CHD2

Question 1

indication for BE ppx

Answer 1

1. prosthetic heart valve or other prosthetic material used for valve repair (ie rings or chords).
2. transplanted heart with valve defect in the donor heart
3. hx of BE
4. CHD with
   a. unrepaired cyanotic defects or repaired (including non-cyanotic) for first 6 months
   b. prosthetic material used to repair a shunt but residual flow.

Question 2

abx choice for ppx

Answer 2

amox if can take oral. othewise amoxicillin IV, if pcn allergy then cephalexin or clinda or azithro. Notecephalosporins shouldnt be used in individuals with analphylaxis or angioedema to pcns.

Question 3

What are the cyanotic heart dz’s

Answer 3

5 T’s: 1. Tricuspid atresia (or epsteins with VSD)

2. Transposition
3. Tet
4. Total anomolous pulmonary venous return
5. Trucus arteriosis

Remember 5 T’s

Question 4

The mayo way (alt way) -

What are the two high PAP Cyanotic CHDs

What are the low PAP?

How to destinguis the two

Answer 4

1. Eisenmengers
2. Single ventricles
   - —————————————–

Tet
PS+ASD
Single Ventricle
Epsteins

Loud murmur in low pap by equalization

Question 5

What happens to blood count

Answer 5

erythorcytosis (get headache and can get

- If Hb < 20 dont do anything. If > 20 then need to phelbptomize

Question 6

If phlebotomize a patient with cyanotic

Answer 6

need to replace iron (only 1 tablet per day) so dont give too much fuel., also repelace with equal amount of fluids.

Question 7

Cyanotic defects need what with IV

Answer 7

air filter.

Question 8

3 main renal defects with CHD

Answer 8

1. reduced GFR
2. Proteinuria
3. Hyperuricemia (gout)

Question 9

weird prblems that are more common in ppl with cyanotic heart defects

Answer 9

Cerebral anuersyms, brain abcess, scoliosis