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PEDS FINAL > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What are Congenital Heart Diseases (CHD) due to? What are the two types?

A

Abnormal fetal heart development

- Acyanotic vs. Cyanotic

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2
Q

What are Acquired Heart Diseases (AHD) due to?

A

Disease or genetic predisposition

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3
Q

What are the two signs/symptoms of cardiac issues in INFANTS?

A
  • FTT (failure to thrive)

- Tachypnea with feeding/activity

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4
Q

What are the five signs/symptoms of cardiac issues in CHILDREN?

A
  • Palpitations/chest pain
  • Dizziness
  • Syncope
  • Exercise intolerance/SOB
  • Unexplained HTN
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5
Q

What three findings on physical exam are indicative of cardiac disease?

A
  • Femoral pulses unequal and not simultaneous with brachial
  • Clubbing of fingers/toes
  • Hepatomegaly
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6
Q

What are the two primary tests used to diagnose cardiac issues in peds? what other three tests should be considered, if needed?

A

Echocardiogram (TTE) and pulse ox

- Consider EKG, CXR and catheterization

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7
Q

What are the three types of innocent murmurs?

A
  • Still murmur
  • Pulmonary flow murmur
  • Venous hum murmur
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8
Q

What five general characteristics are often seen with innocent murmurs?

A
  • Short/Systolic
  • Grade 1 or 2
  • Musical/vibratory quality
  • No FH
  • Normal pulses/exam, normal diagnostics (pulse ox, EKG, CXR)
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9
Q

What five general characteristics are often seen with pathologic murmurs?

A
  • Holosystolic/Diastolic
  • Grade 3-6
  • Harsh/blowing quality, loud
  • Possible FH
  • Abnormal pulses/exam, hepatomegaly, MSK abnorm.
    normal diagnostics (pulse ox, EKG, CXR)
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10
Q

What is considered the age of infants?

A

4-6 months

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11
Q

What is the most common innocent murmur of early childhood? What ages is it typically seen in?

A

Still murmur

- Infancy, 2-7 years

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12
Q

What is the most common innocent murmur of older children/adults? What ages is it typically seen in?

A

Pulmonary flow murmur

- 3+ years

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13
Q

Which murmur is high-pitched at LLSB, musical/vibratory quality; loudest supine, diminished with inspiration or sitting?

A

Still murmur

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14
Q

Which murmur is soft-pitched at ULSB; loudest supine?

A

Pulmonary Flow Murmur

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15
Q

Which murmur sounds like VSD?

A

Still murmur

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16
Q

Which murmur sounds like ASD?

A

Pulmonary Flow Murmur

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17
Q

Which murmur is continuous musical hum at R/LUSB, low anterior neck; louder with sitting or head extension?

A

Venous Hum Murmur

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18
Q

Which murmur sounds like PDA?

A

Venous Hum Murmur

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19
Q

Which of the three innocent murmurs is diastolic? At what age is it typically seen?

Which two are systolic?

A

Diastolic: Venous Hum Murmur
- 2+ years

Systolic: Still, Pulmonary flow

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20
Q

Which of the murmurs disappears when supine or with turning head? What kind of murmur is this?

A

Venous Hum Murmur

- Innocent and Diastolic

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21
Q

Which fetal adaptation brings O2-rich blood from placenta/mother to fetus?

A

Umbilical vein

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22
Q

Which fetal adaptation is an opening between atrium?

When does it typically close?

A

Foramen Ovale

- Closes 2-10 days post-birth

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23
Q

Which fetal adaptation involves the umbilical vein to IVC (bypasses liver)?

A

Ductus Venosus

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24
Q

Which fetal adaptation brings blood from pulmonary a. to aorta (away from lungs)?

When does it typically close?

A

Ductus Arteriosus:

- Closes by 14 days post-birth

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25
Q

Which fetal adaptation is paired vessel that returns O2-poor blood from fetus to placenta/mother?

A

Umbilical arteries

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26
Q

What are the four acyanotic CHD?

A
  • Ventricular Septal Defect (VSD)
  • Atrial Septal Defect (ASD)
  • Patent Ductus Arteriosus (PDA)
  • Coarctation of Aorta (CoA)
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27
Q

What are the six cyanotic CHD?

