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Clinical features of large VSD

A

Symptoms:
- HF - breathlessness and faltering growth
- Recurrent chest infections
Signs:
- Tachypnea, tachycardia, enlarged liver from HF
- Active precordium
- Soft pan systolic murmur or no murmur
- Apical mid-diastolic murmur (from increased flow through the mitral valve)
- Loud pulmonary second sound

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

Left-to-right shunt disorders

A
  • ASD (secundum 80%)
  • VSD (small 80-90%)
  • Persisten ductus arteriosis
  • Endocardial cushion defect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When should the ductus arteriosis close, and when can you say that it is a PDA?

A

Should close shortly after birth.

In PDA is has failed to close by 1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical features of PDA

A
  • Continuous murmur beneath the left clavicle
  • Increased pulse pressure, causing a collapsing or bounding pulse
  • If duct is large - increased pulmonary blood flow with HF and pulmonary HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Management of PDA

A
  • Preterm infants: Indomethacin (PGe inhibitor)

- Term infants: Coil or occlusion device, surgical ligation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Right-to-left shunt disorders

A
  • Tetralogy of Fallot

- Transposition of the great vessels/arteries

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

What is hyperoxia (nitrogen washout) test?

A

Test to determine presence of heart disease in a cyanotic neonate.
- Placed in 100% oxygen for 10 min. - if <15 kPa / 113 mmHg - diagnosis of ‘cyanotic’ congenital heart disease (lung diseases must be excluded)

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

Side-effects of prostaglandin infusion

A
  • Apnea
  • Jitteriness
  • Seizures
  • Flushing
  • Vasodilation
  • Hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most common cause of cyanotic congenital heart disease?

A

Tetralogy of Fallot

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

What are the features of Tetralogy of Fallot?

A
  1. Large VSD
  2. Overriding of the aorta
  3. Subpulmonary stenosis (right ventricular outflow obstruction)
  4. Right ventricular hypertrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Classic old signs of Tetralogy of Fallot

A
  1. Severe cyanosis
  2. Hypercyanotic spells
  3. Squatting on exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a hypercyanotic spell?

A

Rapid increase in cyanosis

  • Severe hypoxia causing:
  • Irritability
  • Inconsolable crying
  • Tissue acidosis causing:
  • Breathlessness
  • Pallor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Signs of Tetralogy of Fallot

Study These Flashcards
A
  • Clubbing of the fingers and toes
  • Loud harsh ejection murmur at the left sternal edge from day 1 of life
  • Systolic thrill
22
Q

Management of Tetralogy of Fallot

Study These Flashcards
A
  • Surgical correction at around 6 months - closing VSD and relieving right ventricular outflow tract obstruction
  • If very cyanosed - shunt between the subclavian artery and the pulmonary artery
23
Q

Management of a hypercyanotic spell

Study These Flashcards
A

Usually self-limiting, if >15 min:

  • Sedation and pain relief
  • IV propranolol
  • IV fluids
  • Bicarbonate
  • Muscle paralysis and artificial ventilation
24
Q

