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Pediatrics - clinical > Cards > Flashcards

Cards Flashcards

1
Q

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

A

Acute Rheumatic fever

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2
Q

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

A

M protein

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3
Q

what is the jones criteria

A

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

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4
Q

what is the treatment of acute rheumatic fever

A

PCN and ASA

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5
Q

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

A

ASD

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6
Q

what murmur is heard with an ASD

A

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

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7
Q

what is the treatment for ASD

A

symptomatic: Diuretics, ACEi, digoxin
Definitive: surgical closure

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8
Q

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

A

coarctation of the aorta

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9
Q

what murmur is heard with coarctation of the aorta

A

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

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10
Q

how is coarctation of the aorta diagnosed

A

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

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11
Q

what is the treatment for coarctation of the aorta

A

balloon angioplasty with stent placement of surgical correction

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12
Q

when is surgery done for coarctation of the aorta

A

between ages of 2-4yo

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13
Q

what should be administered to neonates with aortic coarctation

A

Prostaglandin E1 to keep ductus arteriosus open

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14
Q

what occurs with Coarctationo of the aorta is left untreated

A

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

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15
Q

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

A

Hypertrophic cardiomyopathy

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16
Q

What murmur is heard with Hypertrophic cardiomyopathy (HOCM)

A

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

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17
Q

How is HOCM diagnosed

A

ECHo and MRI

18
Q

what is the treatment for HOCM

A

BB + Disopyramide
CCB

19
Q

what medication class should be avoided with HOCM

A

Diuretics

20
Q

what is Kawasaki disease

A

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

21
Q

what is the pneumonic for Kawaskaki disease

A

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)

22
Q

what is the presentation of Kawasaki disease

A

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

23
Q

how is kawasaki disease diagnosed

A

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

24
Q

what is the treatment for Kawasaki disease

A

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

25
Q

What is a PDA

A

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

26
Q

what is the presentation of a PDA

A

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

27
Q

what is the murmur heard with a PDA

A

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

28
Q

how is a PDA diagnosed

A

ECHO

29
Q

what is the treament for PDA

A

indomethacin

30
Q

what are red flags of syncope

A

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

31
Q

what are the types of syncope (5)

A
  • vasovagal
  • cardiac
  • orthostatic hypotension
  • cerebral vascular disease
  • orther non-cardiogenic causes
32
Q

how is syncope diagnosed

A

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

33
Q

What is a cyanotic heart condition

A

Tetralogy of fallot

34
Q

what is the presentation of tetralogy of fallot

A

difficult feeding, FTT
“tet spells”
Four features: PROVe

35
Q

what are the four features of tetraology of fallot

A

PROVe
- pulmonary stenosis
- RVH
- overriding aorta
- VSD

36
Q

what murmur is heard with tetralogy of fallot

A

crescendo-decrescendo, holosystolic at LSB radiating to back

37
Q

what is seen on CXR with tetralogy of fallot

A

Boot shaped heart

38
Q

what is the most common pathologic murmur in childhood

A

Ventricular septal defect

39
Q

what murmur is heard with VSD

A

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

40
Q

How is VSD diagnosed

A

ECHO

41
Q

what is the treatment for VSD

A

most close by age 6, surgery if large

Pediatrics - clinical (13 decks)

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