Dow - Fundamentals of Pediatric Cardiology

Question 1

What are the CHEAPTORCHES infections?

Answer 1

Chickenpox

Hepatitis C/D/E

Enteroviruses

AIDS/HIV

Parvovirus B19

Toxoplasmosis

Other (Group B strep, Lyme, Candida, Listeria)

Rubella

Cytomegalovirus

Herpes simplex

Everything sexually transmitted

Syphilis

Question 2

What are red flag sx when associated with feeding?

Answer 2

Diaphoresis

Tachypnea

Question 3

Splitting of what heart sound is normal in pediatrics? What kind of splitting of this sound would be considered abnormal?

Answer 3

Physiologic splitting of S2 with respiratory cycle

Abnormal if S2 is split, wide, and fixed

Question 4

What constitutes an innocent murmur in a child?

Answer 4

Low pitched, meaning it is non-turbulent and not high velocity

Question 5

What constitutes a suspicious murmur in a child?

Answer 5

High pitched

Harsh-sounding

S1 coincident, i.e. holosystolic

Diastolic murmurs

Question 6

What differences will newborn EKGs show compared to adults?

Answer 6

R ventricular dominance

Seen as R axis deviation

Changes in different interval lengths

Question 7

What are the 5 T’s of cyanotic congential heart disease?

Answer 7

Truncus arteriosus (1 trunk)

Transposition of the Great Arteries (2 arteries)

Tricuspid atresia (3 leaflets)

Tetralogy of Fallot (4 components)

Total Anomalous Pulmonary Venous Return (5 letters)

Question 8

How will a newborn with transposition of the great arteries apear?

Answer 8

Newborn will be severely cyanotic within the first few hours after birth

Question 9

What is the genetic inheritance pattern of hypertrophic cardiomyopathy?

Answer 9

Autosomal dominant

Question 10

What are the characteristic findings of Kawasaki disease?

Answer 10

High fever for 5 days

Non-exudative conjunctival injection

Strawberry tongue with cracked lips

Cervical lymphadenopathy

Polymorphous rash

Swelling of hands and feet with erythema; may progress to desquamation

Question 11

What is a major cardiovascular complication of untreated Kawasaki disease?

Answer 11

15-25% of cases will progress to coronary artery aneruysm

Question 12

What is the treatment for Kawasaki disease?

Answer 12

IVIG and ASA

Question 13

What is the general rule for HTN in pediatric pts?

Answer 13

The younger the child and the higher the BP, the more likely it is secondary to an identifiable cause

Question 14

What is true of arrythmias in pediatric pts vs adults?

Answer 14

Arrhythmias are less common in peds than adults

Question 15

Is chest pain in children more commonly from a cardiac or non-cardiac source?

Answer 15

Non-cardiac

Question 16

When should you refer a pediatric patient for cardiology workup?

Answer 16

Exertional chest pain

Exertional syncope

Significant family hx of arrhythmias, sudden death, or genetic disorders

Question 17

In a sports physical, what cardiac findings should you evaluate for?

Answer 17

Family hx of early sudden death

Murmurs or hypertrophic cardiomyopathy

Marfan’s stigmata

Question 18

What is chest pain reproducible with palpation typically associated with?

Answer 18

Costochondritis