Cardiology Flashcards
1
Q
descriptions of innocent murmurs
A
vibratory, venous hum, carotid bruit
2
Q
3rd heart sound
A
could be normal if only when laying
3
Q
murmur with fixed and split 2nd heart sound
A
ASD
4
Q
ASD murmur is hear best where
A
L upper sternal border (murmur is from increased flow through the pulmonary valve)
5
Q
if ASD is missed it could lead to
A
Eisenmenger syndrome (eventual R to L flow 2/2 pulmonary HTN)
6
Q
VSD murmur
A
blowing and holosystolic, best heard at L lower sternal border
7
Q
VSD murmur and size
A
larger size = softer murmur because less turbulence
8
Q
murmur with an ejection click that varies with respiration and normal splitting of S2
A
pulmonic stenosis
9
Q
pulmonic stenosis echo finding
A
RVH
10
Q
pulmonic stenosis murmur location
A
L upper sternal border with thrill and radiation to the back
11
Q
blowing/harsh holosystolic murmur
A
VSD
12
Q
high pitched holosystolic murmur
A
mitral regurgitation
13
Q
ejection click that does not vary with respiration
A
aortic stenosis
14
Q
aortic stenosis murmur best heard
A
right upper sternal borer with a thrill at the sternal notch
15
Q
echo finding in aortic stenosis
A
LVH
16
Q
to and fro machinery type murmur
A
PDA
17
Q
AV canal defect association
A
Down syndrome
18
Q
AV canal defect on EKG
A
superior QRS axis and L axis deviation
19
Q
things that produce L axis deviation on EKG but not LVH
A
AV canal defects and tricuspid atresia
20
Q
R sided aortic arch association
A
22q11 deletion
21
Q
coarctation murmur
A
systolic murmur in the L axilla with radiation to the upper back
22
Q
cardiac murmur that is louder in the back
A
coarctation
23
Q
echo findings in newborn with coarctation
A
RVH (RV is the main pumper in fetus)
24
Q
coarctation treatment
A
prostaglandin drip to maintain PDA to increase blood flow to the descending aorta
25
causes of severe central cyanosis in immediate newborn period
1. Transposition
2. pulmonary atresia
3. Epstein malformation
26
cyanotic congenital heart disease
1. truncus arteriosus
2. transposition
3. tricuspid atresia
4. tetralogy of fallot
5. total anomalous pulmonary venous return
27
tetralogy of fallot
1. pulmonary stenosis
2. overriding aorta
3. VSD
4. RVH w. R axis deviation
28
most common cyanotic heart disease in newborn
transposition
29
most common cyanotic heart disease in infant
tetralogy of fallot
30
boot shaped heart with decrease pulmonary vascularity
tetralogy of fallot
31
typical time to present with tetralogy of fallot
3 to 5 months
32
palpable R ventricular impulse and single 2nd heart sound
tetralogy of fallot
33
common triggers of a tet spell
anemia and dehydration
34
murmur during a tet spell
disappears (increased R to L shunting causing less flow to the lungs)
35
to correct a tet spell
increase peripheral vascular resistance (knees to chest)
| can give morphine, phenylephrine or IV propranolol to slow HR and increase filling)
36
egg shaped heart and increased pulmonary vascularity
transposition of the great arteries
37
genetic condition associated with aortic arch defects
digeorge
38
genetic condition associated with AV canal defects
Down syndrome
39
genetic condition associated with aortic root direction and mitral valve prolapse
marfan
40
genetic condition associated with supravalvular aortic stenosis
William syndrome
41
genetic condition associated with supravalvular pulmonic stenosis
Noonan syndrome
42
genetic condition associated with coarctation of the aorta
turner syndrome
43
what medication puts you at risk for PAC's turning into atrial flutter
digoxin
44
shortened PR interval with distorted QRS upstroke
WPW
45
diagnosis with recurrent syncope particularly during prolonged periods of standing
neurocardiogenic syncope
46
most common symptomatic arrhythmia in children
SVT
47
first thing to do in cardiovascularly stable patient in SVT
12 lead EKG then vasovagal maneuvers
48
treatment for SVT if vasovagal maneuvers don't work
