Cards

Question 1

Causes of syncope in children? (7)

Answer 1

1. Neurally mediated syncope (~75%)
2. Cardiac (Long QT / pHTN / HCM; 2-3%)
3. Seizures (2%)
4. Conversion rxns (1.4%)
5. hypoglycemia (0.4%)
6. severe anemia (0.2%)
7. hyperventilation (0.2%)

Question 2

Features of an innocent murmur (7)

Answer 2

1. Quiet 1-2/6
2. systolic
3. LSB sometimes w/radiation to RUSB or LUSB
4. Low pitched
5. Vibratory
6. Decreases when moving to sitting position
7. Accentuated in high output states (fever / infection /anemia)

Question 3

Cardiomyopathy seen in Duchenne MD? Age of onset?

Answer 3

1. Dilated cardiomyopathy due to dystrophin mutation
2. >10 years old

Question 4

Cardiomyopathy seen in Friedrich’s ataxia?

Answer 4

Hypertrophic cardiomyopathy

Question 5

Type of CHF seen in SCD?

Answer 5

HOHF

Question 6

Sx of PCA aneurysm (2)

Answer 6

1. Dilated pupil
2. Everted eye (all 2/2 CNIII compression / palsy)

Question 7

Cause of preductal sat being >10% a post-ductal sat?

Answer 7

R -> L shunt via PFO / PDA

Question 8

Cause of post-ductal sat >10% a pre-ductal sat?

Answer 8

Cyanotic heart disease (ie TGA)

Question 9

Age at which mod VSDs present? Why?

Answer 9

1-2 months. That is when pulmonary vascular resistance falls enough to result in CHF.

Question 10

When do HLHS neonates usually present and why?

Initial treatment?

Question 11

Which of the following represent O2 sats in babies w/obligate R->L shunts and why?

1) Pre > post
2) Post > pre
3) Pre = post

Answer 11

1) Pre > post

Due to shunting of deoxygenated blood at level of PDA in HLHS or w/critical coarct

Question 12

Norwood procedure (2 steps):

Answer 12

1. Dissection of the main PA from branch PA and connection to aorta
2. Modified BT shunt to supply circulation to lungs (conduit from SCA or carotids to branch PAs)

Question 13

Indications for Norwood?

Answer 13

HLHS

Question 14

BT shunt?

Answer 14

SCA or ICA shunt to PAs

Question 15

Purpose of a Fontan procedure?

Answer 15

Bypassing the RV to offload pressure or valve atresias

Question 16

Stage 1 of the Fontan? Also referred to as?

Answer 16

1. SVC and branch PAs separated from their respective connections and connected to each other
2. Bidirectional Glenn

Question 17

Stage 2 of the Fontan?

Answer 17

IVC redirected to the PAs

Question 18

Flow of blood in uncorrected TGA (starting in RV)?

Answer 18

Systemic deoxygenated in RV -> aorta -> PDA -> PAs -> lungs -> LA -> foramen ovale -> aorta -> rest of body