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MRCP 1 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Tet of fallot infant in which medical mgmt is inadequate but they do not weight enough for definitive surgical repair, what tx?

A

Place stent across the pulm outflow tract (AKA RV outflow tract) allowed improved palm blood flow until desired weight is reached

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2
Q

Std surgical repair for tet of fallot?

A

Transannular patch repair

Note: RV opened and enlarged with a patch while VSD is closed. Removes R -> L shunt and relieved outflow tract obstruction. But this does 1 . impair palm valve function leading to severe palm regurg 2. impair the conduction system resulting in R BBB. These children usually require palm valve replacement in teen year as the right heart becomes less hypertrophied and then dilated over the following decade

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3
Q

What is the most common congenital cardiac defect?

A

Bicuspid aortic valce

Followed by VSD

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4
Q

Where are VSD more common muscular or septum?

A

Septum

Note: if muscular they are usually multiple

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5
Q

VSDs are associated with a high oxygen content in the blood of the right ventricle than the right atrium T/F

A

T

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6
Q

What is the most common cardiac cause of cyanosis in the first week of life?

A

TGA

Also: poor response to supplemental oxygen; loud single 2nd heart sound, no murmur, narrow mediastinum

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7
Q

4 abnormalities in tet of fallot?

A
  1. Perimembranous VSD
  2. PS
  3. Over riding aorta
  4. Right ventricular hypertrophy
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8
Q

Ebstein anomaly affects what valve?

A

Tricuspid valve

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9
Q

Holt Oram syndrome is assoc with what cardiac abnormality?

A

ASD

Hypoplastic left heart

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10
Q

Infective endocarditis is assoc with an up to 20% mortality rate T/F

A

T

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11
Q

Treatment of a hypercyanotic spell in a patient with tet of F

A

First simple interventions: manoeuvers, then oxygen, then fluid bolus.
If theses do not work can try dose of morphine, then esmolol infusion

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12
Q

TAR syndrome (thrombocytopenia and absent radius) associated with what cardiac abnormality?

A

Tetrology

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13
Q

EKG finding to differenciate VSD from complete AV canal?

A

Superior axis is present in complete AV canal

Both can present with HF and a harsh pansystolic murmur

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14
Q

Which type of cardiac lesion is most likely to present with faltering growth?

A

Large left to right shunt with pulm oedema

Example: complete AV septal defect or a large VSD

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15
Q

How long does a PDA need to be present to be defined as persistent?

A

3 months post term

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16
Q

In an infant without any risk factors a PDA is more common in which sex?

A

More common in females (2:1)

Main risk factor is pre term

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17
Q

Coarctation of the aorta is more common in which sex?

A

More common in males (2:1)

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18
Q

What is the max dose of adenosine for SVT?

A

500mcg/kg

or max 6mg for 1st dose and 12mg for second

Note: after this move on to cardioversion 1J/kg

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19
Q

What is the most common cause of myocarditis in the western world?

A

Viral

Note: of this adenovirus is the most common

20
Q

Most common type of ASD?

A

Ostium secundum

21
Q

What is the mgmt of a persistent asymptomatic ASD?

A

Interventional cardiac cath at 3 yrs

22
Q

What % of VSDs close by 1 yr?

A

90%

23
Q

What % of pts with Turners syndrome have a coarcation of the aorta?

A

About 15%

24
Q

What is the most common cardiac arrest rhythm in children?

A

Asystole

25
Q

What is the sex distribution of WPW?

A

More common in males (60-70%)

26
Q

WPW is usually associated with congenital heart disease T/F

A

F - WPW is usually seen in patients with structurally normal hearts (70-80%)

27
Q

Are the vast majority of transposition of the great arteries diagnosed ante or postnatally?

A

Post natal. It is difficult to diagnosis on antenatal USS

28
Q

When does tet of fallot usually present?

A

Sometime in the first year of life

29
Q

Infant with a murmur and blue stellate irises what pathology?

A

Williams syndrome

30
Q

What is the most common cardiac defect in those with T21

A

Atrioventricular septal defect

31
Q

Which of these complications is most common following cardiac surgery? Endocarditis, heart block, pericardial effusion or myocarditis?

A

Pericardial effusion -many cardiac units will scan patients at 2 weeks post op/post discharge to screen for this complication as it can initially be asymptomatic

32
Q

Atrial septal defect what type and location of murmur?

A

Soft systolic murmur at upper left sternal edge

Note: can present at any age

33
Q

What ECG findings that may be present in a patient with LV cardiomyopathy?

A

Inverted T waves in the chest leads (such as V6)

34
Q

What ECG findings that may be present in a patient with tetralogy of Fallot?

A

Upright T waves in V1 due to RVH

35
Q

What the the management of coarctation of aorta in the newborn?

A

Prostaglandin 0.05 uk/kg/min (duct dependant lesion) followed by corrective surgery when the patient is stable

36
Q

Main features of Jervell-Lange-Nielsen syndrome?

A

Long QT
SN hearing loss
AR inheritance

37
Q

What is the mechanism of action of adenosine?

A

Reduced conduction velocity in the AV node

38
Q

What genetic disorders is hypoplastic left heart associated?

A 
Turner syndrome
T 13, 18 or 21
Jacobsen syndrome
Holt Oram 
Rubinstein Taybi syndrome
39
Q

What is the initial starting dose of adenosine?

A

100 mcg/kg

40
Q

Management of pulseless VT vs VT with pulse

A

Pulseless VT = CPR followed by unsynchronised cardioversion initially at 4 J/kg

VT with pulse = Synchronised cardioversion initially 2J/kg, followed by 4J/kg. NB to synchronise as do not want to change rhythm to v fib

Note: v fib is also unsynchronised cardio version initially at 4J/kg

41
Q

Rheumatic fever often leads to mitral regurg many years after the acute episode T/F

A

F - it causes mitral and aortic regurg acutely which can lead to stenosis long term

42
Q

What feature on exam is indicative of severe aortic stenosis?

A

A soft S2

As the aortic valve becomes severely stenotic or calcified the 2nd heart sound becomes inaudible

43
Q

In a patient with TGA without VSD with the surgical mgmt?

A

Switch operation

44
Q

In a patient with a TGA with VSD with is the surgical mgmt?

A

Rastelli operation (close VSD and do a conduit from RV to pulmonary artery)

45
Q

Mechanim of action of amiodarone?

A

K channel blocker

MRCP 1 (21 decks)

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