Cardiovascular

Question 1

What occurs during S1?

Answer 1

Mitral and tricuspid valves close

Aortic and pulmonic valves open

Question 2

What heart sound is associated with S1?

Answer 2

“Lub”

Question 3

What occurs during S2?

Answer 3

Aortic and pulmonic valves close

Mitral and tricuspid valves open

Question 4

What heart sound is associated with S2?

Answer 4

“Dub”

Question 5

What period is systole?

Answer 5

between S1 and S2

Question 6

What period is diastole?

Answer 6

between S2 and S1

Question 7

What heart sound is described as “Ken-tuck’-y”?

Answer 7

S3

Question 8

What heart sound is described as “Ten-ne-ssee’”?

Answer 8

S4

Question 9

What heart sound would you expect to hear with a stiff ventricular wall (i.e. MI, left ventricular hypertrophy, chronic HTN)?

Answer 9

S4 “TEN-NE-SSEE’”

Question 10

When would you expect to hear S3?

Answer 10

With increased fluid states, such as CHF or pregnancy

Question 11

Where is the aortic valve heard?

Answer 11

Right upper sternal border (RUSB)

Question 12

Where is the pulmonic valve heard?

Answer 12

Left upper sternal border (LUSB)

Question 13

Where is Erb’s point found?

Answer 13

At the apex

Question 14

Where is ventricular septal defects or tricuspid valve heard?

Answer 14

Left lower sternal border (LLSB)

Question 15

Blood flows from ___ to ___ pressure.

Answer 15

High to low

Question 16

If a diastolic murmur is heard, this always points to something _________.

Answer 16

Pathological

Question 17

What scale is used to diagnose murmurs?

Answer 17

I to VI

Question 18

This congenital heart defect comprises 30% of all congenital heart defects

Answer 18

VSD

Question 19

Acyanotic lesions have what type of shunting?

Answer 19

Left to right

Question 20

Cyanotic lesions have what type of shunting?

Answer 20

Right to left

Question 21

ASD is what type of defect?

Answer 21

Acyanotic (L to R shunting)

Question 22

Where is the ASD best heard?

Answer 22

Left upper sternal border

Question 23

When a thrill is present, this typically describes what type of defect?

Answer 23

VSD

Question 24

Where is the VSD best heard?

Answer 24

Left lower sternal border

Question 25

VSD is what type of defect? (Acyanotic vs. Cyanotic)

Answer 25

Acyanotic

Question 26

Patent ductus arteriosus (PDA) is what type of defect?

Answer 26

Acyanotic

Question 27

Where is the PDA best heard?

Answer 27

Left upper sternal border

Question 28

What does the PDA sound like?

Answer 28

"machinery" sound

Question 29

A machinery sound murmur, typical of a PDA, is what type of murmur?

Answer 29

Holosystolic

Question 30

Transposition of the Great Arteries is what type of defect?

Answer 30

Cyanotic

Question 31

With TGA, the murmur is similar to that of what other type of defect?

Answer 31

VSD

Question 32

What does the Xray show of a patient with TGA?

Answer 32

"Egg on a string" with cardiomegaly and increased pulmonary vascular markings

Question 33

TET is what type of defect?

Answer 33

Cyanotic

Question 34

What are the four defects associated with TET?

Answer 34

Large VSD Pulmonary Stenosis Overriding Aorta Right Ventricular Hypertrophy

Question 35

What does the murmur sound like in TET and where is it best heard?

Answer 35

Loud systolic ejection click at the middle and upper left sternal border

Question 36

What does the heart look like in TET as seen on XR?

Answer 36

Boot-shaped

Question 37

What is a TET spell and how can you correct this?

Answer 37

It is a hypercyanotic spell and is corrected by placing the patient in a knees to chest position

Question 38

Aortic stenosis is what type of defect?

Answer 38

Cyanotic

Question 39

Aortic stenosis has a systolic ____ where? There may also be a systolic ejection click that does not vary with _____.

Answer 39

Thrill | Respiration

Question 40

Pulmonic stenosis is heard loudest where?

Answer 40

Left upper sternal border

Question 41

Unlike aortic stenosis, pulmonic stenosis ______ with inspiration and ______ with expiration.

Answer 41

Decreases with inspiration | Increases with expiration

Question 42

Coarctation of the aorta is what type of defect?

Answer 42

Cyanotic

Question 43

With coarc, there is a systolic ejection murmur with radiation where?

Answer 43

Left interscapular area

Question 44

The blood pressure in the lower extremities is _____ compared to the upper extremities in Coarctation of the Aorta.

Answer 44

Decreased

Question 45

X-ray findings can show ___ _______ due to collateral circulation

Answer 45

Rib notching

Question 46

What are three common signs/symptoms of a child with cardiac defects?

Answer 46

Frequent respiratory infections, feeding problems, clubbing | Also: diaphoresis

Question 47

Functional, benign, or physiologic murmurs are examples of what types of murmurs?

Answer 47

Innocent Murmurs

Question 48

Innocent murmurs occurs in more than __% of children

Answer 48

50%

Question 49

True or False: innocent murmurs may vary with position

Answer 49

True

Question 50

What is the most common innocent murmur?

Answer 50

Still's murmur

Question 51

What causes the Still's murmur?

Answer 51

Turbulence in the left ventricular outflow tract

Question 52

How is a Still's murmur described?

Answer 52

Musical systolic murmur

Question 53

A venous hum can be heard where? What position is it heard best in? Does it change with movement?

Answer 53

Continuous humming murmur in the Right upper sternal border, heard best in the sitting position and disappears in the supine position

Question 54

A persistent elevation of average systolic/diastolic blood pressure > 95th percentile with measurements obtained on at least three separate occasions.

Answer 54

Hypertension

Question 55

A post-infectious inflammatory disease that can affect the heart, joints, and central nervous system.

Answer 55

Rheumatic Fever

Question 56

Rheumatic fever follows that type of infection? What valve is most affected?

Answer 56

Group A strep | Mitral valve

Question 57

Diagnosis of an initial attack of rheumatic fever must contain __ major OR ___ major and __ minor Jone's criteria.

Answer 57

Two major | 1 major, 2 minor

Question 58

What diagnostic test would you anticipate ordering for rheumatic fever?

Answer 58

ECG, Echocardiogram

Question 59

Patients with rheumatic fever may require ______ ______ for invasive procedures.

Answer 59

Prophylactic antibiotics

Question 60

Acute febrile syndrome causing vasculitis and is the leading cause of coronary artery disease in children of an infectious etiology under the age of TWO.

Answer 60

Kawasaki disease

Question 61

The patient must have a fever for how many days for Kawasaki. They must also have ___ other symptoms associated with the disease.

Answer 61

5 days 4

Question 62

What are the other criteria for Kawasaki? (CRASH)

Answer 62

``` Conjuctivae injected without exudate Rash (polymorphic) Adenopathy (cervical lymphadenopathy) Strawberry (hyperemic lips, strawberry tongue) Hands (Erythema/dysquamation) ```

Question 63

What is given to provide immediate vasodilation with Kawasaki disease?

Answer 63

Aspirin