Cardiology

Question 1

3 main/ extra things in fatal blood circulation

Answer 1

ductus arteriosus
ductus venosus
formane ovale

Question 2

what happens to fetal circulation after brith?

Answer 2

pulmonary vascular resistance falls , pulmonary blood flow increase and the ductus and Forman ovale close

Question 3

what is an innocent murmur?

Answer 3

murmur with no associated structural abnormality

Question 4

incidence of innocent murmur

Answer 4

heard in up to third of children at some time

Question 5

S of innocent murmur

whats the murmur like?

Answer 5

systolic 
soft
does not radiate 
changes with posture 
often heard in febrile child (hyper dynamic circulation)

Question 6

Ix in innocent murmur

Answer 6

re-examine when well
consider ECG
CXR
echo if thought to be significant

Question 7

causes of cyanotic heart disease

Answer 7

ventricular septal defect
patent ductus arteriosus
atrial septal defect 
coarctation of the aorta 
aortic stenosis

Question 8

causes of cyanotic heart disease

Answer 8

tetralogy of fallot

transposition of the great arteries

Question 9

ventricular septal defect Sy

Answer 9

usually come on once shunt reversal has occurred
dyspnoea
chest pain
syncope
haemoptysis

Question 10

Si ventricular septal defect

Answer 10

cyanosis
clubbing
loud pan systolic murmur

Question 11

Ix VSD

Answer 11

echo

Question 12

Tx VSD

Answer 12

spontaneous closure in about half of small ones

surgical correction when there is moderate/large left to right shunt

Question 13

atrial septal defect Sy

Answer 13

usually asymptomatic until adulthood
palpitations (arrhythmias)
dyspnoea
cyanosis

Question 14

atrial septal defect Si

Answer 14

heave
cyanosis
clubbing

Question 15

Ix of ASD

Answer 15

ECG
CXR
echo

Question 16

Rx of ASD

Answer 16

can be left
or
surgery

Question 17

Tetralogy of Fallot pathology

Answer 17

1. VSD
2. Right ventricular hypertrophy
3. overriding aorta
4. right ventricular outflow tract obstruction (pulmonary stenosis)
   PROVe

Question 18

A of tetralogy of fallot

Answer 18

most common cyanotic heart disease congenital

associated with di George syndrome

Question 19

S of tetralogy of fallot

Answer 19

cyanosis 
murmur
cyanotic spells when crying / upset
suat to increase venous returns
clubbing

Question 20

Ix of tetralogy of fallot

Answer 20

ECG
CXR boot shaped heart
echo

Question 21

Rx of tetralogy of fallot

Answer 21

O2
morphine
propanolol
surgery

Question 22

transposition of the great arteries

Answer 22

they swap
2 parallell circulations
mixing maintained by one of the 3 fatal circulation things

Question 23

S of transposition of great arteries

Answer 23

cyanosis at birth or presentation when duct closes

Question 24

Ix of transposition of great arteries

Answer 24

CXR

echo

Question 25

Rx of transposition of great arteries

Answer 25

surgery

Question 26

coarctation of aorta is associated with what birth defect?

Answer 26

Turners syndrome

Question 27

S of coarctation of aorta

Answer 27

absent/ weak femoral pulses, hypertension in arms but not legs

Question 28

Ix of correction of aorta

Answer 28

CXR
ECG
Echo

Question 29

Rx of coarctation of aorta

Answer 29

surgical resection and anastomosis

prostaglandin E is critical to keep ductus open