Jeopardy 2- Cardio GI Flashcards

1
Q

CHF drugs that increase the efficiency of contractions and can relieve tachycardia

A

Digoxin (Cardiac Glycosides)

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2
Q

% of children who at one point have an Innocent Heart Murmur

A

50%

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3
Q

Vibratory, twangy or buzzing systolic murmur heard at the mid LSB

A

Stills Murmur

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4
Q

Age group that have Stills Murmur

A

2-7

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5
Q

Continuous murmur heard at the neck and clavicles that disappears if supine

A

Venous Hum

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6
Q

Type of ASD seen in Down Syndrome

A

Ostium Primum

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7
Q

MOST COMMON type of ASD

A

Ostium Secundum

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8
Q

ASD that occurs in the middle of the septum

A

Ostium Secundum

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9
Q

ASD that occurs high in the septum and may –> anomalous return of the R. Pulm Veins into the R. Atrium

A

Sinus Venosus

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10
Q

Affect of ASD on pulm blood flow

A

Increases pulm blood flow

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11
Q

Ostium Primum ASD may result in ___ that causes CHF

A

Mitral Regurgitation

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12
Q

Murmur heard w/ ASDs

A

Fixed splitting of the second heart sound

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13
Q

Why is there splitting of the second heart sound w/ ASDs?

A

ASD –> increased pulm blood flow –> no more variation in timing of the aortic and pulmonic valve closure w/ respiration

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14
Q

Treatment of ASD

A

Surgical closure

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15
Q

High pitched holosystolic murmur at LLSB

A

VSD

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16
Q

Continuous machine-like murmur at ULSB

A

Patent Ductus Arteriosus

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17
Q

Systolic ejection murmur w/ radiation to carotids

A

Aortic Stenosis

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18
Q

Systolic ejection murmur at ULSB w/ a click

A

Pulmonic Stenosis

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19
Q

Direction of the shunt in VSD is determined by

A

Size of the VSD and Pulmonary Vascular Resistance

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20
Q

As a VSD becomes SMALLER the murmur…

A

INCREASES

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21
Q

VSDs large enough to cause >2:1 ratio of blood going to the lungs vs going to the systemic circulation may have what murmur and why?

A

Murmur of Mitral Turbulence (excess blood from the lungs is now passing through the mitral valve)

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22
Q

Reversal of L–>R shunt to R–>L shunt that occurs because PVR&raquo_space; SVR

A

Eisenmenger Syndrome

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23
Q

Large shunts are associated w/

A

Increased risk of pulm infections

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24
Q

Ductus Arteriosus connects

A

Pulmonary Artery to the Aorta

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25
Q

Drug used to close a PDA

A

Indomethacin

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26
Q

The ACYANOTIC heart defects

A

1) ASD
2) VSD
3) PDA
4) Coarctation
5) Aortic Stenosis
6) Pulmonic Stenosis

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27
Q

50% of patients w/ coarctations may also have

A

Bicuspid Aortic Valves or Aortic Stenosis

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28
Q

To preserve circulation to lower body, the Ductus Arteriosus must be kept open in a coarctation patient via

A

PGE2

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29
Q

How is renal blood flow maximized in coarctation patients

A

Dopamine

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30
Q

Severe aortic stenosis may be associated w/

A

Hypoplasia of the Left Ventricle

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31
Q

Treatment for pulmonic stenosis

A

Balloon Valvuloplasty

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32
Q

The 5 CYANOTIC Heart defects

A

1) Truncus Arteriosus
2) Transposition of the Great Arteries
3) Tricuspid Atresia
4) Tetralogy of Fallot
5) Total Anomalous Pulmonary Venous Connection

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33
Q

MOST COMMON cause of central cyanosis after newborn period

A

Tetralogy of Fallot

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34
Q

4 Components of Tetralogy of Fallot

A

VSD, Pulmonic Stenosis, Over-riding Aorta and RV Hypertrophy

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35
Q

CXR showing upturned cardiac apex (boot shape)

A

Tetralogy of Fallot

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36
Q

CXR showing small heart w/ narrow mediastinum (egg on a string)

A

Transposition of the Great Arteries

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37
Q

CYANOTIC heart defects which are associated w/ Right Aortic Arch

A

Tetralogy of Fallot and Truncus Arteriosus

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38
Q

Things that worsen the R–>L shunting in Tetralogy of Fallot

A

1) Decreasing SVR (exercise, vasodilation, volume depletion)

2) Increase RVOT resistance (crying, tachycardia)

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39
Q

Things that would improve the R–>L shunting in Tetralogy of Fallot

A

Increase SVR and decrease RVOT resistance (volume infusion, HTN, Valsalva, brady)

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40
Q

How does squatting help in a Tet spell?

