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PEDIATRICS > CARDIOVASCULAR > Flashcards

CARDIOVASCULAR Flashcards

1
Q

What is the etiology of Atrial Septum Defect (ASD)?

A

osteum secundum

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2
Q

What is the definition of ASD?

A

hole in the ATRIAL septum

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3
Q

What are the S/S of ASD?

A

most patients are asymptommatic until > 30 years old

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4
Q

What type of murmur is ASD?

A

systolic ejection crescendo-decrescendo murmur at the PULMONIC area

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5
Q

What type of split does ASD have?

A

WIDELY SPLIT S2 that does NOT vary with respirations (splits all throughout respirations)

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6
Q

What would see on the EKG for a patient that has ASD?

A

incomplete or complete RBB - present in ALL ASD patients

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7
Q

What is the treatment for ASYMPTOMATIC patients with ASD?

A

no treatment needed. Shunts will likely close on their own and require nO intervention

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8
Q

What is the treatment for SYMPTOMATIC patients with ASD?

A

shunts > 1:5:1 - percutaneous device or surgery

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9
Q

What is the definition of Ventricular Septum Defect (VSD)?

A

hole in the ventricular septum

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10
Q

What is the most common type of VSD?

A

membranous

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11
Q

What type of murmur do SMALL shunts cause in VSD?

A

HIGH PITCHED, HARSH HOLOSYSTOLIC murmurs

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12
Q

Where is the murmur best heard at in VSD?

A

3rd or 4th intercostal spaces along the LEFT sternal border

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13
Q

What is Eisenmenger Syndrome?

A

occurs when a left to right shunt switches to a RIGHT to LEFT hunt

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14
Q

What are the S/S of Eisenmenger Syndrome?

A

cyanosis, dyspnea, syncope, desaturation, clubbing

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15
Q

What is the diagnostic test of choice for ALL pediatric murmurs?

A

ECHO

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16
Q

Treatment for VSD?

A

observation as most are asymptomatic

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17
Q

Treatment when VSD is residual from a prior patch closure, pulmonary HTN or cyanosis?

A

antibiotic prophylaxisis

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18
Q

treatment for large shunts of VSD?

A

patch closure surgery

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19
Q

What is Patent Ductus Arteriosus (PDA)?

A

persistent aortic-pulomonary shunt via ductus arteriosus that fails to completely close at birth

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20
Q

What is the etiology of PDA?

A

HIGH PGE E2 production and LOW oxygen promote patency (keeps ductus OPEN!)

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21
Q

Most kids with PDA are ___________

A

asymptommatic

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22
Q

What symptoms will develop in kids with PDA?

A

poor feeding, poor weight gain, weight loss

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23
Q

What kind of murmur is in a patient with PDA?

A

Machine like murmur that is loudest in the PULMONIC area. May radiate to the back

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24
Q

What type of pressure is in patients with PDA?

A

WIDE bounding pulse pressure (> 30 mmHg) including BOUNDING peripheral pulses

LOUD S2 sounds

25
Q

What is the treatment for PDA?

A

FIRST LINE: IV Indomethacin or Ibuprofen (NSAIDS)

26
Q

What is the most common form of cyanotic heart disease in a newborn?

A

Transposition of the great vessels

27
Q

Failure of the _____ to increase suggest cyanotic heart disease

A

PaO2

28
Q

What would you see on a physical exam of a patient with TofGV?

A

Systolic murmur and a single S2 sound

29
Q

What is coarctation of the aorta?

A

Congenital nearing of the aortic looming at the distal, arch or descending or aorta

30
Q

What does CoA cause?

A

Systolic hypertension in the upper extremities relative to the lower extremities (blood pressure is higher in the arms than it is the legs)

31
Q

CoA is associated with what syndrome?

A

Turner’s syndrome

32
Q

What heart valve is CoA associated with?

A

Bicuspid valve

33
Q

What is the most symptom of CoA?

A

Hypertension (MC in adults)

34
Q

What type of pulses does CoA have?

A

STRONG arterial pulses that are seen in the neck and super sternal notch

35
Q

Describe the type of murmur in CoA?

A

Harsh systolic murmur along the left sternal border radiating to the back, left in scapular region, or chest

36
Q

What are some physical exam findings in a patient with CoA?

A

Systolic hypertension is higher in arms > legs (> 10 mmHg)

37
Q

How are the femoral pulses affected in CoA?

A

For more pulsations are weak and delayed in comparison with the brachial and radial pulse

38
Q

What does the EKG show in a patient with CoA?

A

LVH

39
Q

What is a Hallmark finding in the chest ray for a patient with CoA?

A

Posterior rib notching
Figure 3 sign

40
Q

What is a confirmatory test for CoA?

A

ECHO

41
Q

What is the treatment of choice for a patient with CoA?

A

Endovascular stenting (balloon preferred over metal)

42
Q

What conditions are associated with Tetralogy of Fallot ?

A

Down syndrome
DeGeorge’s syndrome

43
Q

Is tetralogy of fallot cyanotic or acyanotic

A

Cyanotic (right to left shunt)

44
Q

What are the four parts that make up the etiology of TofF?

A

Overarching aorta
VSD
Pulmonary stenosis
Right ventricular hypertrophy

45
Q

TofF is also known as what?

A

Blue baby syndrome

Blue spells and issue the first two years of life this consist of restlessness, cyanosis, gasping, respirations, and syncope

46
Q

What is the treatment for? TofF?

A

Surgical repair in the first 3 to 12 months of life

And patients TOF, a TTE is recommended every 12 to 14 months based on his degree of regurgitation

47
Q

What type of murmur is TofF?

A

Harsh holosystolic murmur at the left upper sternal border

48
Q

What type of murmur is TofF?

A

Harsh holosystolic murmur at the left upper sternal border

49
Q

What EKG findings would you see on a patient with TofF?

A

RVH

50
Q

What would you see on a chest rate in a patient with TofF?

A

“Boot shaped” with the prominence of right ventricular and a cavity in the right ventricular outflow tract

51
Q

What is the second most common CYANOTIC congenital heart disease?

A

Transposition of the Great Arteries (TOGA)

52
Q

Where does the majority of mixing in the Transposition of the Great Arteries?

A

at the atrial level

53
Q

If the atrial communication is inadequate at birth in TGV then a patient can becomes severely ________

A

cyanotic

54
Q

What are the signs and symptoms of TOGA?

A

many newborns are profoundly cyanotic newborn WITHOUT distress or a significant murmur
MC in males

55
Q

Imaging on TOGA

A

CXR: show egg on a string apprance

56
Q

In TOGA, there is + involution but no ______

A

twisiting (hence arteries are PARALLEL

57
Q

INITIAL treatment of TOGA

A

Prostalglandin E1 (Alprostadil) to maintain PDA

58
Q

DEFINITIVE treatment for TOGA

A

Arterial Switch Operation (ASO)

PEDIATRICS (8 decks)

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