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Clinical Medicine 2 > Exam 1 - Congenital Heart Defects > Flashcards

Exam 1 - Congenital Heart Defects Flashcards

1
Q

What is the most common congenital disease?

A

Congenital Heart Dz

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2
Q

What is the most common Congenital Heart Dz?

A

Ventricular Septal Defect

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3
Q

Common risk factors for CHD?

A

Premarure, FHx, maternal infection in utero, rubella, genetic sundromes

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4
Q

Left to Right shunting of blood does what to the size/shape right side of the heart?

A

Dilates the right side of the heart

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5
Q

Right heart dilation causes what to the RV and pulmonary artery?

A

Decreased RV function and dilated pulmonary artery, then increased pulm vasculature

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6
Q

Is Left to Right shunting cyanotic?

A

No

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7
Q

Is Right to Left shunting cyanotic?

A

Yes

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8
Q

Why prenatal US so important?

A

To catch CHDs. New baby screenings only catch 50%

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9
Q

What is an Atrial Septal Defect? Shunt goes which way? Cyanotic?

A

Hole in atrial septum between RA and LA. Left to right shunting (noncyanotic).

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10
Q

Two main types of ASD?

A
  1. Ostium Secundum #1

2. Ostium Primum #2

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11
Q

Etiology of Ostium Secundum?

A

Second walls does not cover second hole d/t growth retardation. Spontaneous vs genetic.

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12
Q

Etiology of Ostium Primum?

A

First and Second Walls don’t fuse to endocardial tissue

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13
Q

Is an Ostium Primum isolated?

A

Usually not isolated. AV Canal defects, VSD, MR….

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14
Q

Symptoms of ASD?

A

Usually asymptomatic. Dyspnea, fatigue, exercise intolerant, recurrent rep infx.

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15
Q

Murmur and sounds in ASD?

A

Midsystolic pulmonary ejection murmur. Fixed-splie S2. Precordial thrill/lift

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16
Q

PE in ASD?

A

Failure to thrive. HF signs (tachycardia, hepatomegaly, ralls), irregular heart beat, IE, Eisnmenger Syndrome (Left to Right shunting, clubbed fingers).

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17
Q

EKG on ASD?

A

Tall P-waves=dilated right heart.

Complete or incomplete RBBB. Right axis deviation.

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18
Q

DX ASD gold standard?

A

Echo

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19
Q

Tx for ASD if no Sx and small defect?

A

Wait until 2

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20
Q

Tx for ASD if have Sx?

A

Surgery or percutaneous transcath repair

21
Q

What percent of adults have a Patent Foramen Ovale?

A

30%

22
Q

Is PFO an ASD?

A

Neyt

23
Q

Sx of PFO?

A

Asymptomatic most ofren.
+/- stroke-like sx
+/- migraine HA

24
Q

PE in PFO?

A

Cryptogenic stroke (stroke of unknown cause)

25
Q

Dx in PFO?

A

2d Echo w/doppler

26
Q

Tx in PFO?

A

Treat if have cryptogenic stroke/TIA. Anticoag, antiplatelet. Surgical closure of PFO.

27
Q

What class of defect is the most common of all CHDs?

A

Ventricular Septal Defect

28
Q

VSDs are what percent of all septal defects

A

50%

29
Q

Two main types of VSD?

A
  1. Membranous/Pesudomembranous Type 2 (most common)

2. Muscular Defect Type 4 (5-20% of VSDs)

30
Q

Etiology of Membranous/Pseudomembranous VSD?

A

Deficiency of membranous septum. Tricuspid regurg or aneurysm. Blood from LV goes to RV.

31
Q

Sx of VSD?

A

Asymptomatic, SOB/DOE, fatigue.

32
Q

Murmur and sounds in VSD?

A

Holosystolic Murmur. Palpable thrill.

33
Q

PE on VSD

A

Holosystolic murmur, palbable thrill.
Peds=failure to thrive
HF signs: tachy, hepatomegaly, rales

34
Q

Dx in VSD?

A

2D echo w/Doppler

35
Q

CXR in VSD?

A

Cardiomegaly

36
Q

EKG in VSD?

A

Often normal. Rght, left, of biventricular hypertrophy.

37
Q

Tx in VSD depends on what?

A

Depends on size, location, and complications

38
Q

Tx for small Type 2 and 4 VSD?

A

40% close spontaneously. If not, surgial repair.

39
Q

VSD can cause what sort of hypertension? How to tx?

A

Pulmonary HTN. Meds for vasodilation.

40
Q

Which gender develops a Patent Ductus Arteriosus most often

A

Women, 2:1.

41
Q

Risk factors for PDA?

A

Premature birth, congenital rubella, FHx, congenital disorders

42
Q

PDA shunts from where to where? Cyanotic?

A

Shunts blood from aorta to left pulmonary artery. Non-cyanotic.

43
Q

Sx of PDA?

A

Usually Asx.

44
Q

Murmur and sounds in PDA?

A

Continuous machine-like murmur. Thrill in upper right chest.

45
Q

Pulse pressure with BP in PDA?

A

Widended pulse pressure with decreased DBP.

46
Q

Dx in PDA?

A

2D Echo w/Doppler
CXR= normal or cardiomegaly
EKG= normal of LVH

47
Q

Tx for PDA if premature babies?

A

Indomethacin or Ibuprofen. Prostaglandin-ihibitor can help close PDA.

48
Q

Tx for PDA if meds don’t work?

A

Surgical ligation, transcath closure.

49
Q

pick up at coart of aorta

A

pick up at coart of aorta

Clinical Medicine 2 (14 decks)

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