Congenital Heart Diseases

Question 1

caused by ostium secundum

Answer 1

ASD

Question 2

most patients asymptomatic or minimal in childhood until >30y/o

Answer 2

ASD

Question 3

systolic ejection crescendo-decrescendo flow murmur @ pulmonic area (LUSB)

Answer 3

ASD

Question 4

widely split fixed S2 *does not vary with respirations*

Answer 4

ASD

Question 5

CXR in ASD

Answer 5

cardiomegaly

Question 6

crochetage sign (notching of peak of R wave in inferior leads)

Answer 6

ASD

Question 7

Gold standard dx for ASD

Answer 7

echo

Question 8

Mgmt of ASD

Answer 8

spontaneous closure likely in 1st yr, observe

surigcal correction if symptomatic

Question 9

communication between descending thoracic aorta and pulmonary artery

Answer 9

PDA

Question 10

What promotes PDA patency

Answer 10

continued prostaglandin E2 production

Question 11

Eisenmenger’s syndrome associated with which heart defects

Answer 11

everything BUT ASD

Question 12

eisenmengers syndrome

Answer 12

pulm HTN –> left to right shunt switches and becomes R to L (cyanotic)

Question 13

continuous machinery murmur

Answer 13

PDA

Question 14

where is the pulmonic murmur loudest at?

Answer 14

LUSB

Question 15

normal hands with cyanotic lower extremities

Answer 15

eisenmengers syndrome

Question 16

1st line Tx for PDA

Answer 16

IV indomethacin

Question 17

congenital narrowing of descending thoracic aorta

Answer 17

coarctation of aorta

Question 18

bicuspid aortic valve associated with

Answer 18

coarctation of aorta

Question 19

MC presentation of coarctation of aorta

Answer 19

2ry HTN, bilateral claudication

Question 20

systolic murmur that radiates to back/scapula/chest

Answer 20

coractation of aorta

Question 21

Increased upper BP > lower extremities

Answer 21

coarctation of aorta

Question 22

delated/weak femoral pulses

Answer 22

coarctation of aorta

Question 23

CXR of coarctation of aorta

Answer 23

rib notching

“3 sign”

Question 24

Gold standard Dx for coarctation of aorta

Answer 24

angiogram

Question 25

Mgmt of coarctation of aorta

Answer 25

surgery

Question 26

only cyanotic congenital Heart disease

Answer 26

tet of fallot

Question 27

4 pathophysiologies of tet of fallot

Answer 27

1. RV outflow obstruction 2. RV hypertrophy 3. VSD 4. overriding aorta

Question 28

Blue Baby Syndrome (cyanosis)

Answer 28

TOF

Question 29

what are tet spells

Answer 29

paroxysms of cyanosis: older children relieve spells by squatting

Question 30

harsh holosystolic murmur @ LUSB

Answer 30

TOF

Question 31

right ventricular heave

Answer 31

TOF

Question 32

boot shaped heart RVH

Answer 32

TOF

Question 33

gold standard for TOF

Answer 33

echo

Question 34

mgmt for TOF

Answer 34

surgical repair

Question 35

MC congenital heart disease

Answer 35

VSD

Question 36

MC type of VSD

Answer 36

perimembranous

Question 37

loud, high pitched holosystolic murmur at the LLSB

Answer 37

VSD (same as TOF)

Question 38

gold standard dx for VSD

Answer 38

echo

Question 39

What will ECG show for VSD?

Answer 39

LVH

Question 40

what type of VSD is associated with good prognosis

Answer 40

restrictive VSD: normal pressure between ventricles maintained

Question 41

wide pulse pressure: bounding peripheral pulses Loud S2

Answer 41

PDA

Question 42

Ebstein's anomaly associated with what?

Answer 42

maternal lithium use during pregnancy

Question 43

this congenital heart defect is associated with wolf parkinson white syndrome

Answer 43

ebstein's anomaly

Question 44

supplemental oxygen fails to increase arterial oxygen levels.

Answer 44

proof of R to L shunt

Question 45

his occurs when increased pulmonary blood flow from a left-to-right shunt leads to pulmonary hypertension and compensatory right ventricular hypertrophy, and, over time, right ventricular pressures surpass left ventricular pressures, resulting in a change in direction of the shunt.

Answer 45

Eisenmenger's syndrome

Question 46

which congenital heart defect has an association with maternal rubella

Answer 46

PDA

Question 47

which heart defect is associated with turner syndrome and intracranial aneurysms

Answer 47

coarctation of aorta

Question 48

cyanotic within hours of birth

Answer 48

Transposition of the Great Arteries

Question 49

diabetic mother

Answer 49

TOGA

Question 50

CXR shows eggs on a string

Answer 50

TOGA

Question 51

Tx for TOGA

Answer 51

PGE1 analog, surgery

Question 52

boot shaped heart

Answer 52

TOF

Question 53

MC presenting symptom of ALL congenital heart defects

Answer 53

CHF

Question 54

Closure of the ductus arteriosus begins when levels of which of the following substances increases in the immediate post-natal period?

Answer 54

Bradykinin

Question 55

Known adverse effect of PGE 1

Answer 55

apnea