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CardioPulm Final Exam > CP Final: Pediatric Cardiology > Flashcards

CP Final: Pediatric Cardiology Flashcards

1
Q

When does heart begin to form?

A

at 18 days

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2
Q

When do tubes fuse?

A

21 days and are beating by 22 days

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3
Q

When do atrium and ventricles separate?

A

at day 24

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4
Q

When will blood begin to circulate through the embryo from heart?

A

day 27

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5
Q

When does atrium partition?

A

days 27-31 foramen ovale is now open

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6
Q

When do the ventricles divide?

A

by 7 weeks

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7
Q

Which side is dominant during utero?

A

right side

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8
Q

When is development usually complete by?

A

week 10

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9
Q

What is fetal blood flow circuit?

A
  1. oxygen returns to fetus through umbilical vein
  2. RA through Foramen ovale to LA
  3. red blood then goes to LV and out through aorta to body
  4. fetal blood returning goes back to RA and blue blood then goes to RV and instead of going to lungs goes through ductus arteriosus
  5. DA sends blue blood to lower half of body to return blood to placenta to get oxygen
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10
Q

When happens at a new borns first breath?

A

lungs expand with air, lung pressure falls, blood flows into lungs

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11
Q

What happens when blood returns to right atrium in newborn?

A

higher pressure now on left side of heart, functionally F.O will close off a few hours after birth and fully closed by 3 months

oxygen levels of blood rises

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12
Q

When does D.A constrict?

A

10-15 hours after birth due to increased PaO2

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13
Q

What is a normal HR for a 0-3 month old?

A

100-150 then drops until normal HR achieved with the biggest drop in the first year

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14
Q

What is normal BP of 0-3 month old?

A

65-85/ 35-45 then increases with age until normal due to growing body

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15
Q

When can a congenital heart defect occur?

A

at any point during the development of cardiac system

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16
Q

What can cause a CHD?

A
  1. genetics
  2. maternal rubella
  3. maternal infection before week 10
  4. maternal substance abuse/ diabetes/ radiation exposure/ obesity
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17
Q

What are clinical signs of CHD?

A

tach, JVD, crackles, cyanosis, abnormal heart sounds

Failure to thrive is big one but may not notice this one for months or years

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18
Q

What are some respiratory distress symptoms?

A

tach, retractions, nasal flaring, grunting, stridor, head bobbing, pallor

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19
Q

What are the two main types of defects?

A
  1. Acyanotic

2. Cyanotic

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20
Q

What are acyanotic defects?

A

not as bad, defects that cause a left to right shunt of blood but does not mix deoxygentaed blood going out to body

this impairs preload and after load and impairs contractility, like CHF

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21
Q

What is atrial septic defect?

A

most common is patent foramen ovale, more common in females than males and FO does not close at birth

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22
Q

What happens in ASD over time?

A

pressure shift from left to right causing RA and RV hypertrophy

sx: could lead to stroke, loud systolic murmur, Sx of R CHF

Tx: surgery if not closed by 2-3, on anti coags for 6 months

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23
Q

What is ventricular septal defect?

A

hole or multiples holes within inter ventricular septum, blood is shunted from left to right ventricle during systole

this is worse than ASD

24
Q

What is happening during VSD?

A

increases blood going back to lungs, making gas exchange less efficient , also returning more blood to LV which may stretch it

25
Q

What are sx of VSD?

A

loud systolic murmur, dyspnea, diffculty feeding, failure to thrive, perfuse sweating, sx of CHF, resp distress

TX: some may close on own by age 2 but if not by 5-7 then surgery

26
Q

What is atrioventricular septal defect?

A

AVSD, large hole in IV septum moving larger amounts of blood from left to right side

common in babies with down syndrome

27
Q

What are sx of AVSD?

A

significant lung congestion, pulm HTN, increased WOB, failure to thrive

tx: surgery within first few months of life

28
Q

What is patent ductus arteriosis?

A

DA remains and allows blood to flow between aorta and pulm artery, causing more blood to go to lungs

29
Q

What are sx of PDA?