A
  • Tetralogy of Fallot (ToF)
  • Transposition of Great Arteries
  • Tricuspid Atresia
  • Truncus Arteriosus
  • Total Anomalous Pulmonary Venous Return (TAPVR)
  • Hypoplastic Left Heart Syndrome
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28
Q

What is the most common congenital heart defect? What type of defect is this?

A

Ventricular Septal Defect (VSD)

- Acyanotic CHD

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29
Q

What type of defect involves blowing/harsh holosystolic murmur at LLSB (also tachycardia, tachypnea, hepatomegaly)?

A

Ventricular Septal Defect (VSD)

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30
Q

What type of defect involves CXR shows cardiomegaly, increased pulm vasc markings?

A

Ventricular Septal Defect (VSD)

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31
Q

If a Ventricular Septal Defect (VSD) is asymptomatic, what is the recommended treatment?

If it is symptomatic or treatment fails, what is recommended?

A
  • Asymptomatic = observe (can spontaneously close)

- Symptomatic/failed tx: surgical closure via median sternotomy

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32
Q

What medication is often administered with treatment of Ventricular Septal Defect (VSD), and why?

A

Diuretics

- Manage CHF

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33
Q

What type of defect is an opening between ventricles so LV → RV shunt?

A

Ventricular Septal Defect (VSD)

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34
Q

What type of defect is an opening between atria so LA → RA shunt? What type of defect is this?

A

Atrial Septal Defect (ASD)

- Acyanotic CHD

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35
Q

What is the most common classification/location of an Atrial Septal Defect (ASD)?

A

Ostium Secundum most common (vary in size and usually solo)

36
Q

What type of defect involves fixed, widely split S2 (also tachypnea, hepatomegaly, rales)?

A

Atrial Septal Defect (ASD)

37
Q

What type of defect involves EKG shows rsr’ in V1?

A

Atrial Septal Defect (ASD)

38
Q

What type of defect involves if <6 mm, spontaneous close; if larger, surgical patch as treatment?

A

Atrial Septal Defect (ASD)

39
Q

What type of defect is more common in preemies, females, maternal rubella?

A

Patent Ductus Arteriosus (PDA)

40
Q

What type of defect involves delay/failure of Ductus Arteriosus closure? What must be determined with this type of defect?

A

Patent Ductus Arteriosus (PDA)

- Direction of shunt (L→ R OR R → L)

41
Q

What type of defect involves continuous “machinery” murmur; wide pulse pressure, bounding pulses?

A

Patent Ductus Arteriosus (PDA)

42
Q

What medication is given at birth to keep a shunt OPEN? What defect is it often used to treat?

A

IV Prostaglandin E1

- Patent Ductus Arteriosus (PDA)

43
Q

What medication is given before surgery to CLOSE a shunt? What defect is it often used to treat?

A

IV Indomethacin/NSAIDs

- Patent Ductus Arteriosus (PDA)

44
Q

What defect is more common in males, but if it is seen in a female, it is associated with Turner Syndrome?

A

Coarctation of Aorta (CoA)

45
Q

What defect is often associated with Turner Syndrome?

A

Coarctation of Aorta (CoA)

46
Q

What condition involves short stature/poor growth, congenital lymphedema, web neck, renal anomalies?

A

Turner Syndrome

47
Q

What defect involves absent/decreased femoral pulses; UE SBP >20 mmHg higher than LE SBP?

A

Coarctation of Aorta (CoA)

48
Q

What defect involves narrowing of aortic arch?

A

Coarctation of Aorta (CoA)

49
Q

Which defect involves CXR shows “Figure 3” sign and inferior rib notching?

A

Coarctation of Aorta (CoA)

50
Q

What two signs are seen on CXR with Coarctation of Aorta (CoA)?

A
  • “Figure 3”

- Inferior rib notching

51
Q

What is the most common cyanotic CHD?

A

Tetralogy of Fallot

note: still rare

52
Q

Which defect involves right ventricular hypertrophy (RVH), ventricular septal defect (VSD), overriding aorta, RV outflow obstruction/pulmonary stenosis?

A

Tetralogy of Fallot

53
Q

Which cyanotic CHD is OFTEN associated with a Ventricular Septal Defect (VSD)?

A

Tetralogy of Fallot

54
Q

Which defect involves “tet spells”?

