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Peds Shelf > Cardiology_UW_Pretest > Flashcards

Cardiology_UW_Pretest Flashcards

1
Q

TCA overdose should be treated with

A

Sodium bicarbonate

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2
Q

Turner syndrome is a/w karyotype?

A

XO karyotype

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3
Q

Marfan syndrome mutation?

A

15a21.1

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4
Q

Incidence of congenital heart disease in population is ? If one child has CHD, risk for second child? If 2 children have CHD, risk for third is?

A

1%; 2-6%; 20-30%

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5
Q

Kawasaki presentation

A

Prolonged fever, polymorphous rash, extremity changes (swelling in early period, peeling in later), non-purulent conjunctivitis, lymphadenopathy, oral mucosal changes.

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6
Q

How do you diagnose infective endocarditis

A

Serial positive blood cultures and echo findings of vegetations and mycoardial abscesses

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7
Q

Tx for infective endocarditis

A

Appropriate antibiotic for 4-8 weeks; surgical intervention is reserved for patients with valvular obstruction, CHF or abscess.

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8
Q

Organisms that cause IE?

A

Strep, Staph, coag neg strep pneumo, HACEK organisms (haemophilis, actinobacillus actinomycetemcomitans, Cardiobacterium hominis, eikenella corrodens, kingella)

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9
Q

SVT is characterized by what heart rate

A

Above 250bpm

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10
Q

Adenosine is used to treat?

A

SVT if maneuvers don’t work. It’s a vasodilator

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11
Q

First line tx for SVT

A

Maneuvers like carotid massage, face immersion in cold water, voluntary straining

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12
Q

Ebstein anomaly murmur

A

Tricuspid regurg murmur, mid-diastolic murmur (due to tricuspid stenosis), quadruple rhythm (s3 and s4)

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13
Q

Presentation of juvenile idiopathic arthritis?

A

1) Polyarthritis (five or more joints, systemic sx not so severe or persistent) 2) pauciarticular (4 or fewer joints, LE joints, extra-articular disease) or 3) systemic disease (severe constitutional disease, systemic sx prior to arthritis, rheumatoid rash, high spiking fevers, also known as still’s disease).

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14
Q

What kind of swelling can JIA cause?

A

Spinle shaped swelling of finger joints

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15
Q

LVH, L v impulse with left axis deviation and left ventricular hypertrophy due to a congenital heart disease, makes you think of?

A

Tricuspid atresia. In tricuspid atresia, there’s hypoplastic RV => no right axis deviation => left axis deviation

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16
Q

Neonatal lupus can cause what heart condition?

A

Congenital heart block. Rare manifestation of transferred maternal IgG autoantibodies. Infants can have thrombocytopenia, neutropenia, rash and liver dysfunction.

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17
Q

Turner syndrome phenotype

A

Webbed neck, widely spaced nipples, narrow high arched palate, low set ears, bicuspid aortic valve, coarctation of the aorta, horse shoe kidneys, streak ovaries, amenorrhea, infertility

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18
Q

Common cardiac abnormalities with turner syndrome

A

Do echo to check for 1) bicuspid aortic valve 2) coarctation of aorta and 3) aortic root dilation

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19
Q

VSDs are a/w mostly with?

A

Aneuploidys. 13, 18 and 21.

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20
Q

MVP is a/w patients with what?

A

Connective tissue disorders (marfan, ehlers danlos, OI)

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21
Q

Most common congenial heart disease in neonatal period

A

Transposition of the great arteries

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22
Q

PE and Xray findings for TGA

A

Loud single S2, VSD murmur may or may not be present depending on whether there is a VSD; egg on a string heart (narrow mediastinum)

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23
Q

Tx for TGA?

A

Start prostaglandins immediately to keep PDA open till septostomy of surgical repair can be done.

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24
Q

Most common congenital heart disease after neonatal period

A

Tetralogy of Fallot

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25
Q

What are the precordial leads

A

V1-V3

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26
Q

Stridor due to vascular ring improves with what maneuver and do not improve with what meds?

A

Neck extension; don’t improve with steroids, racemic epinephrine or bronchodilators

27
Q

In older intants an children, inspiratory stridor is most commonly caused by?

A

Croup (laryngotracheobronchitis); a/w barky cough, fever, rhinorrhea

28
Q

In infants

A

antomotic abnormalities like vascular rings

29
Q

What is the distinguishing feature of laryngomalacia

A

Severe stridor between 4 and 8 months; worsens in supine position, improves in prone position

30
Q

Infants with vascular rings (before age 1) present with what symptoms?

A

Respiratory or esophageal sx such as stridor, wheezing, cough dysphagia

31
Q

Wht are the most common cause of pediatric myocarditis?

A

viruses especially coxsackie and adenovirus. Other offenders - toxins, autoimmune diseases.

32
Q

How does viral myocarditis present?

A

Viral prodrome (nausea, fever, fatigue, muscle aches etc) and signs of heart failure (respiratory distress - tachypnea, dyspnea, wheezing, crackles) and pulmonary edema. Also cardiothoracic ratio is greater than normal. (normal is less than or equal to 60% for healthy infants

33
Q

Presentation for Kawasaki

A

Fever for 5 days, bilateral non exudative conjunctivitis, mucositis, cervical lymph node >1.5cm, rash, swelling and or erythema of palms/soles

34
Q

What is Jervell and Lange-Nielsen syndrome? a/w what sx?

A

AR congenital long QT syndrome caused by molecular defects in potassium channels. a/w deafness

35
Q

What is the tx for Jervel-Lange-Nielsen syndrome?

A

Avoid any drugs that block potassium channels/prolong QT interval. Give beta blockers and pacemaker placement can prevent cardiac arrest.

36
Q

Mitral stenosis is almost always due to?

A

Rheumatic fever

37
Q

Patients who hve a hx of rheumatic fever should have what kind of prophylaxis to avoid future GAS pharyngitis.

A

Im benzathine penicillin q4wks. Depends on level of cardiac involvement.

38
Q

PDA is a/w what kind of murmur?

A

Continuous murmur.

39
Q

VSD murmur ?

A

holosystolic mumur over LLSB with a diastolic rumble over cardiac apex

40
Q

TOF murmur

A

Harsh systolic ejection murmur over left upper sternal border from the pulmonary stenosis. Also, just a single S2.

41
Q

What is indomethacin

A

potent prostaglandin inhibitor

42
Q

PDA is a/w what disease?

A

Congenital rubella syndrome

43
Q

Downs syndrome has what kind of congenital heart defects (in order)

A

AVSD, VSD, ASD and ToF

44
Q

What are breath holding spells? What age does it usually occur?

A

Episodes of apnea precipitated by anger, frustration, pain or minor trauma. Usually also color change. Usually occurs between 6 months and 2 years.

45
Q

What is the work-up for breat holding spells?

A

Complete blood count and serum ferritin. Breath holding spells are a/w iron deficiency anemia.

46
Q

What is post pericardiotomy syndrome?

A

Can occur within days or months after cardiac surgery. Life threatening fluid accumulation -> distant heart sounds, jugular vein distension, hypotension. Requires drainage.

47
Q

Hypertrophic cardiomyopathy is inherited in what pattern?

A

A/D

48
Q

Long QT syndrome vs HCM. What’s more prevalent

A

HCM

49
Q

EKG in WPW syndrome is characterized by?

A

Widened QRS complexes, shortened PR intervals, and delta waves.

50
Q

Snowman heart

A

TAPVR. A/w obstruction to pulmonary venous return and classic finding of marked, fluffy appearing venous congestion.

51
Q

Boot shaped heart

A

Tricuspid Atresia, TOF

52
Q

Egg shaped heart

A

TGA

53
Q

Mom taking phenytoin increases risk for?

A

VSD, ASD, PS, AS, coarctation (VAPAC)

54
Q

Mom taking valproate, risk for?

A

VAHC - VSD, AS, HLHS, Coarctation

55
Q

Mom has DM, kid at risk for

A

TGA, coarctation, VSD (2-3%)

56
Q

Mom has PKU kid at risk for

A

TOF (25-50%)

57
Q

Mom has SLE, kid has

A

Complete heart block(20-40%)

58
Q

PE for ASD

A

grade 2-3/6 pulmonic flow mumur (systolic ejection murmur), mid-diastolic rumble at left lower sternal border (due to increased flow through tricuspid valve), widely split and fixed S2 (left to right shunt leads to increased right ventricle volume, leads to delayed S2 closing)

59
Q

PE for VSD

A

holosystolic murmur at LLSB

60
Q

PE for PDA

A

Widened pulse pressure, hyperactive precordium, big bouning pulse, heavy machinery murmur, high puse rate.

61
Q

Features of hypoplastic left heart syndrome

A

Hypoplastic LV, narrow mitral/aortic valves, small ascending aorta, contracted aorta

62
Q

features of CHF

A

tachycardia, tachypnea, cardiomegaly, hepatomegaly

63
Q

Thrombocytopenia absent radius syndrome? Most common cardiac lesions.

A

Profound thrombocytopenia, bilateral absene of radius and abnormally shaped thumbs. ToF and ASD.

Peds Shelf (12 decks)

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