Cards

Question 1

What is the leading cause of mitral valve stenosis and valve replacement in adults in the US

Answer 1

Acute Rheumatic fever

Question 2

What protein is most important virulence factor for group A streptococcal infections

Answer 2

M protein

Question 3

what is the jones criteria

Answer 3

cardial manifestions for rheumatic fever
Major: Carditis, chorea, erytehma marginatum, polyarthritis, subcutaneous nodule
Minor: arthralgia, elevated ERS or CRP, fever, prolonged PR interval, leukocytosis

Question 4

what is the treatment of acute rheumatic fever

Answer 4

PCN and ASA

Question 5

what is a noncyanotic heart condition when the foramen ovale fails to close.

Answer 5

ASD

Question 6

what murmur is heard with an ASD

Answer 6

Wide fixed, split S2.
Systeolic ejection murmurat the second left intercostal space with an early to mid-systolic rumble

Question 7

what is the treatment for ASD

Answer 7

symptomatic: Diuretics, ACEi, digoxin
Definitive: surgical closure

Question 8

what is a noncyanotic heart condition that causes high blood pressure in UE, and low BP in LE

Answer 8

coarctation of the aorta

Question 9

what murmur is heard with coarctation of the aorta

Answer 9

ejection murmur heard at the aortic area and LSB that radiates into the left axilla and left back

Question 10

how is coarctation of the aorta diagnosed

Answer 10

definitive dx with echo or CT/MR angiography
EKG - LVH
CXR: notcing of ribs, “figure of 3 sign”

Question 11

what is the treatment for coarctation of the aorta

Answer 11

balloon angioplasty with stent placement of surgical correction

Question 12

when is surgery done for coarctation of the aorta

Answer 12

between ages of 2-4yo

Question 13

what should be administered to neonates with aortic coarctation

Answer 13

Prostaglandin E1 to keep ductus arteriosus open

Question 14

what occurs with Coarctationo of the aorta is left untreated

Answer 14

adults die by age of 50yo due to arotic rupture, CVA or aortic dissection

Question 15

what is the most common cause of sudden death in young athletes

Answer 15

Hypertrophic cardiomyopathy

Question 16

What murmur is heard with Hypertrophic cardiomyopathy (HOCM)

Answer 16

systolic murmur at LSB/ loud S4
increases with standing and valsalva, decreases with squatting

Question 17

How is HOCM diagnosed

Answer 17

ECHo and MRI

Question 18

what is the treatment for HOCM

Answer 18

BB + Disopyramide
CCB

Question 19

what medication class should be avoided with HOCM

Answer 19

Diuretics

Question 20

what is Kawasaki disease

Answer 20

vasculitis mostly affecting children where the immune system attacks arteries, damaging endotherlial cells of Blood vessels

Question 21

what is the pneumonic for Kawaskaki disease

Answer 21

CRASH and burn
- conjunctival injection (spares limbus)
- Rash (all body parts; flakes)
- Adenopathy (enlarged cervical lymph nodes)
- Hand and Foot rash
- Fever (5 or more days that doesnt resolve with antipyretics)

Question 22

what is the presentation of Kawasaki disease

Answer 22

5 days or more of high fever
bilat non-purulent conjunctival injection
erytheamtous morbiliform rash
oral mucositis
asymmetric cervical adenopathy

Question 23

how is kawasaki disease diagnosed

Answer 23

4 of 5 CRASH symtpoms + high fever lasting 5 days
Increase CRP, ESR
Increased platelet count
increase WBCs with left shift
Increase liver transaminases
Echo

Question 24

what is the treatment for Kawasaki disease

Answer 24

IVIG and ASA
self-limited and resolved in 6-8 weeks with or without tx but 25% risk of heart complications if left untreated

Question 25

What is a PDA

Answer 25

ductus arteriosus is a normal fetal structure - if it remains open, its called a PDA

Question 26

what is the presentation of a PDA

Answer 26

3-6 week infants can present with tachypnea, diaphoresis, inability or difficulty with feeding and no weight gain

Question 27

what is the murmur heard with a PDA

Answer 27

rough "machinery" murmur late in systole at the time of S2 making it loud best heard at the pulmonic area, 2nd ICS LSB

Question 28

how is a PDA diagnosed

Answer 28

ECHO

Question 29

what is the treament for PDA

Answer 29

indomethacin

Question 30

what are red flags of syncope

Answer 30

syncope during exertion multiple recurrences in short time heart murmur/structal heart disease old age significant injury during syncope fhx unexpected death/exertional/unexplained recurrent syncope

Question 31

what are the types of syncope (5)

Answer 31

- vasovagal - cardiac - orthostatic hypotension - cerebral vascular disease - orther non-cardiogenic causes

Question 32

how is syncope diagnosed

Answer 32

ECG glucose pulse ox echo tilt table CNS imaging (rare)

Question 33

What is a cyanotic heart condition

Answer 33

Tetralogy of fallot

Question 34

what is the presentation of tetralogy of fallot

Answer 34

difficult feeding, FTT "tet spells" Four features: PROVe

Question 35

what are the four features of tetraology of fallot

Answer 35

PROVe - pulmonary stenosis - RVH - overriding aorta - VSD

Question 36

what murmur is heard with tetralogy of fallot

Answer 36

crescendo-decrescendo, holosystolic at LSB radiating to back

Question 37

what is seen on CXR with tetralogy of fallot

Answer 37

Boot shaped heart

Question 38

what is the most common pathologic murmur in childhood

Answer 38

Ventricular septal defect

Question 39

what murmur is heard with VSD

Answer 39

Loud, harsh, holosystolic murmur, left to right best heard at the LLSB

Question 40

How is VSD diagnosed

Answer 40

ECHO

Question 41

what is the treatment for VSD

Answer 41

most close by age 6, surgery if large