A

depends on size, pulm congestion, sx of CHF, dyspnea, failure to thrive

tx: antibiotics, meds to close DA (Indomethacin), surgery if those don’t work

30
Q

What is coarctation of aorta?

A

narrowing of aorta by DA, increasing after load and pressure significantly

31
Q

What are sx?

A

none until DA closes then CHF and often shock

32
Q

What is aortic stenosis?

A

usually in toddlers or above, narrowing of the outflow tract of the LV, increasing after load and CHF

33
Q

What are sx?

A

none at rest but exercise intolerance, dizziness

TX: aortic surgery

34
Q

What are cyanotic defects?

A

these effects allow for right to left shunting so deoxygenated blood is sent out into the body

results in cyanosis, clubbing due to decreased PaO2

35
Q

What is Tetralogy of Fallout?

A

most common cyanotic CHD, consisting of large VSD, pulm stenosis, aorta over VSD which maximizes mixing, RV hypertrophy

36
Q

Why does this result in hypoxia?

A

blood flow to pulm artery is obstructed- therefore due to path of least resistance will go to aorta bc of VSD

37
Q

What are sx?

A

cyanosis, fatigue, fainting, polycythemia, shock

TX: surgery, 5% mortality rate with surgery

38
Q

What is hypo plastic left heart syndrome?

A

decreases size of left ventricle, may have absent mitral or aortic valves

worst mortality of all CHD

39
Q

What are sx?

A

nothing until DA closes then baby goes into shock and organ failure

TX: use of prostoglandins to keep DA open or surgery even LVAD or transplant possible

40
Q

What is transposition of great vessels?

A

pulm artery and aorta are switched during gestation, aorta from RV, PA from LV

more common in males

41
Q

What are sx?

A

sx: cyanosis, shock and organ failure

TX: try to keep DA open or surgery to switch aorta back

42
Q

What is rheumatic fever?

A

strep A from strep throat with fever and joint pain can lead to rheumatic heart disease

43
Q

What is RHD?

A

this can cause endocarditis, autoimmune reaction in the heart, bacterial sludge grows on heart causing valve issues like mitral or aortic stenosis

TX: antibiotics, ASA, anti inflammatories (steroids)

44
Q

What is cardiomyopathy?

A

defined as decrease in CO caused by myocarditis, genetics, neuromuscular disorder, metabolic disorders

45
Q

What are the three types of cardiomyopathy?

A
  1. dilated- overstretch of left, right or both ventricles
  2. hypertrophic- stiff and thickened heart due to abnormal growth and arrangement of myocytes
  3. restrictive- decreased ability of heart to relax in diastole
46
Q

What are sx?

A

depends on what side affect but could be fatigue, activity intolerance, low BP, abnormal HD to activity

TX: drugs to increase contractility, decrease workload of heart, decrease after load

47
Q

What is most common age for pediatric heart transplant?

A

newborn to one y/o likely due to CHD when other options have failed

ages 1-17 cardiomyopathy most common reason for transplant

48
Q

What are survival rates?

A

72% for 0-1 is 7 years
50% for 1-10 is 17.5 years
50% for over 10 is 11 years

49
Q

What is Marfan’s syndrome?

A

inherited disorder of connective tissue can lead to cardiac manifestations such as aortic dilation, aortic/mitral valve regurgitation

50
Q

What is Ehlers-Danlos syndrome?

A

connective tissue disorder with decreased amount of collagen, same cardiac issues as marfans

51
Q

What is myocarditis?

A

inflammation of myocardium usual due to viral infection

52
Q

What is pericarditis?

A

inflammation of pericardium

53
Q

What are CDC recommendations for activity with children?

A

60 minutes of moderate to vigorous activity a day, 3x a week for vigorous

54
Q

What is recommendation for muscle strength?

A

3x/ week- gymnastics, rope/tree climbing

55
Q

What about for bone building?

A

3x /week jump rope, group sports, running, hopping, skipping

CardioPulm Final Exam (4 decks)

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