A

1) Increases SVR

2) Increased venous return

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41
Q

Treatment of Transposition of the Great Vessels

A

Arterial Switch Operation

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42
Q

Only cause of cyanosis in the newborn w/ LEFT AXIS DEVIATION and LEFT VENTRICULAR HYPERTROPHY

A

Tricuspid Atresia

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43
Q

MOST COMMON cause of acquired heart disease worldwide

A

Rheumatic Fever

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44
Q

MOST COMMON cause of acquired heart disease in the US

A

Kawasaki Disease

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45
Q

MOST COMMON causes of bacterial endocarditis

A

Gram + Cocci (Strep Viridans and Staph)

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46
Q

MOST IMPORTANT lab test in bacterial endocarditis

A

Blood Cultures

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47
Q

Tender swollen lesions on the palms, soles or toes/fingers in endocarditis

A

Osler’s Nodes

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48
Q

Erythematous hemorrhagic lesions on the palms or soles

A

Janeway lesions

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49
Q

Round or oval white spots in the retina w/ endocarditis

A

Roth’s Spots

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50
Q

MOST SENSITIVE way to evaluate vegitations

A

TEE

51
Q

Which heart defect does not require ABX prophylaxis during procedures

A

Secundum ASD

52
Q

MOST COMMON cause of pericarditis

A

Viral Infection

53
Q

MOST COMMON cause of purulent pericarditis

A

Staph and S. pneumo

54
Q

What is pulsus paradoxus

A

> 10mmHg reduction in systolic BP on deep inspiration

55
Q

Symptoms of Pericarditis

A

Friction Rub + Distant Heart Sounds + Pulsus Paradoxus + Hepatomegaly + Positional Chest Pain

56
Q

ST segment changes and low voltage QRS

A

Pericarditis

57
Q

Myocarditis is apparent in __ of children who die suddenly

A

20%

58
Q

Resting Tachycardia + Muffled Heart Sounds

A

Myocarditis

59
Q

Organisms causing myocarditis are identified via

A

PCR of endomyocardial biopsy specimens

60
Q

Viruses, mitochondrial abnormalities, carnitine deficiency, selenium and thiamine deficiency, hypocalcemia and ALCAPA and Doxurubicin may cause

A

Dilated Cardiomyopathy

61
Q

What is ALCAPA

A

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery

62
Q

Hypertrophic Cardiomyopathy is (genetic)

A

Autosomal Dominant

63
Q

What is the cause of hypertrophic cardiomyopathy’s LVOT obstruction

A

Anterior mitral leaflet is swept into the sub aortic region

64
Q

MOST COMMON cause of sudden cardiac death in athletes

A

Hypertrophic Cardiomyopathy

65
Q

Deep and Wide Q Waves in the inferior and lateral leads

A

Hypertrophic Cardiomyopathy

66
Q

MOST COMMON arrhythmia of childhood

A

SVT

67
Q

Delta Wave

A

Wolff Parkinson White

68
Q

Treatment of SVT

A

1) Vagal Maneuvers
2) IV Adenosine
3) Cardioversion
4) Catheter Ablation

69
Q

Congenital 3rd Degree AV Block is associated w/ mothers who have

A

SLE

70
Q

Long QT increases the risk of

A

Torsades de Pointes

71
Q

Drugs which prolong QT

A

TCAs, Phenothiazines, Erythromycin and Terfenadine

72
Q

Autosomal Recessive long QT Syndrome

A

Jervell-Lange-Nielsen Syndrome

73
Q

Long QT associated w/ deafness

A

Jervell-Lange-Nielsen Syndrome

74
Q

Autosomal Dominant long QT Syndrome

A

Ramano-Ward Syndrome

75
Q

MOST COMMON cause of childhood chest pain

A

Pericarditis

76
Q

Night Blindness and Xerophthalmia

A

Vit A

77
Q

Rickets

A

Vit D

78
Q

Anemia/Hemolysis

A

Vit E

79
Q

Coagulopathy, prolonged Prothrombin Time

A

Vit K

80
Q

Beriberi (cardiac failure + neuropathy + hoarseness + Wernicke’s Encephalopathy)