adenosine, if it works and then SVT returns then amiodarone or procainamide
49
medication contraindicated in WPW
digoxin
50
long term management for SVT
digoxin (not with WPW)
51
most likely cause of Vtach with LOC
torsades de pointes
52
treatment for sustained Vtach
synchronized cardio version if longer than 30 seconds
53
3 or more continuous PVCs
Vtach
54
joint pain and new heart murmur
rheumatic fever
55
emotional lability with purposeless rapid movement
Sydenham chorea (rheumatic fever)
56
rheumatic fever diagnosis
recent group A strep A infection plus 2 major OR 1 major and 2 minor symptoms
57
most common heart murmur in rheumatic fever
mitral valve regurgitation
58
mitral vale regurgitation is best hear where
apex
59
major criteria for rheumatic fever
```
JONES
Joints (poly arthritis)
Carditis (CHF, new murmur, cardiomegaly)
Nodules (subcutaneous) - firm and painless
Erythema marginatum
Sydenham chorea
```
60
minor criteria for rheumatic fever
fever, arthralgia, elevated acute phase reactants, prolonged PR interval
61
risk factors for infective endocarditis
congenital heart disease and dental work
62
osler nodes
tender nodules on pads of fingers and toes
63
janeway lesions
non tender red nodules on palms or soles
64
best study to confirm diagnosis of infective endocarditis
blood culture
65
most common causes of acute bacterial endocarditis in kids
strep viridian's and staph aureus
66
initial treatment for infective endocarditis
vancomycin and gentamicin for 4-6 weeks minimum
67
alternatives to dental prophylaxis is penicillin allergic
clindamycin or azithromycin
68
dental prophylaxis if
incompletely repaired cyanotic heart disease or surgical correction in the past 6 months
69
diffuse low voltage on EKG
myocarditis
70
most common cause of myocarditis
coxsackie group B
71
myocarditis treatment
supportive care
72
most common bacterial cause of pericarditis
staph aureus
73
diffuse ST segment elevation on EKG
pericarditis
74
snowman or figure 8 on CXR
total anomalous pulmonary venous return
75
diagnosis for 8 hour old infant w/ diminished pulmonary vasculature on CXR, L superior axis deviation and LVH w/ small RV forces on EKG
tricuspid atresia
76
most common aortic arch abnormality
aberrant R subclavian artery
77
most common symptomatic aortic arch abnormality
double aortic arch
78
2nd most common cause of sudden death in high school athlete
anomalous origin of the L coronary artery from the aorta (first is HOCM)
79
diuretic that causes gynecomastia
spironolactone
80
diuretic that causes hyperkalemia
spironolactone
81
most common cause of cardiac chest pain in kids
pericarditis
82
is having an S3 or S4 more likely to be abnormal in a kid
S4
83
most common benign murmur of infancy
physiologic peripheral pulmonary stenosis
84
most common congenital heart defect
VSD
85
lithium in pregnancy is associated with what cardiac defect
Epstein anomaly of the tricuspid vale (leaflets displaced downward and attached to the R ventricular wall)
86
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
aortic regurgitation
87
mid to late systolic murmur at the apex that gets louder with standings and softer with squatting
mitral valve prolapse
88
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
pulmonic stenosis
89
progressive PR prolongation until a dropped QRS
mobitz 1 (wenckebach) second degree AV block
90
normal PR intervals but dropped QRS after every other P wave
mobitz 1 (second degree AV block)
91
most likely diagnosis with prolonged QT and failed newborn hearing screen
Jervell and Lange-Nielsen syndrome
92
peaked T waves
hyperkalemia
93
EKG with tall R wave and negative T wave in lead 6
LVH
94
alagille and noonan syndrome are both associated with what cardiac abnormality
pulmonic stenosis
95
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
aortic stenosis
96
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
aortic stenosis
97
cardiac condition associated with williams syndrome
supravalvular aortic stenosis
