Congenital Heart Disease Exam 4

Question 1

In fetal development, how are the common atrium and ventricles formed?

Answer 1

The tube rotates upon itself and forms the atrium and ventricles.

Question 2

In fetal development, what separates into the pulmonary arteries and aorta?

Answer 2

the common truncus arteriosus

Question 3

What term describes the formation of the atrioventricular canal separating the atria from ventricles?

Answer 3

Endocardial cushions. They are two thicker areas that develop into the walls (septum) that divide the four chambers of the heart.

Question 4

T/F. The aorta and pulmonary veins have a common trunk called the Truncus Arteriosis

Answer 4

False. It is the aorta and pulmonary arteries that have Truncus Arteriosis

Question 5

In fetal circulation, 75% of blood from ductus venosus and IVC are directed through the ____ ____ into the left atria.

Answer 5

Foramen ovale

Question 6

Why do fetuses have a ductus arteriosis?

Answer 6

because the lungs are not used while a fetus is in the womb, baby gets oxygen directly from the mother’s placenta.

Question 7

The incomplete formation of the atrial septum is called _____.

Answer 7

Atrial septal defect

Question 8

The incomplete formation of the ventricular septum is called _______.

Answer 8

Ventricular septal defect

Question 9

Tetralogy of Fallot is caused by the malalignment of the conal septum separating the ______ from the ______ outflow tracts.

Answer 9

pulmonary from the aortic

Question 10

T/F Persistent Truncus Arteriosis is the failure of septation between the pulmonary veins and pulmonary arteries.

Answer 10

False. It’s between the aorta and pulmonary arteries.

Question 11

What is the most common type of CHD in children?

Answer 11

ventricular septal defect (VSD)

Question 12

T/F the most common type of CHD in adults is ventricular septal defect.

Answer 12

False. It’s atrial septal defect (ASD)

Question 13

The congenital cardiac lesion in which there is complete mixing of deoxygenated and oxygenated blood is called what?

Answer 13

Admixture lesion. MC example is truncus arteriosis

Question 14

T/F- ASD has to be surgically corrected.

Answer 14

False, it has a high spontaneous closure rate

Question 15

T/F- Patients with ASD are usually asymptomatic

Answer 15

True. However, adults may be easily fatigued and also have exertional dyspnea

Question 16

ASD causes ____ to ____ shunt

Answer 16

left to right d/t higher pressure in left atria

Question 17

What diagnostic lab/imaging should you order to differentiate between VSD and ASD?

Answer 17

Echo, then order 2-D color doppler for eval.

Question 18

The most common isolated congenital cardiac malformation is ______. And it accounts for __ % of all congenital cardiac anomalies

Answer 18

VSD. 20%

Question 19

Why are LA, LV, and pulmonary a. enlarged in VSD?

Answer 19

Volume overload. Same reason why there is RV and right artery HTN

Question 20

What is Eisenmenger syndrome and why is it rare?

Answer 20

When a long standing L -> R shunt causes pulmonary HTN, resulting in flip of shunt, oxygen-poor blood to flow from the R -> L ventricle and then to the body, causing cyanosis. The high pressure also causes the wall of your heart’s right ventricle to hypertrophy.

Question 21

When the atrial septum, ventricular septum, and mitral/tricuspid valves have a defect resulting in incomplete closure is called ______.

Answer 21

Endocardial cushion defect or AV cushions.

Question 22

What CHD sounds like a machine murmur?

Answer 22

Patent ductus arteriosis, blood is flowing from aorta to pulmonary a. during systole and diastole

Question 23

In what patients is patent ductus arteriosis most seen?

Answer 23

Premature babies, infant exposed to hypoxemia, birth at high alt, and rubella exposure early on in infancy.

Question 24

Obstruction of the ductal region of aorta is called ______. What are some physical findings?

Answer 24

Coarctation of aorta. UE HTN, absent LE pulses, systolic murmur heard in left sternal border

Question 25

In coarc, blood gets beyond by anastomoses of what arteries?

Answer 25

costcocervical trunk, intercostal, lateral thoracic, internal thoracic.

Question 26

Why does rib notching occur in coarc?

Answer 26

D/t dilated tortuous intercostal arteries putting pressure on adjacent ribs.

Question 27

If you see a blue baby, they likely have ______ and that’s due to ______ shunt.

Answer 27

Tetralogy of fallot d/t R -> L shunt, deoxygenated blood mixing with oxygenated.

Question 28

What is a major defect of tetralogy of fallot?

Answer 28

Pulmonic stenosis and right ventricular outflow obstruction.

Question 29

All of the following may be an atrial septal defect (ASD) except for:

a. Ostium primum
b. Ostium secundum
c. Sinus venosus
d. Sinus arteriosis

Answer 29

d. Sinus arteriosis

Question 30

In ASD, a fossa ovalis defect is called

a. Ostium primum
b. Ostium secundum
c. Sinus venosus
d. Sinus arteriosis

Answer 30

b. Ostium secundum. Defect in mid septum

Question 31

The most common congenital cardiac malformation in 6 month old baby is-

a. ASD
b. VSD
c. Tetralogy of fallot
d. AV cushion defect

Answer 31

b. VSD

Question 32

Endocardial (aka AV) Cushion has a high incidence in patients who are-

a. premature
b. young teens
c. down syndrome
d. exposed to viral infections early on

Answer 32

c. down syndrome (per Dr. W if you also hear murmur with these pts be concerned)

Question 33

Majority of Patent Ductus Arteriosis close within

a. 4-7 days
b. 7-10 days
c. 14-22 days
d. Never close

Answer 33

a. 4-7 days

Question 34

If not by 4-7 days, virtually all Patent Ductus Arteriosis close by-

a. by 6 months
b. by 12 months
c. by 24 months
d. by 48 months

Answer 34

b. 12 months (year one)

Question 35

CXR findings in Patent Ductus Arteriosis MAY include:

a. mild cardiomegaly
b. rob notching
c. “E” sign
d. “3” sign

Answer 35

a. mild cardiomegaly

Question 36

CXR findings in tetralogy of fallot MAY SHOW-

a. nothing abnormal
b. ceur en sabot
c. boot shaped
d. two of the above
e. all of the above

Answer 36

e. all of the above