A

Thiamine B1

81
Q

Dermatitis and Glossitis

A

Pyridoxine B6

82
Q

Megaloblastic Anemia, Demyelination and elevated MMA

A

Cobalamin B12

83
Q

Scurvy (hematologic + edema + poor wound healing + impaired collagen)

A

Vitamin C

84
Q

Megaloblastic Anemia w/o neuro sx

A

Folic Acid

85
Q

Pellagra (diarrhea, dermatitis and dementia)

A

Niacin

86
Q

Skin lesions and immune dysfunction

A

Zinc

87
Q

Stool pH below 5.6 suggests

A

Poor absorption of carbohydrates

88
Q

Fecal A1 Antitrypsin levels show

A

Enteric Protein Loss

89
Q

CBC finding of abetalipoproteinemia

A

Acanthocytosis of erythrocytes

90
Q

Schwachman Diamond Syndrome

A

AR disease of pancreatic insufficiency + FTT and neutropenia

91
Q

Protein intolerance resolves by

A

1-2 years

92
Q

Celiac Disease Antibodies

A

IgA-Endomysial and Tissue Transglutaminase

93
Q

Celiac Disease Antibody if IgA deficient

A

Anti-Gliadin IgG

94
Q

5 Complications of Short Bowel Syndrome

A

TPN Choletatsis, Bacterial Overgrowth, Poor Bone Mineralization, Renal Stones, Diarrhea

95
Q

Torticollis 2/2 painful esophagitis

A

Sandifer Syndrome

96
Q

Malrotation twists around the

A

Superior Messenteric Artery

97
Q

Intestines return to the abdomen in the

A

10th week gestation

98
Q

Duodenum re-cannalizes at

A

8-10 weks

99
Q

MOST COMMON cause of obstruction in the neonate

A

Intestinal Atresia

100
Q

Cause of Jejunoileal Atresia

A

Mesenteric Vascular Accident in fetal life

101
Q

Most common location of intussusception

A

Ileocolic Intussesception

102
Q

Perforation of an appy occurs after

A

36-48 hours

103
Q

Bluish discoloration of flanks seen w/ pancreatitis

A

Gray-Turner Sign

104
Q

Bluish discoloration of the periumbilical area w/ pancreatitis

A

Cullen Sign

105
Q

Most specific marker of pancreatitis

A

Lipase

106
Q

MOST COMMON cause of constipation in childhood

A

Functional Fecal Retention

107
Q

MOST COMMON cause of organic constipation in childhood

A

Hirschprung’s Disease

108
Q

Other symptoms of UC

A

Uveitis, Arthropathy, PYODERMA GANGRENOSUM, sclerosing cholangitis

109
Q

Other symptoms of Crohns

A

FTT, delayed sexual maturity, Oral ulcers, erythema nodosum, arthritis and renal stones

110
Q

Serologic marker of UC

A

Anti-neutrophil cytoplasmic antibody

111
Q

Serologic marker of Crohns

A

Anti-Saccharomyces cervisiae antibody

112
Q

MOST COMMON cause of significant lower GI bleeding beyond infancy

A

Juvenile Polyp

113
Q

Hemolytic Anemia + Thrombocytopenia + ARF

A

HUS

114
Q

Palpable purpuric rash on butt + arthritis, renal disease + GI bleeding (abdominal pain)

A

Henoch-Schonlein Purpura

115
Q

HSP pathology

A

an IgA mediated vasculitis

116
Q

Specific marker of liver disease

A

Alanine Aminotransferase

117
Q

Jaundice is noticeable at

A

> 3mg/dL

118
Q

Crigler Nijjar 1 is

A

Autosomal Recessive and 100% no UDPGT

119
Q

Crigler Nijjar 2 is

A

Autosomal Dominant and 90% no UDPGT

120
Q

Polysplenia Syndrome (bilobed lungs, abdominal heterotaxia and situs ambiguous is associated w/

A

Biliary Atresia

121
Q

Hep C causes chronic infection in

A

80%

122
Q

Genetics of Alagille Syndrome

A

Autosomal Dominant Chromosome 20 (Jagged 1 Gene)

123
Q

Intrahepatic bile duct disorder + unusual facies + POT obstruction + renal disease + butterfly vertebrae + broad thumbs + Panc problems and hypercholesterolemia

A

Alagille Syndrome