A

Tetralogy of Fallot

55
Q

Which defect involves sudden onset cyanosis, dyspnea; consciousness issues, often with crying/feeding?

A

Tetralogy of Fallot

56
Q

Which defect involves CXR shows “boot-shaped” heart with upturned apex?

A

Tetralogy of Fallot

57
Q

What sign is seen on CXR with Tetralogy of Fallot?

A

“Boot-shaped” heart with upturned apex

58
Q

Which defect requires surgery by age 1 for survival?

A

Tetralogy of Fallot

59
Q

What is the recommended treatment for Tetralogy of Fallot?

A

Surgery by age 1

60
Q

Which defect involves aorta comes off RV, PA comes off LV?

A

Transposition of Great Arteries (TGA)

61
Q

Which defect involves “blue baby”?

A

Transposition of Great Arteries (TGA)

62
Q

Which defect involves cyanotic neonate without respiratory distress or significant murmur?

A

Transposition of Great Arteries (TGA)

- AKA “blue baby”

63
Q

Which defect involves CXR shows “egg-on-a-string”?

A

Transposition of Great Arteries (TGA)

64
Q

What sign is seen on CXR with Transposition of Great Arteries (TGA)?

A

“Egg-on-a-string”

65
Q

Which defect involves Prostaglandin E1 administration; SURGERY (4-7 days) as treatment?

A

Transposition of Great Arteries (TGA)

66
Q

What is the recommended treatment for Transposition of Great Arteries (TGA) (2)?

A
  • Prostaglandin E1

- SURGERY (4-7 days)

67
Q

Which defect is ALWAYS associated with a Ventricular Septal Defect (VSD)?

A

Truncus Arteriosus

68
Q

Which defect involves aorta and pulmonary a. do not separate so only ONE artery arises from heart?

A

Truncus Arteriosus

69
Q

Which defect involves narrow S2 split (also poor feeding, lethargy, respiratory distress)?

A

Truncus Arteriosus

70
Q

Which defect involves absence of tricuspid valve so NO communication between RA and RV?

A

Tricuspid Atresia

71
Q

Which defect involves single heart sound of S2 (also FTT, tachypnea)?

A

Tricuspid Atresia

72
Q

What is the recommended treatment for Tricuspid Atresia?

A

Prostaglandin E1 to maintain PDA then surgery

73
Q

Which defect is often concurrent defects like ASD, VSD, PDA?

A

Tricuspid Atresia

74
Q

Which defect must have ASD with R → L shunt for oxygenation?

A

Total Anomalous Pulmonary Venous Return (TAPVR)

75
Q

Which defect involves pulmonary veins drain into venous system (SVC) so blood mixes in RA?

A

Total Anomalous Pulmonary Venous Return (TAPVR)

76
Q

Which defect ALWAYS involves PDA?

A

Hypoplastic Left Heart Syndrome

77
Q

Which defect involves Prostaglandin E1 MUST BE GIVEN to maintain PDA, then staged surgery as treatment?

A

Hypoplastic Left Heart Syndrome

78
Q

Which defect involves stable at birth while ductus is still patent (“honeymoon period”) then rapid deterioration (shock)?

A

Hypoplastic Left Heart Syndrome

79
Q

Which four defects are associated with Trisomy 21?

A
  • VSD
  • ASD
  • ToF
  • PDA
80
Q

Which two defects are associated with Fetal Alcohol Syndrome?

81
Q

Which defect is associated with maternal rubella?

82
Q

What condition often involves carditis (valvulitis, especially of mitral valve)?

A

Acute Rheumatic Fever (ARF)

83
Q

When does Acute Rheumatic Fever (ARF) often occur?

A

2-4 weeks post-GAS pharyngitis

Loving the HEENT Peds overlap here…

84
Q

What condition is associated with coronary artery aneurysms (CAAs), and involves small/medium vessel vasculitis?

A

Kawasaki Disease

85
Q

What condition is the leading cause of sudden cardiac death in young people?

A

Hypertrophic Cardiomyopathy

86
Q

What is a common PE finding associated with Hypertrophic Cardiomyopathy?

A

Audible S4 heart sound

87
Q

What risk factor is often associated with Hypertrophic Cardiomyopathy?

A

Family history of Hypertrophic Cardiomyopathy

PEDS FINAL (3 decks)

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