Diseases

Question 1

Inflammation of the pericardium

Results in
- cardiac tamponade, pericardial effusion, and precordial/epigastric pain.

• pericardial murmur or pericardial friction rub (pericardium surfaces get rough and rub against each other)

Answer 1

Pericarditis

Question 2

Accumulation of fluid in pericardial space compresses the heart, interfering with cardiac filling.

Answer 2

Pericardial effusion

Question 3

Cardiac tamponade- what is it, what are the signs, and how do you treat it?

Answer 3

Acute compression of the heart from pericardial effusion reduces venous return

• -> Beck’s triad:
  (1) Low bp
  (2) Quiet heart (bc fluid insulates)
  (3) Distended jugular vein bc blood can’t get back into the vena cava.

Treated with pericardiocentesis thru the 5th intercostal space

Question 4

Twin-twin transfusion syndrome: blood vessel connections form between the umbilical vessels of twins, so one twin steals blood from another.

What kind of twins must they be?

Answer 4

Monochorionic, diamniotic

This makes up 66% of monozygotic twins.

Question 5

Monozygotic twins who are mono-,mono- are…

Answer 5

Conjoined.

They make up 1% of monozygotic twins.

Question 6

Klippel-Feil

Answer 6

Fusion of cervical vertebrae.

Short, stiff neck; limited motion; scoliosis; UTIs; abnormal brainstem or cerebellum

Question 7

What spinal abnormality affects thoracic vertebrae?

Answer 7

Kyphosis

Question 8

Rib hump when bending over

Answer 8

Scoliosis

Question 9

Hangman’s fracture

Answer 9

Hyperextension fractures the pars interarticularis (pedicles) of C2 and tears the cruciform ligament
–> dens crushes the spinomedullary jxn

Comes with paravertebral swelling and anterior dislocation of the C2

Question 10

Muscular dystrophy & polio can mess up the alignment of the vertebral column and cause

Answer 10

Scoliosis

Question 11

Laryngeal atresia

Answer 11

Obstruction of the fetal airway

Distal to the site, airways dilate; lungs enlarge and become echogenic; diaphragm flattens or inverts; fetal ascites.

Question 12

Tracheal atresia (obstruction of trachea) results from

Answer 12

Unequal division of foregut into esophagus and trachea.

Question 13

Polyhydramnios

Answer 13

Excess of amniotic fluid often associated with EA or TEF

May occur if the baby has tracheobronchial atresia and can’t swallow its own urine to make its lungs (–> hypoplasia), so all the fluid stays outside.

Question 14

Oligohydramnios

Answer 14

Decrease in amniotic fluid; often comes with stunted lung development and pulmonary hypoplasia

Question 15

Tetralogy of Fallot - signs and cause?

Answer 15

Right ventricular hypertrophy
Pulmonary stenosis
Overriding aorta
VSD

Cause: malalignment of the subpulmonary infundibulum

Question 16

Membranous VSDs result from a defect in

Answer 16

endocardial cushions

Question 17

Transposition of the great arteries results form a defect in

Answer 17

the aorticopulmonary septum

Question 18

Murmur from an ASD vs a VSD

Answer 18

ASD - diastolic murmur in the tricuspid valve

VSD - pansystolic murmur

Question 19

____ and ___ would cause a murmur at S1

Answer 19

Transposition of great arteries & aortic stenosis

Question 20

Down syndrome is associated with

Answer 20

Arrhythmias

Atrial & VSDs

Question 21

Coarctation of the aorta occurs at portions arising from which pharyngeal arches?

Answer 21

3, 4, and 6

Question 22

Hyperresonance to percussion
Decreased breath sounds
Reduced vascular markings
Distended jugular

Answer 22

Pneumothoax.

If accompanied by tracheal deviation or if you know it was caused by sudden trauma –> tension pneumothorax

Question 23

Large QRS complexes suggest

Answer 23

Ventricular hypertrophy –> can lead to pitting edema by retrograde pressure backing up

Question 24

Inflammatory change weakens and tears the heart’s intimal wall, forming a false and true lumen –> occludes blood flow to major organs or causes tamponade.

What is the disease and what are the signs?

Answer 24

Aortic dissection.

Chest pain with

• low blood pressure
• widened mediastinum
• moves front to back

Question 25

Angina pectoris (chest pain from needing oxygen) follows a dermatomal pattern along what spinal cord distribution? What relieves it?

Answer 25

T1-T5

Rest.

Question 26

How can increased heart rate cause angina?

Answer 26

Tachycardia diminishes diastolic filling time

Question 27

Enlarged lymph node posterior to the clavicle that can’ t drain; often associated with gastric cancer

Answer 27

Virchow’s node

Question 28

Horner’s Syndrome

Answer 28

Loss of sympathetic function to head, such as by crushing the superior cervical ganglion.

• Ptosis: drooping eyelid
• Pupillary constriction
• Absence of sweating

Question 29

Winging of scapula - what got clipped?

Answer 29

Long thoracic nerve