Cardiology

Question 1

Four pathologies in tetralogy of Fallot?

Answer 1

Ventricular septal defect
Overriding aorta
Pulmonary valve stenosis
Right ventricular hypertrophy

Question 2

Risk factors for tetralogy of Fallot?

Answer 2

Rubella infection
Increased age of mother
Alcohol consumption in pregnancy
Diabetic mother

Question 3

Investigations in tetralogy of Fallot?

Answer 3

Echocardiogram

Chest x-ray boot shaped heart

Question 4

Management in tetralogy of Fallot?

Answer 4

Prostaglandin infusion in neonates can help

Open heart surgery

Question 5

Syndrome associated with coarctation of the aorta?

Answer 5

Turner’s syndrome

Question 6

Syndrome associated with pulmonary stenosis?

Answer 6

Noonan syndrome

Question 7

Syndrome associated with supravalvular aortic stenosis?

Answer 7

Williams syndrome

Question 8

4 innocent murmurs?

Answer 8

Still’s murmur
Pulmonary outflow murmur
Carotid bruits
Venous hum

Question 9

Common features of innocent murmurs?

Answer 9

Soft
Short
Systolic
Symptomless
Situation dependent

Question 10

Investigations in cardiology?

Answer 10

ECG
Blood pressure
O2 saturation
Chest x-ray
Echo
Exercise testing

Question 11

Ventricular septal defects?

Answer 11

Subaortic
Perimembranous
Muscular
(L to R shunt)

Question 12

Presentation of ventricular septal defects?

Answer 12

Pansystolic murmur, lower left sternal edge

Sometimes with thrill

Question 13

Causes of pansystolic murmur are?

Answer 13

Ventricular septal defect
Mitral regurgitation
Tricuspid regurgitation

Question 14

VSD closure?

Answer 14

Amplatzer or other occlusion device

Patch closure open heart surgery

Question 15

Increased risk in VSD?

Answer 15

Infective endocarditis

Question 16

Atrial septal defects?

Answer 16

Ostium secondum
Patent foramen ovale

Often discovered in adulthood

Question 17

Complications of an ASD?

Answer 17

Can cause stroke from a DVT, not a pulmonary embolism

Question 18

Presentation of ASD?

Answer 18

Wide fixed splitting of 2nd heart sound, pulmonary flow murmur

Question 19

Treatment of ASD?

Answer 19

Transvenous catheter closure
Open heart surgery
(anticoagulants to reduce risk of stroke in adults)

Question 20

Atrioventricular septal defect?

Answer 20

Ostium primum

Associated with trisomy 21

Question 21

Pulmonary valve stenosis

Answer 21

Mild - asymptomatic
Moderate/severe - exertional dyspnoea and fatigue
Ejection systolic murmur upper left sternal border, radiating to back

Question 22

Treatment for pulmonary stenosis?

Answer 22

Balloon valvuloplasty

Question 23

Congenital aortic stenosis?

Answer 23

Mostly asymptomatic

Worse on exertion

Question 24

Examination finding in aortic stenosis?

Answer 24

Ejection systolic murmur, upper right sternal border with radiation into carotids

Question 25

Treatment for aortic stenosis?

Answer 25

Percutaneous balloon aortic valvuloplasty
Surgical aortic valvotomy
Valve replacement

Question 26

Patent ductus arteriosus?

Answer 26

Common in preterm infants

In term babies good chance of spontaneous closure

Question 27

Treatment of patent ductus arteriosus?

Answer 27

Monitor until age 1

If not closed, close using umbrella device transcatheter

Question 28

Coarctation of the aorta?

associated with?

Answer 28

Narrowing of the aortic arch, increasing pressure before the stricture and decreasing pressure after the stricture
(Turners)

Question 29

Management of coarctation of the aorta?

Answer 29

Prostaglandins can be used to maintain ductus arteriosus while waiting for surgical resection
Balloon aortoplasty? depending on severity

Question 30

Transposition of the great arteries?

Answer 30

Aorta and pulmonary trunk transposed, creating two closed circuits

Question 31

Presentation of TGA?

Answer 31

Antenatal screening
or
Cyanosis of foetus when ductus arteriosus starts to close

Question 32

Management of TGA?

Answer 32

Switch procedure