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Pediatrics Exam 1 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

MC birth defect

A

congenital heart disease

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2
Q

Left to Right shunts → acyanotic

A

the “D”s → ASD, VSD, PDA, AVSD

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3
Q

Right to Left shunts → cyanotic

A

the “T”s → ToF, TGA, TA, TA, TAPVC

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4
Q

obstructive lesions that cause congenital heart defects

A 
coarctation of aorta 
pulmonary stensosis 
pulmonary atresia 
aortic stenosis 
aortic atresis (HLHS)
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5
Q

when there is a defect or communication between the left and right heart blood usually shunts _____

A

from left to right

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6
Q

why is cyanosis not typical in left to right shunts?

A

Pulmonary vascular resistance is less than systemic → increase in pulmonary blood flow occrs

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7
Q

Pulmonary vascular bed (after being exposed to excessive flow and pressure) undergoes vasoconstriction that becomes irreversible → increased pulmonary vascular resistance and shunt reversal

A

Eisenmenger Syndrome

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8
Q

MC type of atrial septal defect

A

secundum ASD → at fossa ovalis

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9
Q

endocardial cushion defect just above the AV valves associated with cleft mitral valve

A

Primum ASD

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10
Q

located near the SVC and often associated with anomalous pulmonary vein

A

Sinus venosus ASD

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11
Q

Atrial septal defect is often seen in

A

Holt-Oram Syndrome

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12
Q

How may large ASD present?

A

murmur

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13
Q

Treatment for Secundum ASD

A

heart cath to close the defect with plug like device

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14
Q

when in the cardiac cycle will shunting occur in ASD?

A

diastole

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15
Q

MC common congenital heart defect

A

Ventricular Septal Defect

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16
Q

Three types of VSD

A

membranous MC (below aortic valve)
muscular (often small and self limited)
infundibular

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17
Q

How will small VSD present?

A

loud blowing systolic murmur

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18
Q

How will moderate VSD present?

A

murmur and HF due to excessive pulmonary blood flow

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19
Q

Large VSD can cause ___ if not surgically closed during infancy

A

pulmonary hypertension

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20
Q

when is blood shunted with a VSD?

A

systole → excess blood goes directly to the lungs since RV in contracting

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21
Q

how are VSD surgically repaired?

A

patched

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22
Q

persistence of a normal fetal structure → commonly seen in premature infants and produces machine like murmur

A

Patent Ductus Arteriosus [PDA]

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23
Q

If an infant with PDA is cyanotic or has obstructive heart disease, what can you use to maintain the patency of PDA?

A

prostaglandin E

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24
Q

Treatment for PDA

A

close with coil or occluder in cath lab

25
Q

Infants with PDA have continous left to right shunt but when does it increase?

A

systole

26
Q

what patient population is atrioventricular septal defect commonly seen in?

A

Down Syndrome

27
Q

due to failure of superior and inferior endocardial cushions to fuse and related to primum ASD

A

atrioventricular septal defect

28
Q

when do you routinely repair AVSD?

A

6 months of age

29
Q

deoxygenated blood gets into systemic circulation

A

right to left shunt

30
Q

Three ways that Right to Left Shunt occurs

A 
septal defect and obstruction to pulmonary blood flow (ToF)
obligate right to left shunt (transposition of great arteries)
obligate mixing (TAPVC)
31
Q

cyanosis + complications (sterile or septic embolization) + hypertrophic osteoarthropathy (clubbing) and polycythemia

A

right to left shunt

32
Q

5 “T”s of Right to Left shunts

A 
Tetralogy of Fallot
Transposition of Great Arteries 
Truncus Arteriosus 
Tricuspid Atresia 
Total Anomalous Pulmonary Venous Connection
33
Q

Four classic features of Tetralogy of Fallot

A
  1. VSD
  2. obstruction right ventricular outflow (pulmonary valve and/or subpulmonic stenosis)
  3. Right ventricular hypertrophy on EKG
  4. Overriding aorta
34
Q

MC cyanotic lesion → 3 or 4 year old who is squating

A

Tetralogy of Fallot

35
Q

Severity of Tetralogy of Fallot is based on…

A

severity of subpulmonic stenosis

36
Q

CXR reveals “boot shaped” heart

A

Tetralogy of Fallot

37
Q

results from abnormal septation of truncal and aortopulmonary septa → atrioventricular concordance and ventriculoarterial discordance

A

d-TGA (transposition of great arteries)

38
Q

If your patient has D-TGA, what do you hope they also have?
Having this allows the blood to mix so you aren’t circulating deoxygenated blood in the body and oxygenated blood stays circulating in the lungs

A

VSD

39
Q

For TGA, what do you look for on fetal ultrasound?

A

pulmonary artery and aorta are running parallel

[normal → pulmonary artery crosses over aorta]

40
Q

How do you manage newborn with TGA without VSD presenting with profound cyanosis?

A

palliation with prostaglandin and possibly balloon atrial septostomy

41
Q

failure of separation of embryologic pulmonary artery and aorta

A

truncus arteriosus

42
Q

100% of truncus arteriosus also have

A

VSD

43
Q

result from unequal division of AV canal

A

tricuspid atresia

44
Q

three things also seen with Tricuspid Atresia

A

ASD
VSD
small right ventricle

45
Q

Name of procedure used for Tricuspid Atresia and patients with only one ventricle

A

Fontan Procedure

46
Q

common pulmonary vein fails to connect to left atrium + ASD

A

total anomalous pulmonary venous connection (TAPVC)

47
Q

3 types of total anomalous pulmonary venous connection

A

infracardiac
cardiac
supracardiac

48
Q

location of coarctation of aorta that presents in infant

A

proximal to PDA

49
Q

location of coarctation of aorta that presents in adult

A

paraductal or postductal

50
Q

increased incidence of coarctation of aorta in patients with

A

Turner Syndrome

51
Q

Treatment for pulmonary valve stenosis

A

balloon dilation → may leak and get SOB → replace valve with bovine jugular vein valve

52
Q

intact ventricular septum + RV is hypoplastic + ASD is present + flow to lungs occurs through PDA or multiple aorta to pulmonary collateral vessels

A

pulmonary atresia

53
Q

Three types of aortic stenosis

A

valvular
subvalvular
supravalvular

54
Q

supra AS often seen in

A

Williams Syndrome

55
Q

MC seen in hypoplastic left heart syndrome (HLHS)

A

Aortic atresia

56
Q

benign, vibratory and low pitched murmur “groaning sound”
LLSB and radiates to aortic outflow tract
loudest at 5 months - 5/6 years

A

Still’s murmur

57
Q

high pitch murmue that radiates all over the chest

common in babies

A

branch pulmonary stenosis

58
Q

high frequency and blowing murmur

A

VSD

59
Q

crunchy and medium pitched murmur

A

pulmonary and aortic stenosis

Pediatrics Exam 1 (7 decks)

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