Cyanotic Heart Disease

Question 1

Hypoxemia and Cyanosis

Answer 1

Cyanosis appears around <85%, so kid can still be hypoxemic w/ 90% and not blue

Question 2

Tetralogy of Fallot

Answer 2

1. VSD
2. Overriding of the aorta
3. Pulmonary stenosis
4. RVHypertrophy

Question 3

Initiation of TOF

Answer 3

Malalignment of conal septum leads to VSD -> overriding of aorta -> PS -> RVH

Question 4

TOF Degree of Cyanosis

Answer 4

Dependent on degree of PS

Question 5

Physical Exam Finding of TOF

Answer 5

Long loud systolic ejection murmur radiating to axilla

Question 6

TOF CXR

Answer 6

Boot shaped heart

Question 7

Hypoxic Spell

Answer 7

Hyperpnea and some other shit around 204 months w/ TOF. Caused by crying decreasing SVR, which increases the RL shunt, decreasing O2 and increasing CO2, yielding hyperpnea, increasing VR, and thus increasing RL shunt again. Cycle. Very dangerous

Question 8

TGA

Answer 8

Great vessels switched, causing in parallel circulation rather than in series circ

Question 9

3 Potential Connections in TGA

Answer 9

ASD, VSD, and PDA

Question 10

Physical Exam Finding of TGA

Answer 10

Comfortably tachypneic

Question 11

TGA CXR

Answer 11

Egg on a string

Question 12

2 Operations for TGA

Answer 12

Used to due atrial inversion (basically connecting veins to the opposite chambers), but causes RV failure after awhile, so now switched to arterial switch procedure (have to switch coronaries too)

Question 13

4 Features of DiGeorge Syndrome

Answer 13

Thymic hypoplasia
T cell immunodeficiency
Tetany (hypocalcemic bc lack of parathyroids)
Truncus arteriosus