Cardiovascular

Question 1

When do you give abx ppx for dental procedures? What do you give?

Answer 1

prosthetic valves
prior endocarditis
heart txp
severe or repaired congenital heart defects

Question 2

what distinguises centrals (heart) vs peripheral cyanosis

Answer 2

central/heart = blue mucous membranes

Question 3

what are 4 characteristics that make a murmmur pathologic

Answer 3

symptomatic
> grade III
diastolic
continuous

Question 4

clicks = pahologic mumur?

Answer 4

no

Question 5

main diff between early onset and late onset cyanosis

Answer 5

early = R to L shunts
late = L to R shunts

Question 6

Drugs that keep PDA patent vs closed

Answer 6

patent = PDE1
close = indothemacin

Question 7

thrombocytopenia + bilaterial absent radii, look for what heart defect?

Answer 7

ASD

Question 8

MC congenital heart disease?

Answer 8

VSD

Question 9

murmur of VSD?

Answer 9

holosystolic blowing

Question 10

how long to wait until get surgical closure of PDA

Answer 10

1 month

Question 11

what is elsenmenger syndorme?

Answer 11

pulm HTN reverses L to R shunts to R to L shunts

Question 12

What are the 4 CHD that cause of early onset cyanosis?

Answer 12

1. tricuspid atresia
2. transposition of the great vessels
3. tetrology of fallot
4. TAPVR (total anomalous pulmonary venous return)

Question 13

find tricuspid atreasia, next step after birth?

Answer 13

give PGE1 to keep PDA open then get surgury

Question 14

egg on a string on CXR

Answer 14

transposition of great vessels

Question 15

CXR with diffuse reticular pattern in cyanoic newborn

Answer 15

TAPVR

Question 16

4 components of TOF

Answer 16

1. pulmonic stenosis (determines prognosis)
2. RVH
3. overridign aorta
4. VSD

Question 17

what is ebstein anomaly? what is it assc with?

Answer 17

RA hypertrophy with atrialized RV and tricuspif valve dilation

seen in babies whose mom was on Li

Question 18

trauma to hed/neck with stroke like presentation, Dx and next step

Answer 18

carotid artery disseaction, get MRI

Question 19

what infection classically causes myocarditis?

Answer 19

coxsackie B

Question 20

presentation of myocarditis

Answer 20

fever + lethargy + CHF

Question 21

MC restrictive cardiomyopathy in kids

Answer 21

endocardial fibroelastosis

Question 22

sore throat –> arthritis, erythema marginatum, choream subcut nodules

Answer 22

rheumatic fever

Question 23

tx for rheumatic fever

Answer 23

amoxicillin + PO steroids

Question 24

what is postpericardiotomy syndrome?

Answer 24

pericardial effusion (with possible tamponade) s/p cardiac surgury

Question 25

tx WPW

Answer 25

radiofrequency ablation

Question 26

pathophys of WPW

Answer 26

accessory tract

Question 27

Tx for prolonged QT/torsades

Answer 27

IV mag

Question 28

prolonged QT + deafness =

Answer 28

jervell-lang-nielsen syndrome

Question 29

wide QRS + ingestion, what was ingested? Tx?

Answer 29

TCAs (imipramine, amitriptyline)

give sodium bicarb

Question 30

syncope w/ upright Posture, Precipitating event causing intense emotion, Prodrome of dizziness or light-headedness, Pallor, no Palpitations, no Postictal sx

Dx? How to Dx? Tx?

Answer 30

neurocardiogenic syncope

Dx with tilt table testing
Tx: adequate hydration