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Pediatric EOR > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Systolic ejection crescendo-decrescendo best heard at pulmonic area. Widely fixed, split S2

A

Atrial septal defect

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2
Q

Usually asymptomatic until > 30 y/o

A

Atrial septal defect

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3
Q

Diagnosis of atrial septal defect

A

CXR: cardiomegaly
ECG: incomplete RBBB
Echo: gold standard

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4
Q

Management of atrial septal defect

A

Spontaneous closure likely in first year so may observe if small
Surgical correction if symptomatic

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5
Q

Bilateral lower extremity claudication

A

Coarctation of the aorta

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6
Q

Systolic blood pressure in upper extremities > lower extremities, delayed or weak femoral pulses

A

Coarctation of the aorta

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7
Q

Systolic murmur that radiates to the back/scapula/chest

A

Coarctation of the aorta

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8
Q

Diagnosis of coarctation of the aorta

A
  1. CXR: rib notching - “3” sign
  2. ECG: LVH
  3. Angiogram: gold standard, CT scan
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9
Q

Management of coarctation of the aorta

A

Surgical correction

Balloon angioplasty, prostaglandin E preoperatively

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10
Q

Continuous machinery murmur loudest at pulmonic area

A

Patent ductus arteriosus

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11
Q

Bounding pulses, wide pulse pressure

A

Patent ductus arteriosus

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12
Q

Pulmonary hypertension - left to right shunt switches and become right to left shunt (cyanotic). Normal hands with cyanotic lower extremities (clubbed, blue toes)

A

Eisenmenger’s Syndrome
Patent Ductus Arteriosus
Ventricular Septal Defect
Tetralogy of Fallot

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13
Q

Diagnosis of patent ductus arteriosus

A
  1. CXR: normal or cardiomegaly
  2. ECG: LVH, left atrial enlargement
  3. Echo: gold standard
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14
Q

Management of patent ductus arteriosus

A

IV indomethacin - closes

Surgical correction if fails

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15
Q

Most common cyanotic heart disease overall

A

Tetralogy of Fallot

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16
Q

Tet spells - period of episodes of cyanosis relieved with squatting or putting an infant’s knees to its chest

A

Tetralogy of Fallot

17
Q

4 components of tetralogy of fallot

A
  1. RV outflow obstruction - pulmonary artery stenosis
  2. RV hypertrophy
  3. VSD
  4. Overriding aorta
18
Q

Harsh holosystolic murmur at left upper sternal border, right ventricular heave

A

Tetralogy of fallot

19
Q

Diagnosis of tetralogy of fallot

A
  1. CXR: boot shaped heart
  2. ECG: right ventricular hypertrophy
  3. Echo - gold standard
20
Q

Management of tetralogy of fallot

A

Surgical repair performed in first 4-12 months of life

21
Q

Most common type of congenital heart disease

A

Ventricular septal defect

22
Q

Most common type of ventricular septal defect

A

Perimembranous

23
Q

Loud high-pitched harsh, holosystolic murmur at the lower left sternal border

A

Ventricular septal defect

24
Q

Diagnosis of ventricular septal defect

A
  1. CXR: RV hypertrophy
  2. Echo: preferred over cath
  3. ECG: OVH, RAE/LAE
  4. MRI: only if echo nondiagnostic
  5. Cardiac cath - if other tests fail
25
Q

Management of ventricular septal defect

A

Most will close spontaneously within 10 years
Restrictive VSD (left > right pressure) associated with good prognosis
Surgery - patch closure

26
Q

Acute autoimmune inflammatory multi-systemic illness mainly affecting children 5-15 y/o

A

Acute rheumatic fever

27
Q

Complications of rheumatic fever

A

Cardiac

Rheumatic valvular disease - mitral MC, then aortic

28
Q

Diagnosis of rheumatic fever

A

Jones criteria

29
Q

Signs/symptoms of rheumatic fever

A
  1. Polyarthritis
  2. Active carditis
  3. Erythema marginatum (rash)
30
Q

Management of rheumatic fever

A
  1. Aspirin
  2. Penicillin G
    +/- corticosteroids if severe and with carditis
31
Q

Warm + CREAM

Kawasaki Disease

A

Fever + 4 of the following:
Conjunctivitis
Rash
Extremity changes: edema, erythema of palms and soles
Adenopathy
Mucous membranes: pharyngeal erythema, lip swelling and fissures, strawberry tongue

32
Q

Diagnosis of Kawasaki Disease

A 
ESR/CRP elevated
Leukocytosis
Increased platelets
Normochromic normocytic anemia
Echo and angiography needed if heart involvement
33
Q

Management of Kawasaki Disease

A

IV immunoglobulin

High dose aspirin

34
Q

Most common initial complaint of hypertrophic cardiomyopathy

A

Dyspnea

35
Q

Harsh systolic crescendo-decrescendo murmur at lower left sternal border

A

Hypertrophic cardiomyopathy

36
Q

HCM will have decreased murmur intensity with:

A

Squatting, supine, handgrip

37
Q

HCM with have increased murmur intensity with:

A

Valsalva and standing, exertion

38
Q

Diagnosis of HCM

A

Echo

ECG: LVH

39
Q

Management of HCM

A

Avoid exertion, implantable defibrillator
Beta blockers
Surgical: myomectomy, EtOH ablation

Pediatric EOR (10 decks)

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