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Paediatrics > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What is Kawasaki disease?

A

systemic vasculitis

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2
Q

What is the peak age of Kawasaki disease?

A

18-24m

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3
Q

In what races is Kawasaki disease more common?

A

Japanese

afrocaribbean

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4
Q

What are the diagnostic criteria for Kawasaki disease

A

≥5 day fever + at least 4 of the following:

  1. bilateral non-exudative conjunctivitis
  2. Cervical lymphadenopathy
  3. Polymorphous rash
  4. Mucositis - strawberry tongue
  5. Red and oedematous palms and soles w peeling of fingers and toes
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5
Q

What is an important complication of Kawasaki diseasE?

A

aneurysm of the coronary arteries - can be fatal!!

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6
Q

What are the Ix for Kawasaki diseasE?

A
  1. increased WCC - neutrophils
  2. Increased platelets in 2nd week
  3. increased ESR/CRP
  4. serial echos for aneurysm or angiography to be accurate
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7
Q

What is the treatment of Kawasaki disease?

A

IVIG - single dose within first 10 days
Aspirin to decrease risk of thrombosis
If non-responsive to initial dose - prednisolone

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8
Q

Why is aspirin usually contraindicated in children?

A

due to the risk of Reye’s syndrome

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9
Q

What is the cause of rheumatic fever?

A

In susceptible individuals, there is an abnormal immune response to a preceding infection with group A beta-haemolytic strep

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10
Q

What age does rheumatic fever mainly affect?

A

5-15yrs

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11
Q

What is the major concern of rheumatic fever?

A

can cause permanent damage to the heart valves

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12
Q

Where is rheumatic fever common?

A

in developing countries

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13
Q

Give the name of the criteria used to diagnose rheumatic fever

A

Jones criteria

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14
Q

give the major criteria for a diagnosis of rheumatic fever

A
  1. polyarthritis - migratory
  2. pancarditis - 1 of: CCF, cardiomegaly, friction rub, +ve echo
  3. Sydenham chorea - involuntary movements and emotional lability for 3-6m, 2-6m after the inf.
  4. erythema marginatum - rash on trunk + limbs
  5. subcut nodules
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15
Q

What are the minor manifestations of rheumatic fever?

A
  1. fever
  2. arthralgia (pain but not swelling)
  3. Hx of rheumatic fever/HD
  4. Raised ECR (>20mm), CRP, WCC
  5. ECG - PR interval >0.2S
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16
Q

What must be fulfilled in the criteria for a diagnosis of rheumatic fever?

A

2 major
1 major and 2 minor
PLUS evidence of preceding group A strep infection (scarlet fever, throat swab or serum titre)

17
Q

What is the management of an acute episode of rheumatic fever?

A
  1. bed rest, limited exercise
  2. aspirin
  3. prednisolone for fever and inflammation
  4. Pericardiocentesis for pericardial effusions
  5. diuretics and ACEi for symptomatic HF
18
Q

What is the appropriate management for preventing recurrence of rheumatic fever

A

Benzathine penicillin
OR
phenoxymethlypenicillin

19
Q

What is the most common long term consequence of chronic rheumatic heart disease?

A

mitral stenosis from scarring and fibrosis of the valve tissue

20
Q

What is chronic rheumatic heart disease?E

A

Refers to long term cardiac damage caused by a single severe episode or multiple recurrent episodes of

21
Q

What is eisenmenger syndrome?

A

reversal of a left-to-right shunt in a congenital heart defect due to pulmonary hypertension.

22
Q

What heart defects lead to eisenmenger syndrome?

A

VSD
ASD
PDA

23
Q

What are the clinical features of eisenmengers?

A 
original murmur may disappear
cyanosis
clubbing
right ventricular failure
haemoptysis, embolism
24
Q

What is the management of Eisenmenger syndrome?

A

heart-lung transplant

25
Q

What is the most common cause of infective endocarditis?>

A

alpha-haemolytic strep - strep viridans

26
Q

What CHD puts children at risk of infective endocarditis?

A

VSDs, COA, PAD, prosthetics

i.e. when there is a turbulent jet of blood

27
Q

What sx should raise suspicion of infective endocarditis?

A 
sustained fever
malaise
increased ESR
unexplained anaemia
haematuria (microscopic)
28
Q

What are the signs of infective endocarditis?

A 
fever
splenomegaly
CLUBBING
SPLINTER HAEMORRHAGES
anaemia, haematuria
rash 
HF
new murmur
29
Q

what are ix for infective endocarditis?

A

Blood cultures

Echo

30
Q

What is the treatment of infective endocarditis?

A

6 weeks IV therapy of high dose penicillin w amino glycoside
I.E.
IV benzylpenicillin 25mg/kg/4hr
+ gentamicin

31
Q

What is recommended for prophylaxis of infective endocarditis?

A

good dental hygiene

Paediatrics (56 decks)

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