Foetal Circulation and Congenital Heart Disease

Question 1

Atrial septal defects are due to __1____ small ones go unnoticed but large ones can cause ___2___

Answer 1

1) incomplete closure of foramen ovale

2) pulmonary hypertension

Question 2

Transposition of the great arteries occurs when the ____1______ and the __2___ are switched. Often infants have other heart defects that allow them to live but on its own this heart condition is __3____

Answer 2

1) pulmonary artery
2) aorta
3) incompatible with life

Question 3

4 components of the tetralogy of fallot?

Answer 3

Pulmonary stenosis
Hypertrophy of the right ventricle
Ventricular septal defect
Over-riding aorta

Question 4

Half of the blood from the umbilical vein is directed to the _____1_____ and half enters the ___2____

Answer 4

1 ductus venosus

2 liver

Question 5

Blood moves from ductus venosus to _____ to _____

Answer 5

Inferior vena cava to right atrium

Question 6

In the foetus the ____1____ forms an opening between RA and LA and most of the blood flows from RA to LA bypassing the ______2_______

Answer 6

1 foramen ovale

2 pulmonary circulation

Question 7

The blood that bypasses the pulmonary circulation goes into the ___1___ and supplies the __2___

Answer 7

1 left ventricle

2 carotids and ascending aorta

Question 8

In the foetus the pulmonary artery and the aorta are connected by the ____1____ which directs most of the partially oxygenated blood away from the __2___

Answer 8

1 ductus arteriosus

2 lungs

Question 9

With first breath after delivery the vascular resistance in the pulmonary arteries___1___ and more blood moves from __2__ to __3__ to ____4____ and oxygenated blood flows back from the lungs by ______5_______

Answer 9

1 falls
2 RA
3 RV
4 pulmonary artereis 
5 pulmonary veins

Question 10

After delivery the decrease in RA pressure and the relative increase in LA pressure results in the closure of the _______

Answer 10

foramen ovale

Question 11

Over the first few hours the __1____ will functionally shut and it will anatomically shut within 7-10 days forming the ____2_____

Answer 11

1 ductus arteriosus

2 ligamentum arteriosum

Question 12

What happens in persistent pulmonary hypertension of the newborn

Answer 12

Resistance to flow in the lungs has failed to drop so RA pressure is still higher resulting in shunting with foramen vale and ductus arteriosus.

Question 13

There will be a large difference in _______________________ in PPHN

Answer 13

pre and post ductal O2 sats

Question 14

Treatment of PPHN?

Answer 14

Reduce pulmonary vascular resistance: oxygen, ventilation, sedation, thermoregulation, correction of acidosis, treatment of sepsis, inhaled O2.

Increase systemic vascular resistance: maintain higher than adequate blood pressure, inotropes, support other organ function, in severe cases ECMO

Question 15

Two types of duct dependent circulations?

Answer 15

Duct dependent systemic circulation

Duct dependent pulmonary circulation

Question 16

Presentation of duct dependent circulation

Answer 16

Sudden collapse when the duct closes

Question 17

Treatment of duct dependent circulations

Answer 17

Support airways and breathing
Large dose of prostaglandin E2 to open the duct
Ultimately surgery

Question 18

Patent ductus arteriosus murmur and pulse?

Answer 18

Continuous machinery murmur and bounding pulse

Question 19

Treatment of patent ductus arteriosus?

Answer 19

NSAIDs and surgery

Question 20

Most common congenital heart malformation?

Answer 20

VSD

Question 21

Baby with low pan systolic murmur is likely to be?

Answer 21

VSD