Cardiology

Question 1

S1

Answer 1

closure of mitral and tricuspid valves heard at LLSB/apex

Question 2

S2

Answer 2

closure of aortic and pulmonic valves split only on inspiration

Question 3

S3

Answer 3

early diastolic murmur d/t rapid ventricular filling heard at LLSB/apex

Question 4

S4

Answer 4

late diastolic sound usually found w/ reduced ventricular compliance

Question 5

cause of clicks

Answer 5

valvular abnormality or dilated aorta/pulmonary artery

Question 6

cause of mid systolic click

Answer 6

MVP

Question 7

Grade 1 murmur

Answer 7

soft, heard only under quiet conditions

Question 8

Grade 2 murmur

Answer 8

soft, heard under noisy conditions

Question 9

Grade 3 murmur

Answer 9

easily heard

Question 10

Grade 4 murmur

Answer 10

loud murmur associated with thrill

Question 11

Grade 5 murmur

Answer 11

loud murmur w/ stethoscope tilted and thrill

Question 12

Grade 6 murmur

Answer 12

loud murmur heard 5-10 mm from chest w/ thrill

Question 13

early systolic murmurs

Answer 13

AS, MS, ASD, coarctation

Question 14

holo systolic murmurs

Answer 14

MR, TR, VSD

Question 15

late systolic murmurs

Answer 15

MVP

Question 16

early diastolic murmurs

Answer 16

AR, PR

Question 17

late diastolic murmurs

Answer 17

MS, TS

Question 18

continuous diastolic murmurs

Answer 18

PDA

Question 19

innocent murmurs

Answer 19

venous hum, pulmonary flow, pulmonic stenosis, Stills

Question 20

Stills murmur

Answer 20

low pitched musical sound at LLSB age 3 - adolescence

Question 21

P wave

Answer 21

atrial depolarization

Question 22

increased P wave amplitude

Answer 22

enlarged right atrium

Question 23

prolonged p wave

Answer 23

enlarged left atrium

Question 24

PR interval

Answer 24

beginning of P wave to beginning or QRS

Question 25

elongated PR interval

Answer 25

slowed conduction through AV node

Question 26

QRS complex

Answer 26

ventricular depolarization

Question 27

increased QRS amplitude

Answer 27

greater ventricular volume or mass

Question 28

QT interval

Answer 28

depolarization and repolarization of ventricles

Question 29

normal QT interval

Answer 29

< 0.45 sec

Question 30

prolonged QT interval

Answer 30

sudden death, hypocalcemia, hypokalemia, arrhythmia, Torsades de Pointes

Question 31

syncope workup

Answer 31

reassurance, EKG, GTT, EEG

Question 32

chest pain workup

Answer 32

MSK Hx, CXR, EKG, Holter, exercise stress test

Question 33

Supraventricular Tachycardia (SVT)

Answer 33

rapid regular rate with narrow QRS, abrupt onset and termination, pounding HB, pallor, fatigue

Question 34

SVT treatment

Answer 34

vagal maneuver, IV Adenosine, synchronized cardioversion if Sx

Question 35

Premature Ventricular Contractions (PVC)

Answer 35

premature HB /w no preceding P wave, QRS wider and abnormal

Question 36

PVC treatment

Answer 36

no intervention, remove caffeine, proper fluid intake

Question 37

ventricular septal defect (VSD)

Answer 37

holosystolic murmur at LLSB; Tx: after load reduction and surgical closure

Question 38

atrial septal defect (ASD)

Answer 38

fixed split S2, soft systolic ejection murmur, increased RV impulse; Tx: surgery by age 3

Question 39

patent ductus arteriosus (PDA)

Answer 39

continuous machine-like murmur infraclavicularly; Tx: IV indomethacin or ibuprofen, surgury

Question 40

drug to maintain PDA

Answer 40

prostaglandins (PGE)

Question 41

endocardial cushion defect

Answer 41

atrioventricular canal defect seen with Down's and causing HF

Question 42

pulmonary stenosis (leaflet development failure)

Answer 42

systolic ejection murmur at 2nd ICS, some w/ click, dyspnea; Tx: valvuloplasty

Question 43

aortic stenosis (leaflet development failure)

Answer 43

systolic ejection murmur w/ click, chest pain; Tx: often leads to valve insufficiency, observation

Question 44

coarctation of aorta

Answer 44

narrowing of aorta, assoc. w/ Turner's (XO), UE HTN w/ LE low BP, S3; Tx: surgery

Question 45

cyanotic CHD mnemonic

Answer 45

5 T's and an H screened during newborn

Question 46

Tetralogy of Fallot

Answer 46

MC cyanotic, truncus arteriosus w/ mult. defects, severe cyanosis, "tet" spells (blue skin when crying or feeding), squatting; Tx: knee-chest position, VSD and pulm. stenosis repair, prophylaxis for endocarditis

Question 47

transposition of great arteries

Answer 47

switched aortic and pulmonic arteries, death w/out blood mixing; Tx: prostaglandins, atrial septoplasty if severe, switch w/in 2 weeks

Question 48

tricuspid atresia

Answer 48

no tricuspid and hypoplastic RV, severe cyanosis; Tx: prostaglandin, Staged surgery: 1)Blalock 2)bidirectional Glenn 3)Fontan

Question 49

truncus arteriosus

Answer 49

failure of truncus septation, cyanosis and cough; Tx: supportive CHF care, surgical repair

Question 50

total anomalous pulmonary venous return (TAPVR)

Answer 50

pulmonary veins connect to right atrium instead of left, hyperactive RV and widely split S2 w/ systolic ejection murmur; Tx: open pulmonary vein into L atrium

Question 51

hypoplastic left heart

Answer 51

MCC death in 1st mo, failed dev. of aortic arch/mitral valve/aortic valve, gray mottled skin; Tx: prostaglandins, ventilation, surgical: Norwood, Glenn, Fontan

Question 52

rheumatic fever

Answer 52

group A strep then autoimmune attack of valves, triad: erythema marginatum, subcutaneous nodules, Sydenham chorea; Tx: benzathine PCN, salicylate, bedrest

Question 53

Jones Criteria

Answer 53

evidence of strep + 2 major or 1 major and 2 minor criteria

Question 54

pediatric autoimmune neuropsychiatric disorders associated with strep (PANDAS)

Answer 54

post strep autoimmune d/o with onset or worsening of OCD/tic disorders