cardiovascular defects

Question 1

What type of murmur is always pathologic?

Answer 1

Diastolic

Question 2

What are the physiological characteristics of left to right shunts?

Answer 2

• Increased pulmonary flow
• increased pulmonary vasculature
• increased pulmonary pressure
• RVH
• Potential for Eisenmenger’s syndrome (reversal of flow)

Question 3

A child with recurrent colds and a wide, split S2 has this heart defect?

Answer 3

ASD

Question 4

What is the most common congenital heart disease?

Answer 4

VSD

Question 5

The sound typically heard in a child with a VSD is?

Answer 5

harsh holosystolic murmur. The smaller the defect, the louder the murmur. If its a large defect a loud P2 sound will be heard.

Question 6

What are common exam findings in a child with a PDA?

Answer 6

• harsh machine like murmur that is continuous
• Loud S2
• Wide pulse pressure
• bounding peripheral pulses

Question 7

What medication can close a PDA?

Answer 7

indomethacin

Question 8

What are the physiologic characteristics of a right to left shunt?

Answer 8

• decreased pulmonary flow (almost absent)
• decreased pulmonary vasculature
• Deoxygenated peripheral blood
• Cyanosis

Question 9

What is the most common cyanotic defect of the newborn? What must be present for these babies to be alive?

Answer 9

Transposition of the great vessels

PDA-so give PG’s to keep open

Question 10

What is a risk factor for transposition of the great vessels?

Answer 10

maternal pre-gestational diabetes. Also have asymmetric septal hypertrophy.

Question 11

What two conditions are associated with an increased risk of ASD?

Answer 11

Down Syndrome and Fetal alcohol syndrome

Question 12

What are the two common heart defects associated with Turner Syndrome?

Answer 12

Coarctation of the aorta and bicuspid aortic valve

Question 13

TORCH infections are likely to lead to this heart defect?

Answer 13

VSD

Question 14

Supravalvular aortic stenosis is seen in this genetic condition?

Answer 14

Williams Syndrome

Question 15

Neonatal lupus has this heart defect?

Answer 15

congenital heart block

Question 16

What are the four characteristics of tetralogy of fallot?

Answer 16

1. Over-riding aorta
2. pulmonary stenosis-Systolic ejection murmur with a single S2 and RV heave
3. RVH
4. VSD

Question 17

Tet spells, commonly seen in babies with TOF, present as?

Answer 17

A cyanotic baby who squats to increase systemic vascular resistance, push more blood from the RV into the lungs, and is able to relieve the cyanosis.

Question 18

What cxr finding is characteristic of TOF?

Answer 18

Booth shape heart

Question 19

What two conditions are associated with TOF?

Answer 19

DiGeorge syndrome and Down syndrome

Question 20

What are the exam findings typical of Coarctation of the aorta?

Answer 20

1. HTN
2. Claudication
3. Weak femoral pulses
4. temperature difference between arms and legs

Question 21

What are the CXR findings seen in coarcatation of the aorta?

Answer 21

• Rib notching from collaterals

- “3” sign