Congenital heart disease

Question 1

In fetal circulation, SVR is ___ and PVR is ____

Answer 1

SVR is low, PVR is high

Question 2

The ductus venous bypasses the ____ and shunts blood from the umbilical vein to the IVC

Answer 2

Bypasses the liver

Question 3

The ductus arteriosus shunts blood from the ___ to the ___ bypassing the ____

Answer 3

pulmonary artery to the aorta bypassing the lungs

Question 4

There is ___ umbilical vein that carries oxygenated blood from the mother to the fetus

Answer 4

one

Question 5

There are ____ umbilical arteries that carry deoxygenated blood from the fetus to the mother

Answer 5

2

Question 6

Fetal circulation is arranged in ____ and adult circulation is ____

Answer 6

Fetal circulation is arranged in PARALLEL and adult circulation is SERIES

Question 7

With the first breath, PAO2 ____ and co2 ___, PVR ____

Answer 7

PAO2 increases, Co2 decreases, PVR decreases

Question 8

What increases PVR?

Answer 8

Hypercarbia, hypoxemia, acidosis, atelectasis, Trendelenburg, hypothermia, vasoconstrictors, light anesthesia, pain.

Question 9

What are the cyanotic shunts? (right to left)

Answer 9

TOF, transposition of the great arteries, Ebstein’s anomaly, trunctus arteriosis, total anomolous pulmonary venous connection

Question 10

Which shunts are ACYANOTIC? (left to right)

Answer 10

VSD, ASD, PDA, coarctation of the aorta

Question 11

A right to left shunt is associated with a ____ inhalation induction and a _____ IV induction.

Answer 11

Slower inhalation, faster IV

Question 12

A left to right shunt is associated with a ____ inhalation induction and a _____ IV induction.

Answer 12

FasterISH/minimal inhalation, slower IV

Question 13

Esienmenger syndrome is when a left to right shunt switches to a right to left shunt because of _________

Answer 13

pulmonary hypertension

Question 14

What is TOF?

Answer 14

The most common cyanotic congenital heart anomaly

Question 15

What 4 defects come with TOF?

Answer 15

1. RV outflow tract obstruction
2. RV hypertrophy from RV tract obstruction
3. VSD
4. Overriding aorta that receives blood from both ventricles

Question 16

How does a TET spell present?

Answer 16

Hypoxemia and cyanosis

Question 17

Best way to treat TOF?

Answer 17

Ketamine is best. Avoid morphine, meperidine, atracurium
(histamine release), keep adequate preload and SVR

Question 18

Which direction is flow through an ASD usually in?

Answer 18

Left to right

Question 19

Where is the best place to monitor arterial BP on a patient getting surgery for coarctation of the aorta?

Answer 19

right arm

Question 20

What are 2 signs of coarctation of the aorta?

Answer 20

Systolic higher in upper extremities
Differential cyanosis will be present

Question 21

What drug do you give before coarctation of the aorta surgery?

Answer 21

Prostaglandin E1 - it keeps the ductus arteriosis open which helps peruse the lower extremities

Question 22

The patient scheduled for a fontan procedure most likely has….

Answer 22

Hypoplastic left heart syndrome

It’s a single ventricle