Cardiovascular - Pathology

Question 1

Failure of truncus arteriosus to divide into pulmonary trunk and aorta; most patients have accompanying VSD.

Answer 1

persistant truncus arteriosus

Question 2

What is a persistent truncus arteriosus? What disease usually accompanies it?

Answer 2

It is failure of the truncus arteriosus to divide into the aorta and the pulmonary trunk. It is usually accompanied with ventricular septal defect.

Question 2

What is the frequency of left to right shunts considering the most common causes of this type of shunting?(3 points)

Answer 2

VSD > ASD > PDA

Question 3

What causes the right to left flow of blood in teratology of fallot?

Answer 3

Pulmonary stenosis which forces blood through the ventricular septal defect

Question 3

What left to right shunt cardiovascular disease cause polycythemia?

Answer 3

Eisenmenger syndrome

Question 4

What is the most common cause of early childhood cyanosis?

Answer 4

teratology of fallot

Question 5

What type of image are you going to see with teratology of fallot?

Answer 5

A boot-shaped heart on CXR due to right ventricular hypertrophy

Question 5

What is total anomalous pulmonary venous return? What conditions are associated with this disease?(2 points) Why?

Answer 5

The pulmonary veins drain into right heart circulation(SVC, coronary sinus, etc.). VSD and PDA to allow right to left shunting and maintain CO.

Question 6

What is Eisenmenger syndrome?( 3points) What is the pathology of the disease?(5 points) What does the disease cause?(2-3)

Answer 6

It is uncorrected left to right shunt (VSD, ASD, PDA). There is an increase in pulmonary blood flow, pathologic remodeling of vasculature, pulmonary arterial hypertension, RVH to compensate, shunt becomes right to left shunt. It cause slate cyanosis, clubbing and polycythemia

Question 7

What type of pathological shunt is produced by patent ductus arteriosus? How is the heart affected?(3 points) What type of murmur is produced by patent ductus arteriosus? How do you maintain the patency?(2 points)

Answer 7

There is a left to right shunt. There is RVH and/or LVH followed by heart failure. There is a machine-like murmur. The potency is maintained by PGE and low oxygen tension.

Question 8

What are the five congenital heart disease that cause right to left shunts?(5 points)

Answer 8

Truncus arteriosus, transposition of the great arteries, tricuspid atresia, teratology of ballot and TAPVR

Question 9

What is the anatomical anomaly found in tricuspid atresia? How do you treat?(2 points)

Answer 9

It is the lack of the tricuspid valve with hypoplasia of the RV. It requires both a ASD and a VSD.

Question 11

What is D-transposition of the great vessels?(anatomy) Is this compatible with life? What is the aetiology?(embryology)?

Answer 11

The aorta is connected to the right ventricle. The pulmonary trunk is connected to the left ventricle. No, it’s not compatible with life. It is failure of the aorta pulmonary septum to spiral

Question 12

Where does atrial septal defects usually occur? What type usually occurs with other defects? What are the range of symptoms? Why is this different than foramen ovale?

Answer 12

Septum secundum. An atrial septal defect in the septum premium usually are associated with other defects. it ranges from no symptoms to heart failure. The atrial septa are missing rather than unfused.

Question 12

What type of shunt is produced by PDA during fetal period? What type of shunt is produced when PDA is closed postnatally? What is the reason for the change?

Answer 12

There is a right to left shunt produced by PDA during fetal period. There is a left to right shunt produced when PDA is closed. There is decrease resistance of the lungs

Question 14

What are early signs for a let to right shunt? When is it usually diagnosed?(2 points) How is it treated?(2 points)

Answer 14

Early cyanosis is an early sign. It is diagnosed prenatally or immediately after birth. It is rated with surgical correction or maintenance of a patent doctor arteriosus.

Question 16

VSD results in what type of shunt? When is it usually detected? How do you treat? What can it lead to?(2 points)

Answer 16

Left to Right Shunt. It is detected weeks after birth or sometimes it remains asymptomatic throughout life. It usually resolves itself in most cases. It can lead to LV overload and heart failure

Question 17

What type of maneuver could improve the cyanotic condition?

Answer 17

Squatting, which increase systemic vascular resistance, which decreases right to left shunt which improves the cyanosis

Question 18

How do you treat teratology of fallot?

Answer 18

Early surgical correction

Question 19

What type of shunts have an earlier manifestation; right to left shunts or left to right shunts?

Answer 19

Right to left shunts; left to right shunts are detected later

Question 20

What is a nemonic used to remember the disease which causes right to left shunts?

Answer 20

The 5 T’s: Truncus arteriosus, transposition of the greater arteries, tricuspid atresia, teratology of fallot and TAPVR. You should remember the first four numbers correlate to the number of vessels involved. The last is just the number of latter in the acronym

Question 21

Uncorrected PDA could lead to what physical findings on examination?

Answer 21

late cyanosis of the lower extremities

Question 22

What is the most common congenital heart defect?

Answer 22

VSD

Question 23

What is a nemonic used to remember the associated conditions of teratology of fallot?

Answer 23

PROVe: Pulmonary infundibular stenosis is the most important determinant for prognosis; RVH - boot-shaped heart on CXR, Overriding aorta, VSD

Question 25

Absence of tricuspid valve and hypo plastic RV

Answer 25

tricuspid atresia

Question 26

How do some patients survive with D-transposition of the great vessels?(3 points) What is the life expectancy?

Answer 26

They have a patent ductus arteriosus, foramen oval or san ventricular septal defect. Without surgical intervention , most children die within the first few months of life.

Question 27

Aortic narrowing near insertion of ductus arteriosus(juxtaductal)

Answer 27

correction of the aorta

Question 28

Coarctation of the aorta is associated with what disease?(2-3 points) What type of symptoms do you see in the pulses?(2 points) What happens with age with this disease?

Answer 28

Turner syndrome, other heart defects and bicuspid aortic valve. You see hypertension in the upper extremity and a delayed pulse in the lower extremity. With age, collateral arteries erode the ribs and you see noticed appearance on CXR/

Question 29

What is a deficit associated with intertribal septum? What type of problem do you find when you auscultate?(2 points)

Answer 29

atrial septal defect. It has a loud S1 and it is associated with a loud S1 and a wide, fixed split S2.