cards

Question 1

fixed split second heart sound

Answer 1

ASD
(sound comes from increased flow through pulmonary valve)
best heard at LUSB

Question 2

harsh holosystolic murmur at LLSB

Answer 2

VSD

Question 3

systolic click that varies with respiration, normal split S2, located at LUSB

Answer 3

pulmonary stenosis

may have thrill or radiate to back

Question 4

systolic click heard at apex, does not vary with respiration

Answer 4

aortic stenosis

Question 5

superior QRS axis

Answer 5

AV canal defect

Question 6

left axis deviation without hypertrophy

Answer 6

tricuspid atresia and AV canal defects

Question 7

LVH without left axis deviation

Answer 7

HOCM

Question 8

systolic murmur in L axilla, louder in the back

Answer 8

coarctation of the aorta

Question 9

tx of coarct

Answer 9

prostaglandins if neonate –> surgical

Question 10

causes of cyanotic heart disease without murmur

Answer 10

TGA
tricuspid atresia
pulmonary atresia
TAPVR

Question 11

causes of severe cyanosis in neonatal period

Answer 11

TGA
pulmonary atresia
tricuspid atresia

Question 12

risk with cyanotic heart disease and polycythemia

Answer 12

stroke

Question 13

infant with increased RV activity, cyanosis, hypoxia, pulmonary edema/congestion on CXR

Answer 13

TAPVR

Question 14

components of Tet

Answer 14

pulmonary stenosis
overriding aorta
VSD
RVH and right axis deviation

Question 15

signs of tet spell

Answer 15

sudden cyanosis and hyperpnea, murmur disappears

Question 16

risk factors that worsen cognitive effects of cyanotic heart disease

Answer 16

decreased neurological baseline prior to surgery
seizures prior to surgery
coexistent problems
duration of intraop circulatory arrest

Question 17

tx of tet spell

Answer 17

knee to chest
morphine
propraolol
volume expansion

Question 18

cyanosis, egg shaped heart, increased pulmonary casbularity

Answer 18

TGA

Question 19

tx TGA

Answer 19

prostaglandins, balloon septostomy

Question 20

tx SVT

Answer 20

vagal maneuvers
adenosine
amiodarone/procainamide 2nd line
cardioversion esp if unstable or adenosine not available

Question 21

emotional lability, purposeless rapid movements, muscle weakness

Answer 21

Sydenham’s chorea

Question 22

Major Jones criteria

Answer 22

polyarthritis
carditis
subcutaneous nodules
erythema marginatum
sydenham chorea

Question 23

minor jones criteria

Answer 23

arthralgia
fever
elevated inflamm markers
prolonged PR

Question 24

rheumatic fever dx

Answer 24

2 major criteria or 1 major and 2 minor

Question 25

tx rheumatic fever

Answer 25

penicillin
aspirin (for arthritis)
steroids for carditis?

Question 26

most common bugs in endocarditis in children

Answer 26

S aureus and viridans streptococci

Question 27

initial tx of endocarditis

Answer 27

vanc and gent

Question 28

when do you need dental ppx

Answer 28

repaired cyanotic heart disease
surgery with hardware/device in last 6 months
residual defect near prosthetic device

Question 29

most common cause of myocardiits

Answer 29

coxsackie B

Question 30

most common causes of pericarditis

Answer 30

viral
collagen vascular disease

bacterial less common; most common bacterial cause is S aureus