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Cardiovascular System > Congenital Heart Disease > Flashcards

Congenital Heart Disease Flashcards

1
Q

_______ bypasses hepatic circulation in utero

A

Ductus venosus

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2
Q

_______ typically closes 10-15 hours after birth.

A

Ductus arteriosus

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3
Q

_______, especially _____, are produced in the ______ and maintain the patency of the ductus arteriosus

A

Prostaglandins; PGE2; placenta and ductal wall

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4
Q

ASD management children and older

A

Percutaneous closure

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5
Q

ASD management infants

A

Medical management of symptoms

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6
Q

ASD Natural History (4)

A

Undetected in children; Pulmonary Vascular Disease, Atrial arrhythmias, heart failure

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7
Q

ASD Presentation

A

Rare in infancy

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8
Q

Causes of secundum ASD

A

too large of an osteum secundum in the septum primum or an inadequate development of the septum secundum

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9
Q

Coarctation management adult

A

Stent or surgery

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10
Q

Coarctation management child

A

Balloon angioplasty or surgery

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11
Q

Coarctation management infant

A

Prostaglandins then end-to-end anastomosis surgical repair

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12
Q

Coarctation Natural History (5)

A

Development of collateral circulation; death from HF, aortic rupture/dissection, infective endocarditis, cerebral hemorrhage

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13
Q

Coarctation Presentation (1-2 weeks) (3)

A

Tachypnea, poor feeding, cardiogenic shock

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14
Q

Coarctation Presentation (Adult) (1)

A

Hypertension

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15
Q

Coarctation Presentation (Childhood) (4)

A

Asymptomatic, hypertension, claudication symptoms, headache

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16
Q

Coarctation Presentation (Infancy) (2)

A

Cardiogenic shock, absent femoral pulses

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17
Q

Complication of cyanotic CHD with persistent fevers and behavioral changes

A

Cerebral abscess

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18
Q

Components of Tetrology of Fallot

A

RV hypertrophy, RV outflow tract obstruction, Overriding aorta, VSD

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19
Q

Consequences of aortic coarctation (3)

A

Leg pain with exercise, elevated RAA release, necrotizing enterocolitis

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20
Q

CXR findigns of coarctation (4)

A

Rib notching, dilated aortic nob, coarctation, post-stenotic dilation

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21
Q

EKG for adult coarctation

A

ST depression, T wave flattening or inversion

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22
Q

EKG for child coarctation

A

modest LV hypertrophy

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23
Q

EKG for infant coarctation

A

RV hypertrophy with R axis deviation

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24
Q

EKG for VSD

A

hypertrophy and right axis deviation

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25
Q

Genetic Syndrome associated with Aortic Coarctation

A

Turner Syndrome

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26
Q

Masses appear in the truncus: ________ and _______ truncal swellings

A

dextrosuperior, sinistroinferior

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27
Q

Masses appear on the inside wall of the conus: _______ and _______ conal crests

A

dextrodorsal, sinistroventral

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28
Q

PDA (large or symptomatic) in older child

A

Percutaneous occlusion

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29
Q

PDA Natural History

A

Eisenmenger’s, increased risk of endocarditis

30
Q

PDA symptomatic neonate management (not responsive to medical treatment)

A

Surgical ligation

31
Q

PDA symptomatic neonate medical treatment

A

Cyclooxygenase inhibitors/NSAIDs: IV indomethacin, IV ibuprofen lysate

32
Q

Physical exam findings for blue tet

A

Tachycardic and cyanotic, displacement of precordial impulse

33
Q

Physical exam findings for pink tet

A

Tachypnic and diaphoretic, displacement of precordial impulse

34
Q

Physical exam findings of coarctation (3)

A

Tachycardia, Blood pressure difference between upper and lower extremities, hepatomegaly

35
Q

Physical exam findings of large ASD (4)

A

Increased RR, Liver descension below costal margin, systolic ejection murmur, Fixed widely split S2

36
Q

Physical exam findings of large VSD (4)

A

Active precordium, accentuated S2, harsh holosystolic murmur, mitral diastolic murmur

37
Q

Physical exam findings of PDA (4)

A

Bounding pulses, variable murmur, wide pulse pressure, hyperactive precordium

38
Q

Physical exam findings of small ASD

A

Normal exam

39
Q

Physical exam findings of small VSD

A

Early systolic murmur

40
Q

Products of 3rd aortic arch

A

Carotid Arteries

41
Q

Products of 4th aortic arch

A

BCT, LSC, transverse aortic arch

42
Q

Products of 5th aortic arch

A

Pulmonary arteries and ductus arteriosus

43
Q

Tet (ductal-dependent) management

A

Prostaglandins (to maintain DA patency), early surgical repair

44
Q

Tet (ductal-independent) management

A

Elective surgical repair (2-4 months)

45
Q

Tet management in addition to primary defects

A

Pulmonic valve replacement

46
Q

Tet Natural History (adequate PBF) (5)

A

Cyanotic saturations, poor enamel, clubbing, bleeding tendency, arrhythmias

47
Q

Tet Natural History (severe RVOT obstruction)

A

Death at DA closure

48
Q

Tet spell presentation

A

2-6 months of age; hypercyanosis and hypoxia

49
Q

Tet spell prevention

A

Beta-Blockers (to reduce RVOT obstruction)

50
Q

Tetrology of Fallot EKG

A

RV hypertrophy, R axis deviation

51
Q

Tetrology of Fallot results from abnormal development of the ________, which results in an infundibular septum that is displaced __________.

A

conal crests; anteriorly, rightward, and superiorly

52
Q

VSD management for pulmonary vascular changes, secondary complications, or severe symptoms

A

Surgical closure

53
Q

VSD management in infants

A

Management of heart failure/pulmonary edema symptoms (diuretics)

54
Q

VSD Natural History

A

Most shrink and/or close; Eisenmenger’s syndrome

55
Q

VSDs come in two more common types: _______ (75% of cases) and _______ (10% of cases)

A

Perimembranous VSD; Muscular VSD

56
Q

What is the developed structure? AV sulcus

A

IV septum

57
Q

What is the developed structure? Bulbus Cordis

A

Trabeculated RV

58
Q

What is the developed structure? Conus

A

Outflow tracts of both ventricles

59
Q

What is the developed structure? Inferior Endocardial cushion

A

inlet portion of IV septum, membranous portion of IV septum, parts of the tricuspid and mitral valves

60
Q

What is the developed structure? Laeral Endocardial cushion

A

parts of the tricuspid valve

61
Q

What is the developed structure? Medial Endocardial cushion

A

posterior leaflet of the mitral valve

62
Q

What is the developed structure? Primitive Atria

A

LA, RA

63
Q

What is the developed structure? Primitve ventricle

A

Trabeculated LV

64
Q

What is the developed structure? Superior Endocardial cushion

A

left surface of outlet portion of the IV septum, part of mitral valve

65
Q

What is the developed structure? Truncus

A

Aortic and Pulmonary Valves and Arteries

66
Q

What is the embryonic structure? Aortic and Pulmonary Valves and Arteries

A

Truncus

67
Q

What is the embryonic structure? IV septum

A

AV sulcus

68
Q

What is the embryonic structure? LA, RA

A

Primitive atria

69
Q

What is the embryonic structure? Outflow tracts of both ventricles

A

Conus

70
Q

What is the embryonic structure? Trabeculated LV

A

Primitive Ventricle

71
Q

What is the embryonic structure? Trabeculated RV

A

Bulbus Cordis

Cardiovascular System (11 decks)

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