Symptoms of transposition of the great arteries

Study These Flashcards
A
  • Cyanosis - present of day 2 of life when duct close
25
Physical signs of transposition of the great arteries
- Cyanosis - Loud and single second heart sound - Usually no murmur
26
Eisenmenger syndrome
Left-to-right shunt --> increased pulmonary blood flow --> medial hypertrophy of pulmonary vessels --> increased pulmonary vascular resistance --> right-to-left shunt Shunt reverses at about 10-15 years of age - teenagers become blue, need transplantation
27
Pathophys of endocardial cushion defect
1. Both ASD and VSD | 2. Abnormal atrioventricular valves
28
What is a Blalock-Taussig shunt?
Shunt between subclavian and pulmonary arteries
29
Clinical features of aortic stenosis
- Most asymptomatic. May present with reduced exercise tolerance, chest pain on exertion or syncope - Carotid thrill (always) - Ejection systolic murmur, upper right sternal edge radiating to neck - Delayed and soft aortic second sound - Apical ejection click
30
Features of pulmonary stenosis
- Most asymptomatic - Ejection systolic murmur, upper left sternal edge, thrill may be present - Ejection click, upper left sternal edge
31
Most common type of coarctation of aorta
90% juxtaductal coarctation (adult-type) | Narrowing below left subclavian artery at origin of ductus arteriosus
32
Clinical features of coarctation of the aorta - adult type
- Asymptomatic - Systemic HTN in the right arm - Ejection systolic murmur at upper sternal edge - Radio-femoral delay - Collateral blood vessels heard at the back
33
Features at chest x-ray in coarctation of aorta
- 'Rib-notching' - development of large collateral intercostal arteries running under the ribs - '3-sign' - visible notch in the descending aorta at site of the coarctation
34
What is the most common cause of collapse due to left outflow obstruction?
Coarctation of aorta - infantile type (preductal, tubular hypoplasia)
35
Clinical features of coarctation of aorta - infantile type
First day normal, acute circulatory collapse at 2-days of age - A sick baby, with severe HF - Absent femoral pulses - Severe metabolic acidosis
36
Which syndrome is associated with interruption of the aortic arch?
DiGeorge syndrome
37
Features of hypoplastic left heart syndrome
- Mitral valve is small or atretic - Diminutive left ventricle - Aortic valve atresia - Very small ascending aorta - Invariably coarctation of the aorta
38
Clinical features in hupoplastic left heart syndrome
- Profound acidosis - Rapid cardiovascular collapse - Weakness or absence of all peripheral pulses (in contrast to weak femoral pulses in coarctation)
39
The surgical procedure of hypoplastic left heart syndrome
Three-stage Norwood procedure
40
What is the most common childhood arrhythmia?
Supraventricular tachycardia | 250-300 beats/minute
41
Causes of syncope
Usually benign - Neurally mediated - in response to a range of provocations and stressors - Cardiac - arrhythmic, heart block, QT syndrome, aortic stenosis, etc.
42
Features indicating a cardiac cause of syncope
- Symptoms on exercise - Family history of sudden unexplained death - Palpitations
43
Pathophys. of rheumatic heart disease
Short-lived, multisystem autoimmune response to a preceding infection with group A beta-hemolytic streptococcus
44
Clinical features of rheumatic fever
- Latent interval of 2-6 weeks following a pharyngeal or skin infection (pharyngitis/scarlet fever) - Polyarthritis - Mild fever - Malaise
45
Rheumatic fever, JONES criteria
J - joints (migratory arthritis) O - Carditis (endocarditis, myocarditis, pericarditis) N - Nodes (subcutaneous nodules, extensor surfaces) E - Erythema marginatum (rash on trunk and limbs) S - Sydenham chorea (involuntary movements)
46
Most frequent affected valve in rheumatic fever?
Mitral valve | - Long-term damage from scarring and fibrosis - mitral stenosis
47
Management of rheumatic fever
1. Bed rest, limitation of exercise 2. Anti-inflammatory agents - Aspirin - Corticosteroids may be required - Treatment of heart failure
48
Clinical signs of infective endocarditis
- Fever - Anemia and pallor - Splinter hemorrhages in nailbed - Clubbing (late sign) - Necrotic skin lesions - Changing cardiac signs - Splenomegaly - Neurological signs from cerebral infarction - Retinal infarcts - Arthritis/arthralgia - Microscopic hematuria
49
What does the vegetations in endocarditis contain?
- Fibrin - Platelets - Infecting organisms
50
What is the most common pathogen causing endocarditis?
Alpha-hemolytic streptococcus (Streptococcus viridans)
51
Causes of pulmonary hypertension
- Pulmonary arterial HTN * Idiopathic * Cardiac (post-tricuspid shunts: VSD, AVSD, PDA) * HIV * Peristen pulmonary HTN of the newborn - Pulmonary venous HTN * Left-sided heart disease * Pulmonary vein stenosis - With respiratory disease * Cohronic obstructive disease, BPD * Interstitial lung disease

Pediatrics (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions