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EOR - Pediatrics > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

leading cause of mitral valve stenosis and valve replacement in adults in the US

A

rheumatic fever

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2
Q

rheumatic fever develops in peds following what infxn

A

pharyngitis w. group A beta-hemolytic strep

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3
Q

most important virulence factor for GAS in humans

A

M protein

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4
Q

_ abs against the streptococcal infection may cross react with heart tissue

A

anti M abs

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5
Q

age group mc affected by rheumatic fever

A

5-15

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6
Q

major jones criteria

A

jones
joint pain (polyarthritis)
(o) carditis
nodules (subcutaneous)
erythema marginatum
sydenham’s chorea

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7
Q

minor jones criteria (5)

A

arthralgia
elevated ESR or CRP
fever
prolonged PR
leukocytosis

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8
Q

pt w. rheumatic fever may develop what arrhythmia

A

afib

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9
Q

tx for rheumatic fever

A

pcn
asa

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10
Q

7 pediatric heart defects to know

A

ASD
coarctation of the aorta
HOCM
kawasaki dz
PDA
TOF
VSD

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11
Q

-hyperdynamic precordium w. prominent right ventricular heave
-grade III/IV systolic ejection murmur in 2nd left ICS w. early to mid systolic rumble and split S2

A

ASD

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12
Q

ASD is caused by a patent

A

foramen ovale

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13
Q

what diagnosis makes you think ASD in a kiddo

A

failure to thrive

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14
Q

is ASD cyanotic

A

no!

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15
Q

gs dx for ASD

A

passing a catheter thru the defect

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16
Q

tx for ASD (4)

A

diuretics
ACEI
digoxin
surgical closure

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17
Q

wide, fixed, split S2
systolic ejection murmur at 2nd ICS
early to mid systolic rumble

A

ASD

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18
Q

8 yo M who tires easily and c/o leg weakness - PE is mostly normal but LE are slightly atrophic and mottled - he also has weak/delayed femoral pulses - he has a late systolic ejection murmur

A

coarctation of the aorta

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19
Q

what is this showing

A

figure of 3 sign -> coarctation of the aorta

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20
Q

t/f: coarctation of the aorta is NON cyanotic

A

t!

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21
Q

what pt pop makes you think of coarctation of the aorta

A

teens/twenties w. HTN

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22
Q

hallmark finding of coarctation of the aorta

A

elevated BPin arms
low BP in legs

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23
Q

ejection murmur in aortic area and LSB that radiates to the left axilla and left back

A

coarctation of the aorta

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24
Q

what malformation is seen in 50% of coarctation pt’s

A

bicuspid valve

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25
Q

coarctation increases the risk for

A

berry aneurysm

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26
Q

dx for coarctation of the aorta

A
  1. echo
  2. EKG
  3. CXR
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27
Q

what is this showing

A

figure of 3 sign -> rib notching -> coarctation of the aorta

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28
Q

EKG finding of coarctation of the aorta

A

LVH

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29
Q

tx for coarctation of the aorta

A

prostaglandins E1
surgical repair w. balloon dilation

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30
Q

HOCM is a _ genetic condition

A

autosomal dominant

31
Q

25 yo F presents w. syncopal episode and loss of consciousness x 3 over the past year, each occurring just after PA - normal vitals - systolic ejection murmur heard best at LSB

A

HOCM

32
Q

the HOCM murmur increases w. _ (2)
and decreases w. _

A

increaes: standing, valsalva
decreases: squatting

33
Q

EKG finding of HOCM (2)

A

diffused increased QRS voltage
LVH

34
Q

3 sx of HOCM

A

SOB
CP
syncope after exertion

35
Q

what heart sound is associated w. HOCM

A

S4

36
Q

the HOCM murmur increases in intensity w. any maneuver that

A

decreases preload

37
Q

tx for HOCM

A

bb + disopyramide
CCB

38
Q

_ should be avoided in HOCM tx

A

diuretics (decrease preload)

39
Q

5 yo presents to ED w. 5 days of fevers, morbilliform rash, bilat conjunctivitis, bright red tongue, and swollen hands/feet

A

kawasaki dz

40
Q

4 lab elevations associated w. kawasaki dz

A

ESR
CRP
WBC
PLT

+/- LFTs

41
Q

kawasaki is autoimmune destruction of the

A

arteries -> vasculitis

42
Q

hallmark first sign of kawasaki

A

persistent fever in kids < 5 yo

43
Q

what does crash and burn fever make you think of

A

kawasaki dz:
conjunctival injxn (spares limbus, non purulent)
rash (all body, desquamating)
adenopathy (cervical, assymetric, nontender)
strawberry tongue/red cracked lips
hand/foot rash
burn: fever >/= 5 days unresponsive to antipyretics

44
Q

25% of kawasaki dz pt’s have what sequelae (3)

A

coronary artery aneurysm
myocarditis
MI

45
Q

dx criteria for kawasaki dz

A

4/5 of CRASH
PLUS
high fever >/= 5 days

46
Q

definitive dx for kawasaki dz

A

vasculitis in coronary arteries

47
Q

all pt’s w. suspected kawasaki should get

A

echo:
at time of dx
2-6 weeks later

48
Q

tx for kawasaki

A

IVIG
asa
to reduce risk of cardiac complications

self limited in 6-8 weeks regardless of tx

49
Q

2 week old infant w. PMH prematurity presents w. pink torso and UE plus blue LE

A

PDA

50
Q

murmur associated w. PDA

A

rough, continuous machinery heard over LSB at 2nd ICS

51
Q

sx of PDA

A

tachypnea
diaphoresis
poor feeding
no weight gain

in 3-6 mo old

52
Q

2 PE findings of PDA

A

bounding pulses
widened pulse pressure

53
Q

what substance keeps ductus arteriosus patent

A

prostaglandin e2 (alprostadil)

54
Q

tx for PDA

A

NSAIDs/indomethacin (blocks PG e2 -> closes PDA)

55
Q

transient loss of consciousness/postural tone 2/2 to acute decrease in cerebral blood low w. rapid recovery

A

syncope

56
Q

2 mcc of syncope

A

vasovagal
idiopathic

57
Q

6 red flags w. syncope

A

during exertion
multiple recurrences in short time
murmur/structural heart dz
old age
significant injury during event
fam hx undexpected death

58
Q

5 types of syncope

A

vasovagal
cardiac
orthostatic
cerebral vascular dz
noncardiogenic

59
Q

cardiac syncope is associated w.

A

arrhythmia

60
Q

defect in vasomotor reflexes

A

orthostatic hypotn

61
Q

orthostatic hypotn is common in what pt pops (3)

A

elderly
diabetics
taking diuretics/vasodilating meds

62
Q

workup for syncope (5)

A

ECG
glucose
pulse ox
echo
tilt table

63
Q

2 week old infant w. sudden loss of consciousness during feeding - lips are cyanotic - hypotensive

A

TOF

64
Q

grade 3/6, holosystolic, harsh, decrescendo/crescendo ejection murmur heard best at left left USD

A

TOF

65
Q

what is this showing

A

small, boot shaped heart -> TOF

66
Q

hallmark symptom of TOF

A

tet spell: cyanosis and loss of consciousness w. crying

67
Q

what does PROV stand for

A

4 features of TOF:

pulmonary stenosis
right ventricular hypertrophy
overriding aorta
ventricular septal defect

68
Q

TOF murmur radiates to the

A

back

69
Q

4 yo M who is easily fatigued - has loud, harsh, holosystolic murmur at left lower sternal border w. NO radiation to the axillae

A

ventricular septal defect

70
Q

mc pathologic murmur in peds

A

ventricular septal defect

71
Q

complication of VSD

A

pulmonary HTN

72
Q

t/f: VSD is cyanotic

A

f!

73
Q

t/f: small-med VSD’s may self resolve

A

t!

most close by 6 yo

EOR - Pediatrics (15 decks)

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