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PANCE Subjects > Cardiology- Congenital, Valvular, Infectious > Flashcards

Cardiology- Congenital, Valvular, Infectious Flashcards

1
Q

MC Congenital defect

A

VSD

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2
Q

In VSD a loud murmur means

A

small defect

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3
Q 
1 week old infant with FTT
on exam a pansystolic murmur is heard with a palpable thrill
EKG shows possible LA abnl
dx
tx
A

ECHO demonstrates VSD
symptomatic with diuretics to “buy time”
surgical repair/device closure

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4
Q

3 week old female infant with fixed S2 split and systolic ejection murmur

A

ASD

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5
Q

Infant born at 27 weeks gestation has poor feeding. On exam bounding peripheral pulses. A machine like grinding murmur is heard best on LSB
Dx
Tx

A

PDA
can wait, can try indomethacin if neonate
surgical correction

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6
Q

ToF consists of

A

VSD
Overriding Aorta
Pulmonary Stenosis
RVH

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7
Q

Tx of ToF

A

Surgery always indicated

-temporize with BT shunt until ready for sx

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8
Q

MC cyanotic congenital heart diease

A

ToF

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9
Q

Acyanotic shunts are what direction

A

L to R

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10
Q

Cyanotic shunts are what direction

A

R to L

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11
Q

Eisenmenger Syndrome is

A

reversal of L to R shunt (no big deal) to R to L shunt (cyanotic)
- happens with defect lasts long enough for pulm HTN and RVH to happen which leads to reversal of flow

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12
Q

Tx Coarctation of Aorta

A

simple uncomplicated- balloon angioplasty

otherwise surgical resection

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13
Q

systolic crescendo-descrescendo ejection murmur that radiates to the carotids

A

Aortic Stenosis

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14
Q

Nocturnal angina and nocturnal dyspnea with diastolic murmur

A

Aortic Regurgitation

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15
Q

Harsh decrescendo diastolic murmur best at base. De-Musset pulse present

A

Aortic Regurgitation

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16
Q

How to diagnose all the murmurs…

A

ECHO

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17
Q

MCC Aortic regurg

A

Aortic stenosis

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18
Q

Acute aortic regurgitation treatment of choice

A

vasodilator- sodium nitroprusside

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19
Q

MCC mitral stenosis

A

rheumatic heart disease

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20
Q

Pt complaining of dyspnea. Tachycardic on exam with a low pitched diastolic murmur heard best at the apex and associated opening snap

A

Mitral Stenosis

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21
Q

Holosystolic blowing murmur with radiation to the left axilla

A

Mitral Regurgitation

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22
Q

Pt c/o light headedness and pre-syncopal episodes. PMH significant for Marfans. On exam a late systolic click is heard. ECHO shows leaflets in the LA.

A

Mitral Valve Prolapse

23
Q

MCC of Tricuspid Regurgiation

A

secondary to RV failure/dilation

24
Q

Soft systolic murmur best at 4th ICS LSP that increases with inspiration.

A

Tricuspid Regurgitation

25
Q

MCC Tricuspid Stenosis

A

rheumatic heart disease

26
Q

Pt presents with light headedness. On exam you note JVD and a diastolic murmur at LLSB that increases with inspiration and associated opening snap

A

Tricuspid Stenosis

27
Q

Valsalva ______ MR & _______ AS

A

decreases MR

decreases AS

28
Q

Hand grip ______ MR & ________ AS

A

increases MR

decreases AS

29
Q

MCC myocarditis

A

Viral: coxsackie, influenza, parvovirus, arbo, etc etc

30
Q

Patho of myocarditis

A

Inflammatory process with necrosis that involves the myocardium.
Can be direct injury by infectious agent, immune reaction, or from drugs.

31
Q

Acute onset CHF pts in young pt with few RF suggests

A

Myocarditis in ddx

32
Q

First step in dx myocarditis

Gold standard to dx

A

Cardiac MRI with Gadolinium

Biopsy is gold standard to confirm

33
Q

MC pathogen in endocarditis

A

Strep viridans

34
Q

MC site of endocarditis

A

mitral valve

35
Q

MC site of endocarditis in IVDU

MC pathogen in IVDU

A

Tricuspid valve

Staph aureus

36
Q

HIV/AIDS pts have increased susceptibility to what specific organism in endocarditis

A

Salmonella

37
Q

Native valve IE RF

A 
rheumatic heart
congenital heart
IVDU
poor dental hygiene
DM
on hemodialysis
38
Q

30 M presents with 5 days of fever and night sweats and minor dyspnea. On exam he has splenomegaly and nontender erythematous lesions on palms bilt and R sole.
Test of Choice

A

Blood cultures now!
start empiric abx
likely get ECHO
dx IE

39
Q

How to dx IE

A

Dukes Criteria: 2 major, 1 maj + minor, 5 minor
Major:
+ b.c. for typical organism
+ ECHO
Minor:
predisposing condition (IVDU, rheum)
temp >38.0
vasc phenom: Janeway lesions, ICH, arterial emboli
Immuno phenom: glomeruloneph, Osler nodes, Roth spots
ECHO findings
abnormal organism recovered

40
Q

Empiric treatment of infective endocarditis

A

Vanc + Gentamycin +/- Ceftriaxone

41
Q

MCC pericarditis

A

Viral- esp coxsackie and echoviruses

42
Q

pleuritic CP relieved when sitting up and leaning forward with friction rub on exam

A

Pericarditis

43
Q

Classic EKG findings of pericarditis

A

DIFFUSE ST segment elevation
low QRS amplitude
PR depression
~electrical alternans (from effusion)

44
Q

Work up of pericardial effusion

A

ECHO most sensitive to dx

diagnostic/therapeutic Pericardiocentesis/bx often indicated

45
Q

Cholesterol found in pericardial effusion suggests

A

hypothyroid cause

46
Q

Chylous material found in pericardial effusion suggests

A

lymphatic obstruction

47
Q

6 y/o M with 5 days of fever presents with stomatitis and cervical LAN. He also has a polymorphous exanthema in which there is desquamation of hands and feet.

A

Kawasaki Disease

48
Q

Untreated Kawasaki Disease patients are at risk of developing

A

coronary anuerysm

49
Q

Diagnostic Criteria for Kawasaki Disease

A

Dx if 4/5:
bilat painless conjunctivitis (non exudative)
stomatitis
cervical LAN
polymorphous exanthema
extremity changes- redness, swlling hands and feet with desquamation

50
Q

Treatment for Kawasaki Disease

A

IVIG and high dose ASA

51
Q

Rheumatic Fever caused by

A

immune response triggered by pharyngeal infection with group A strep

52
Q

Diagnostic Criteria for Rheumatic Fever

A 
2 major, 1 major + 2minor
Major:
   carditis
   polyarthritis- migratory
   Sydenham chorea
   erythema marginatum
   subQ nodules

Minor:
polyarthralgias, CRP, prolonged PR, fever, + throat culture, + ASO tier

53
Q

Valve MC affected in rheumatic fever

can lead to___

A

Mitral

mitral stenosis

54
Q

Tx for rheumatic fever

A

1.2 mill units PCN G IM

then PCN IM q month until 21 y/o

PANCE Subjects (12 decks)

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