Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ABSITE > Fiser Chapter 26 CARDIAC > Flashcards

Fiser Chapter 26 CARDIAC Flashcards

1
Q

Shunt causing cyanosis

A

R to L shunt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Children squatting does what

A

Increases SVR and decreases R to L shunt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cyanosis from R to L shunt can lead to what

A

Polycythemia, stroke, brain abscess, endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Eisenmenger’s syndrome

A

L -> R shunt switches to R -> L shunt

Sign of increasing pulmonary vascular resistant and pulmonary HTN, and is generally irreversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Shunt causing CHF

A

L to R shunt

Manifests as failure to thrive, tachycardia, tachypnea, hepatomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

First sign of CHF in children

A

Hepatomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of L to R shunts

A

VSD
ASD
PDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

PDA causes what kind of shunt

A

L to R

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of R to L shunts

A

Tetralogy of Fallot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ductus arteriosus

A

Connection between descending aorta and Left pulmonary artery; blood shunted away from lungs in utero

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ductus venosum

A

Connection between portal vein and IVC; blood shunted away from liver in utero

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fetal circulation at placenta

A

2 umbilical arteries (take blood away from fetus)

1 umbilical vein (brings blood to fetus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most common congenital heart defect

A

VSD causing a L -> R shunt

80% close spontaneously by 6 months

Large VSDs usually cause symptoms after 4-6 weeks old, as PVR decreases and shunt increases

Cx: CHF (tachypnea, tachycardia) and FTT (failure to thrive)

Tx: Diuretics, digoxin, repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

VSD timing of repair

A

FTT: most common reason for earlier repair

Medium (shunt 2-2.5): 5yo

Large (shunt > 2.5): 1yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ASD types

A

Ostium secundum is most common; centrally located

Ostium primum (or atrioventricular canal defects or endocardial cushion defects); can have mitral valve and tricuspid valve problems; frequent in Down’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ASD

A

L -> R shunt

Usually symptomatic when shunt > 2 -> CHF (SOB, recurrent infections)

Can get paradoxical emboli in adult hood

Tx: Diuretics and digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ASD timing of repair

A

1-2yo

If canal defects: 3-6 months old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tetralogy of Fallot

A

PROV:

  • Pulmonic stenosis
  • R ventricular hypertrophy
  • Overriding aorta
  • VSD

R to L shunt -> cyanosis

Tx: Beta blocker, repair at 3-6 months old

19
Q

Most common congenital heart defect that results in cyanosis

A

Tetralogy of Fallot

20
Q

Tetralogy of Fallot repari

A

-RV outflow tract obstruction removal, RVOT enlargement, and VSD repair

21
Q

PDA

A

L to R shunt

Tx: indomethacin to close, rarely successful beyond neonatal period, requires L thoracotomy for repair if persists

22
Q

MCC death in US

A

CAD

23
Q

CAD risk factors

A
  • Smoking
  • HTN
  • Male
  • Family hx
  • HLD
  • DM
24
Q

CAD medical tx

A

-Nitrates, smoking cessation, weight loss, statins, ASA

25
Q

Coronary arteries

A

LMA branches into LAD and LCx

26
Q

Where are most atherosclerotic coronary lesions?

A

Proximal

27
Q

MI complications

A
  • Ventricular septal rupture

- Papillary muscle rupture

28
Q

3-7 days after MI, patient has hypotension, pansystolic murmur, and a step-up in O2 content between R atrium and pulmonary artery

A

Ventricular septal rupture

Dx: Echo

Tx: IABP and patch over septum

29
Q

3-7 days after MI, patient has severe mitral regurgitation with hypotension and pulmonary edema

A

Papillary muscle rupture

Dx: Echo

Tx: IABP, replace valve

30
Q

Incidence in restenosis in CAD revascs

A

Drug-eluting stent: 80% at 1 year

Saphenous vein graft: 80% at 5 years

Internal mammary artery (off subclavian): 95% 20 year patency when placed to LAD; collateralizes with superior epigastric artery

31
Q

What do you use to cause arrest of heart in diastole and keep heart protected and still while grafts are placed during CABG?

A

Potassium and cold solution cardioplegia

32
Q

CABG indications

A

Left main > 50% stenosis or at other site > 70% stenosis

  • Left main disease
  • 2-vessel disease involving LAD
  • 3 vessel disease (LAD, Cx, RCA)
  • Lesion not amenable to stenting
33
Q

High mortality risk factors for CABG

A

Pre-op cardiogenic shock is #1 risk factor

Emergency operations

Age

Low EF

34
Q

Mechanism of aortic stenosis

A

Degenerative calcification

35
Q

Benefit of bioprosthetic tissue valves

A
  • Do not require anticoagulation
  • But not as durable, last 10-15 years
  • Use for patients who want pregnancy, have contraindication to AC, are older >65, and unlikely to require another valve in their lifetime, or have frequent falls
  • Contraindicated in children and young patients d/t rapid calcification
36
Q

DOE, angina, syncope

A

Aortic stenosis

Syncope is the worst with mean survival 3 years (versus 4 and 5 for angina and DOE)

37
Q

AS indications for operation

A

Symptomatic (usually have peak gradient > 50 mm Hg and valve area < 1.0 cm^2)

38
Q

Key index of disease progression in patients with MR

A

Ventricular function. Usually becomes dilated.

Other symptoms: A fib, pulmonary congestion

39
Q

MR indications for operation

A

Symptomatic or severe MR

40
Q

Pulmonary edema, dyspnea, hx of rheumatic fever

A

MS

41
Q

MS indications for operation

A

Symptomatic (usually have valve area < 1 cm^2)

Balloon commissurotomy to open valve often used as 1st procedure

42
Q

Patient with fever, chills, sweats, and heart murmur

A

Endocarditis, usually Staph aureus and Left sided (except drug users: pseudomonas? and Right sided)

43
Q

Most common site of native valve vs prosthetic valve infections

A

Native: mitral

Prosthetic: aortic

44
Q

Endocarditis tx

A

Medical tx successful in 75%, sterilizes valve in 50%

Surgery if failure of abx, severe valve failure, peri

ABSITE (34 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions