CHD trigger

Question 1

fixed, split S2 and pulmonic ejection murmur

Answer 1

ASD

Question 2

MC ASD type

Answer 2

ostium secondum

Question 3

Associated w fetal alcohol syndrome

Answer 3

ostium secondum

Question 4

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

Answer 4

ostium premium

Question 5

CXR shows right sided heart dilation and prominent pulmonary vascularity

Answer 5

ASD

Question 6

increased oxygen saturation in the RA, RV and pulmonary artery

Answer 6

ASD (seen with a heart catheterization?)

Question 7

when should adults receive surgery for ASD

Answer 7

• RV enlargement
• paradoxical embolism
• R–>L shunt

Question 8

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

Answer 8

membranous VSD (upper septum)

Question 9

holosystolic murmur located at lower left sternal border

Answer 9

VSD

Question 10

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

Answer 10

VSD but moderate-large

Question 11

LVH on EKG

Answer 11

VSD

Question 12

treated with diuretics and higher calorie feeds

Answer 12

VSD

Question 13

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

Answer 13

VSD

Question 14

connects pulmonary artery and aorta

Answer 14

PDA

Question 15

holosystolic “machine-like” murmur

Answer 15

PDA

Question 16

associated with female, preemie and high altitude births

Answer 16

PDA

Question 17

EKG shows LVH and LAE

Answer 17

PDA
coarctation of the aorta

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

Question 18

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

Answer 18

PDA

Question 19

when is surgical ligation indicated for PDA

Answer 19

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

Question 20

CBC w schistocytes 2/2 microangiopathic hemolytic anemia

Answer 20

Pulmonic stenosis

Question 21

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

Answer 21

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

Question 22

why are PGEs given?

Answer 22

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

Question 23

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

Answer 23

pulmonary stenosis

Question 24

when is RV lift found on palpation of the precordium

Answer 24

pulmonic stenosis

Question 25

dilation of the main and left pulm arteries on CXR

Answer 25

Pulm stenosis

Question 26

EKG shows RVH

Answer 26

pulmonic stenosis

Question 27

tx w percutaneous balloon valvuloplasty

Answer 27

pulmonary stenosis aortic stenosis

Question 28

this is common in females with turners syndrome

Answer 28

coarctation of the aorta

Question 29

what other cardiac abnormality often appears alongside coarctation of the aorta

Answer 29

bicuspid aortic valve

Question 30

what leads to hypoperfusion of the kidneys and therefore secondary hypertension

Answer 30

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

Question 31

increases risk for berry aneurysms and aortic valve dissection

Answer 31

coarctation of the aorta

Question 32

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

Answer 32

coarctation of the aorta

Question 33

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

Answer 33

coarctation of aorta

Question 34

diagnostic imaging includes an angiogram

Answer 34

coarctation of the aorta would also order: CXR showing 3 sign rib notching

Question 35

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

Answer 35

coarctation of the aorta can also do a balloon angioplasty w stent

Question 36

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

Answer 36

coarctation of aorta

Question 37

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

Answer 37

aortic stenosis

Question 38

dilation of ascending aorta on CXR

Answer 38

aortic stenosis

Question 39

Percutaneous balloon valvuloplasty used when

Answer 39

aortic stenosis pulmonic stenosis

Question 40

when is the Ross procedure used?

Answer 40

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

Question 41

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!

Answer 41

aortic stenosis

Question 42

what test differentiates cardiac and non cardiac cyanosis

Answer 42

hyperoxia test PaO2 >250 = no structural cyanotic heart disease

Question 43

boot shaped heart on CXR

Answer 43

tetralogy of fallot

Question 44

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

Answer 44

tet spell! occurs with TOF

Question 45

MCC of cyanosis in childhood/infancy

Answer 45

TOF

Question 46

tx w morphine and bicarbonate and/or what else?

Answer 46

management of tet spell tx w/ morphine bicarbonate phenylephrine BB

Question 47

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

Answer 47

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

Question 48

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

Answer 48

bicarbonate

Question 49

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

Answer 49

phenylephrine

Question 50

these children MUST undergo open heart surgery prior to age 2

Answer 50

TOF

Question 51

where does the aorta stem off of in D-TGA

Answer 51

the right ventricle!! PA comes off LV (backwards from usual)

Question 52

what is the problem in L-TGA?

Answer 52

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!

Question 53

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

Answer 53

TGA

Question 54

which TGA is asymptomatic

Answer 54

L-TGA

Question 55

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

Answer 55

D-TGA

Question 56

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

Answer 56

TGA

Question 57

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

Answer 57

hypoplastic left heart syndrome

Question 58

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

Answer 58

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

Question 59

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

Answer 59

hypoplastic left heart syndrome

Question 60

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

Answer 60

stills murmur

Question 61

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

Answer 61

Question 62

this murmur occurs after age 2 in the right infraclavicular area

Answer 62

Question 63

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

Answer 63