Clinical cases with embryology Flashcards
what does she have
1) 1 month old female
2) no weight gain for 2 weeks
3) sweaty with feed
4) HR 180, RR 80, equal BP in lower and upper extrem
5) 3/6 blowing holosystolic murmur at left lower sternal base, intermittent gallop
Liver 3 cm below right costal margin
Lung clear
good femoral puls
large VSD
what do you do?
1) 1 month old female
2) no weight gain for 2 weeks
3) sweaty with feed
4) HR 180, RR 80, equal BP in lower and upper extrem
5) 3/6 blowing holosystolic murmur at left lower sternal base, intermittent gallop
Liver 3 cm below right costal margin
Lung clear
good femoral puls
1) refer peds cardio
2) define anatomy
3) begin diuretic
4) monitor growth –> if still poor and sx persist –> Surgery
what does she have
1) 4 month old
2) slow weight gain since 2 month
3) HR 160, RR 60, equal BP in upper and lower extrem
4) 2/6 blowing holosystolic murmur at left lower sternal border
Liver 1 cm below right costal margin
Lungs clear
good femoral pulses
large VSD in baby at high altitudes
physiology of VSD at higher altitudes
1) 4 month old
2) slow weight gain since 2 month
3) HR 160, RR 60, equal BP in upper and lower extrem
4) 2/6 blowing holosystolic murmur at left lower sternal border
Liver 1 cm below right costal margin
Lungs clear
good femoral pulses a
1) pulm resistance take longer to fall after birth
2) magnitude of VSD shunt for comparable size defect is smaller
how to treat
1) 4 month old
2) slow weight gain since 2 month
3) HR 160, RR 60, equal BP in upper and lower extrem
4) 2/6 blowing holosystolic murmur at left lower sternal border
Liver 1 cm below right costal margin
Lungs clear
good femoral pulses
define anatomy
schedule surgery if defect won’t close
what does he have
1) 1 day old
2) breathless with feed
3) HR 170, RR 80
4) 2/6 continuous murmur over L upper sternal border radiating to back
Liver 2 cm below right costal margin
no femoral pulses
coarctation of aorta
what do you do
1) 1 day old
2) breathless with feed
3) HR 170, RR 80
4) 2/6 continuous murmur over L upper sternal border radiating to back
Liver 2 cm below right costal margin
no femoral pulses
1) check 4 extremity BP
(see 15 point differential in systolic pressure btwn arm and leg)
2) consult cardiology
3) initiate prostaglandin to maintain ductal patency
4) schedule surgical
what does he have
1) 5 year old
2) child squats during school
tetralogy of fallot
why is he squatting
1) 5 year old
2) child squats during school
incr systemic vascular resistance to form more blood to flow out of lungs
what would exam be?
1) 5 year old
2) child squats during school
1) cyanosis
2) clubbing of digits
3) 2-3/6 harsh, systolic ejection murmur –> RV outflow tract obstruction
what to do?
1) 5 year old
2) child squats during school
1) refer to cardiology
2) echo and cardiac cath to look at branch pulm arteries
3) surgery repair
