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BOARDS > Cardiology > Flashcards

Cardiology Flashcards

1
Q

descriptions of innocent murmurs

A

vibratory, venous hum, carotid bruit

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2
Q

3rd heart sound

A

could be normal if only when laying

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3
Q

murmur with fixed and split 2nd heart sound

A

ASD

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4
Q

ASD murmur is hear best where

A

L upper sternal border (murmur is from increased flow through the pulmonary valve)

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5
Q

if ASD is missed it could lead to

A

Eisenmenger syndrome (eventual R to L flow 2/2 pulmonary HTN)

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6
Q

VSD murmur

A

blowing and holosystolic, best heard at L lower sternal border

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7
Q

VSD murmur and size

A

larger size = softer murmur because less turbulence

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8
Q

murmur with an ejection click that varies with respiration and normal splitting of S2

A

pulmonic stenosis

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9
Q

pulmonic stenosis echo finding

A

RVH

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10
Q

pulmonic stenosis murmur location

A

L upper sternal border with thrill and radiation to the back

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11
Q

blowing/harsh holosystolic murmur

A

VSD

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12
Q

high pitched holosystolic murmur

A

mitral regurgitation

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13
Q

ejection click that does not vary with respiration

A

aortic stenosis

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14
Q

aortic stenosis murmur best heard

A

right upper sternal borer with a thrill at the sternal notch

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15
Q

echo finding in aortic stenosis

A

LVH

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16
Q

to and fro machinery type murmur

A

PDA

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17
Q

AV canal defect association

A

Down syndrome

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18
Q

AV canal defect on EKG

A

superior QRS axis and L axis deviation

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19
Q

things that produce L axis deviation on EKG but not LVH

A

AV canal defects and tricuspid atresia

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20
Q

R sided aortic arch association

A

22q11 deletion

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21
Q

coarctation murmur

A

systolic murmur in the L axilla with radiation to the upper back

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22
Q

cardiac murmur that is louder in the back

A

coarctation

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23
Q

echo findings in newborn with coarctation

A

RVH (RV is the main pumper in fetus)

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24
Q

coarctation treatment

A

prostaglandin drip to maintain PDA to increase blood flow to the descending aorta

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25
Q

causes of severe central cyanosis in immediate newborn period

A
  1. Transposition
  2. pulmonary atresia
  3. Epstein malformation
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26
Q

cyanotic congenital heart disease

A
  1. truncus arteriosus
  2. transposition
  3. tricuspid atresia
  4. tetralogy of fallot
  5. total anomalous pulmonary venous return
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27
Q

tetralogy of fallot

A
  1. pulmonary stenosis
  2. overriding aorta
  3. VSD
  4. RVH w. R axis deviation
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28
Q

most common cyanotic heart disease in newborn

A

transposition

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29
Q

most common cyanotic heart disease in infant

A

tetralogy of fallot

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30
Q

boot shaped heart with decrease pulmonary vascularity

A

tetralogy of fallot

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31
Q

typical time to present with tetralogy of fallot

A

3 to 5 months

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32
Q

palpable R ventricular impulse and single 2nd heart sound

A

tetralogy of fallot

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33
Q

common triggers of a tet spell

A

anemia and dehydration

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34
Q

murmur during a tet spell

A

disappears (increased R to L shunting causing less flow to the lungs)

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35
Q

to correct a tet spell

A

increase peripheral vascular resistance (knees to chest)

can give morphine, phenylephrine or IV propranolol to slow HR and increase filling)

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36
Q

egg shaped heart and increased pulmonary vascularity

A

transposition of the great arteries

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37
Q

genetic condition associated with aortic arch defects

A

digeorge

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38
Q

genetic condition associated with AV canal defects

A

Down syndrome

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39
Q

genetic condition associated with aortic root direction and mitral valve prolapse

A

marfan

40
Q

genetic condition associated with supravalvular aortic stenosis

A

William syndrome

41
Q

genetic condition associated with supravalvular pulmonic stenosis

A

Noonan syndrome

42
Q

genetic condition associated with coarctation of the aorta

A

turner syndrome

43
Q

what medication puts you at risk for PAC’s turning into atrial flutter

A

digoxin

44
Q

shortened PR interval with distorted QRS upstroke

A

WPW

45
Q

diagnosis with recurrent syncope particularly during prolonged periods of standing

A

neurocardiogenic syncope

46
Q

most common symptomatic arrhythmia in children

A

SVT

47
Q

first thing to do in cardiovascularly stable patient in SVT

A

12 lead EKG then vasovagal maneuvers

48
Q

treatment for SVT if vasovagal maneuvers don’t work

A

adenosine, if it works and then SVT returns then amiodarone or procainamide

49
Q

medication contraindicated in WPW

A

digoxin

50
Q

long term management for SVT

A

digoxin (not with WPW)

