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Pediatrics > CHD trigger > Flashcards

CHD trigger Flashcards

1
Q

fixed, split S2 and pulmonic ejection murmur

A

ASD

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2
Q

MC ASD type

A

ostium secondum

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3
Q

Associated w fetal alcohol syndrome

A

ostium secondum

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4
Q

associated with down syndrome (25% of down syndrome kids have this)

A

ostium premium

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5
Q

CXR shows right sided heart dilation and prominent pulmonary vascularity

A

ASD

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6
Q

increased oxygen saturation in the RA, RV and pulmonary artery

A

ASD (seen with a heart catheterization?)

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7
Q

when should adults receive surgery for ASD

A
  • RV enlargement
  • paradoxical embolism
  • R–>L shunt
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8
Q

what is the absolute MC congenital heart defect (be specific)!!

A

membranous VSD (upper septum)

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9
Q

holosystolic murmur located at lower left sternal border

A

VSD

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10
Q

holosystolic murmur plus a thrill and a diastolic rumble in the mitral area

A

VSD but moderate-large

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11
Q

LVH on EKG

A

VSD

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12
Q

treated with diuretics and higher calorie feeds

A

VSD

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13
Q

Surgical intervention indicated w pulm HTN, aortic insufficiency or LA/LV dilation

A

VSD

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14
Q

connects pulmonary artery and aorta

A

PDA

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15
Q

holosystolic “machine-like” murmur

A

PDA

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16
Q

associated with female, preemie and high altitude births

A

PDA

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17
Q

EKG shows LVH and LAE

A

PDA
coarctation of the aorta

can also use echo for PDA which is diagnostic!!!

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18
Q

tx with PGE inhibitors for neonates up to 14days. if symptomatic tx with digoxin and fureosemide

A

PDA

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19
Q

when is surgical ligation indicated for PDA

A
  • left to right shunting
  • left sided volume overload
  • reversible pulmonary arterial HTN
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20
Q

CBC w schistocytes 2/2 microangiopathic hemolytic anemia

A

Pulmonic stenosis

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21
Q

When obstruction is severe, increased pressure can cause a R-to-L shunt​ (Eisenmenger Syndrome) to occur at the atrial level through a PFO​​

A

this is for pulmonary stenosis but i think this (eisenmenger syndrome) can happen with alot of things!!

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22
Q

why are PGEs given?

A

to keep the PDA open during any critical problems during which blood will not get to the lungs such as:

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23
Q

systolic ejection murmur increasing with inspiration and opening click louder w expiration

A

pulmonary stenosis

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24
Q

when is RV lift found on palpation of the precordium

A

pulmonic stenosis

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25
Q

dilation of the main and left pulm arteries on CXR

A

Pulm stenosis

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26
Q

EKG shows RVH

A

pulmonic stenosis

27
Q

tx w percutaneous balloon valvuloplasty

A

pulmonary stenosis
aortic stenosis

28
Q

this is common in females with turners syndrome

A

coarctation of the aorta

29
Q

what other cardiac abnormality often appears alongside coarctation of the aorta

A

bicuspid aortic valve

30
Q

what leads to hypoperfusion of the kidneys and therefore secondary hypertension

A

coarctation of the aorta (deceased blood to lower extremities, increased blood to upper extremities)

31
Q

increases risk for berry aneurysms and aortic valve dissection

A

coarctation of the aorta

32
Q

diamond-shaped systolic murmur with a high pitched decrescendo diastolic murmur

A

coarctation of the aorta

33
Q

absent/delayed femoral pulse with lower extremity cyanosis and high BP in upper extremities

A

coarctation of aorta

34
Q

diagnostic imaging includes an angiogram

A

coarctation of the aorta

would also order:
CXR showing 3 sign rib notching

35
Q

which can use these as tx:
- Resection with end-to-end anastomosis
- subclavian aortoplasty
- Prosthetic patch aortoplasty (rare)

A

coarctation of the aorta

can also do a balloon angioplasty w stent

36
Q

Exercise testing is mandatory for these children prior to their participation in athletic activities​

A

coarctation of aorta

37
Q

Harsh systolic ejection murmur at the upper right sternal border with radiation to the neck​. Systolic ejection click at the apex​

A

aortic stenosis

38
Q

dilation of ascending aorta on CXR

A

aortic stenosis

39
Q

Percutaneous balloon valvuloplasty used when

A

aortic stenosis
pulmonic stenosis

40
Q

when is the Ross procedure used?

A

aortic stenosis

i think in sub or supra valvular AS mostly. only in symptomatic pts.

41
Q

Severe = predisposed to ventricular dysrhythmias and refrain from vigorous activity; avoid all isometric exercise.

but mild has normal O2 and can do exercise as much as they want!

A

aortic stenosis

42
Q

what test differentiates cardiac and non cardiac cyanosis

A

hyperoxia test

PaO2 >250 = no structural cyanotic heart disease

43
Q

boot shaped heart on CXR

A

tetralogy of fallot

44
Q

increased cyanosis of the hands and feet with hot baths, fever, exercise, crying and feeding

A

tet spell! occurs with TOF

45
Q

MCC of cyanosis in childhood/infancy

A

TOF

46
Q

tx w morphine and bicarbonate and/or what else?

A

management of tet spell

tx w/
morphine
bicarbonate
phenylephrine
BB

47
Q

what do you give TOF pts with tet spells to aid in DECREASING dynamic RVOT

A

BB
Morphine

(phenylephrine given for increasing SVR, bicarb given to decrease PVR)

48
Q

what do you give TOF pts with tet spells to aid in decreasing PVR

A

bicarbonate

49
Q

what do you give TOF pts with tet spells to aid in increase SVR

A

phenylephrine

50
Q

these children MUST undergo open heart surgery prior to age 2

A

TOF

51
Q

where does the aorta stem off of in D-TGA

A

the right ventricle!!

PA comes off LV

(backwards from usual)

52
Q

what is the problem in L-TGA?

A

correct me if im wrong plz cuz i feel like i dont get this:

the VENTRICLES are switched! like the right ventricle is on the left and the left ventricle is on the right!

53
Q

risk factors include rubella, alcohol, diabetes, poor nutrition and maternal age of >40 years old

A

TGA

54
Q

which TGA is asymptomatic

A

L-TGA

55
Q

presents with cyanosis, tachypnea, and acidosis that is UNCHANGED with supplemental oxygen

A

D-TGA

56
Q

CXR shows egg on a string with associated lung congestion and cardiomegaly

A

TGA

57
Q

ASD/PDA required for post-natal survival in this condition

A

hypoplastic left heart syndrome

58
Q

treatment for this condition includes a 3 step surgery occuring at what ages?

A

hypoplastic left heart syndrome

1st - norwood @ 1-2 weeks
2nd - bidirectional glenn @ 4-6 mo
3rd - fontan @ 2 years

59
Q

Children who undergo surgical repair can participate in recreational activities but are restricted from competitive and vigorous athletics

A

hypoplastic left heart syndrome

60
Q

MC innocent murmur of childhood (what is it and descrive it)

A

stills murmur

61
Q

this murmur occurs within the first few days of life and resolves by 1 mo (describe it)

A
62
Q

this murmur occurs after age 2 in the right infraclavicular area

A
63
Q

this murmur occurs in 30-40% of children in the supraclavicular area

A

Pediatrics (41 decks)

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