51
Q

most likely cause of Vtach with LOC

A

torsades de pointes

52
Q

treatment for sustained Vtach

A

synchronized cardio version if longer than 30 seconds

53
Q

3 or more continuous PVCs

A

Vtach

54
Q

joint pain and new heart murmur

A

rheumatic fever

55
Q

emotional lability with purposeless rapid movement

A

Sydenham chorea (rheumatic fever)

56
Q

rheumatic fever diagnosis

A

recent group A strep A infection plus 2 major OR 1 major and 2 minor symptoms

57
Q

most common heart murmur in rheumatic fever

A

mitral valve regurgitation

58
Q

mitral vale regurgitation is best hear where

A

apex

59
Q

major criteria for rheumatic fever

A 
JONES
Joints (poly arthritis)
Carditis (CHF, new murmur, cardiomegaly)
Nodules (subcutaneous) - firm and painless
Erythema marginatum
Sydenham chorea
60
Q

minor criteria for rheumatic fever

A

fever, arthralgia, elevated acute phase reactants, prolonged PR interval

61
Q

risk factors for infective endocarditis

A

congenital heart disease and dental work

62
Q

osler nodes

A

tender nodules on pads of fingers and toes

63
Q

janeway lesions

A

non tender red nodules on palms or soles

64
Q

best study to confirm diagnosis of infective endocarditis

A

blood culture

65
Q

most common causes of acute bacterial endocarditis in kids

A

strep viridian’s and staph aureus

66
Q

initial treatment for infective endocarditis

A

vancomycin and gentamicin for 4-6 weeks minimum

67
Q

alternatives to dental prophylaxis is penicillin allergic

A

clindamycin or azithromycin

68
Q

dental prophylaxis if

A

incompletely repaired cyanotic heart disease or surgical correction in the past 6 months

69
Q

diffuse low voltage on EKG

A

myocarditis

70
Q

most common cause of myocarditis

A

coxsackie group B

71
Q

myocarditis treatment

A

supportive care

72
Q

most common bacterial cause of pericarditis

A

staph aureus

73
Q

diffuse ST segment elevation on EKG

A

pericarditis

74
Q

snowman or figure 8 on CXR

A

total anomalous pulmonary venous return

75
Q

diagnosis for 8 hour old infant w/ diminished pulmonary vasculature on CXR, L superior axis deviation and LVH w/ small RV forces on EKG

A

tricuspid atresia

76
Q

most common aortic arch abnormality

A

aberrant R subclavian artery

77
Q

most common symptomatic aortic arch abnormality

A

double aortic arch

78
Q

2nd most common cause of sudden death in high school athlete

A

anomalous origin of the L coronary artery from the aorta (first is HOCM)

79
Q

diuretic that causes gynecomastia

A

spironolactone

80
Q

diuretic that causes hyperkalemia

A

spironolactone

81
Q

most common cause of cardiac chest pain in kids

A

pericarditis

82
Q

is having an S3 or S4 more likely to be abnormal in a kid

A

S4

83
Q

most common benign murmur of infancy

A

physiologic peripheral pulmonary stenosis

84
Q

most common congenital heart defect

A

VSD

85
Q

lithium in pregnancy is associated with what cardiac defect

A

Epstein anomaly of the tricuspid vale (leaflets displaced downward and attached to the R ventricular wall)

86
Q

high pitched early diastolic decrescendo murmur that begins in the aortic component of the 2nd heart sounds and a low pitched mid diastolic murmur at the apex

A

aortic regurgitation

87
Q

mid to late systolic murmur at the apex that gets louder with standings and softer with squatting

A

mitral valve prolapse

88
Q

systolic ejection click that varies with respiration along the L sternal border, followed by a crescendo-decrescendo murmur at the LUSB, radiates to L clavicle and the back, EKG with peaked P waves in lead 2, R axis deviation and RVH

A

pulmonic stenosis

89
Q

progressive PR prolongation until a dropped QRS

A

mobitz 1 (wenckebach) second degree AV block

90
Q

normal PR intervals but dropped QRS after every other P wave

A

mobitz 1 (second degree AV block)

91
Q

most likely diagnosis with prolonged QT and failed newborn hearing screen

A

Jervell and Lange-Nielsen syndrome

92
Q

peaked T waves

A

hyperkalemia

93
Q

EKG with tall R wave and negative T wave in lead 6

A

LVH

94
Q

alagille and noonan syndrome are both associated with what cardiac abnormality

A

pulmonic stenosis

95
Q

most likely diagnosis in 4 day old who presents looking like shock with systolic murmur at RUSB, early systolic ejection click, diminished pulses and severe pulmonary edema and cardiomegaly on CXR

A

aortic stenosis

96
Q

diagnosis in 10 year old with crescendo-decrescendo harsh systolic murmur at RUSB that radiates to suprasternal notch and neck, systolic ejection click at the apex and suprasternal notch thrill

A

aortic stenosis

97
Q

cardiac condition associated with williams syndrome

A

supravalvular aortic stenosis

BOARDS (24 decks)

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