Lec 12 : Acyanotic Congenital Heart Diseases (Pediatrics) Flashcards
Which of the following is not generally clinically considered as congenital heart defect?
a. bicuspid aortic valve
b. patent foramen ovale
c. atrial septal defect
d. A & B only
e. AOTA
d. A & B only
BAV and PFO are benign lesions.
Patent ductus arteriosus and pulmonary stenosis are related to which known risk factor?
congenital rubella / maternal infection with rubella
This chemical is found mostly on dermatologic products and is a known teratogen.
isotretinoin / retinoic acid
A large percentage of congenital heart diseases are composed of
a. left to right shunts
b. obstructive lesions
c. right to left shunts
d. valvular heart diseases
e. NOTA
a. left to right shunts
40% L-R shunts
25% obstructive lesions
20% R-L shunts
Ventricular septal defects generally presents with volume overload of what heart chamber?
left ventricle
The VSD shunts blood directly into the pulmonary circulation are returns to the LA and eventually the LV.
This if the most common type of VSD.
perimembranous VSD
T/F: A VSD with a harsh and loud murmur predisposes to LV overload and subsequent heart failure.
F
VSDs with harsh and loud murmur are generally small in size and are frequently asymptomatic.
Characterize the murmur of a typical VSD.
holosystolic mumur at the left lower sternal border
The following are radiographic findings in VSD EXCEPT
a. ‘sitting dove’ appearance
b. cardiomegaly
c. ‘boot shaped’ appearance
d. increased pulmonary vascular markings
e. C & D
c. ‘boot shaped’ appearance
This is found in conditions that lead to RV enlargement or hypertrophy.
VSDs may be associated with
a. membranous aneurysm
b. aortic cusp prolapse
c. RV infundibular stenosis
d. AOTA
e. NOTA
d. AOTA
Device closure via percutaneous catheterization can be done in
a. muscular VSDs
b. VSDs <10 mm
c. supracristal VSDs
d. membranous VSDs
e. NOTA
d. membranous VSDs
Indication:
<8 mm membranous VSD
T/F: Anatomic closure of PDA is achieved by 48 hours.
F
Functional closure = 24 hours
Anatomic closure = 2 months (in 90%)
A ductus arteriosus is considered patent or persistent if it does not close by
a. 3 months
b. 6 months
c. 9 months
d. 1 year
b. 6 months
The following are true of PDA EXCEPT
a. continuous machinery-like murmur at LUSB
b. wide pulse pressure
c. bounding pulse
d. volume overload of RV
e. B & D
d. volume overload of RV
PDA overload the LEFT side since blood is dumped back to the pulmonary circulation and returns to the LA & LV.
T/F: ECG of PDA presents with tall R in V6 and deep S in V1.
T
Tall R in V6 and deep S in V1 is characteristic of LVE.
Indomethacin is given to medically close PDA. Give another drug that may be used.
ibuprofen (or any other PGE1 inhibitor)
True about ASD EXCEPT
a. asymptomatic during early life
b. male preponderance by 4:1
c. volume overload of the right chambers
d. A & B
e. AOTA
d. male preponderance by 4:1
female preponderance by 4:1
This type of ASD is associated with abnormal drainage of the right pulmonary vein.
a. primum type
b. secundum type
c. sinus venosus type
d. patent foramen ovale type
e. NOTA
c. sinus venosus type
The most common auscultatory finding in ASD.
fixed split S2
A murmur may not be present due to low pressure difference between LA and RA.
Complete atrioventricular septal defect is commonly associated with what syndrome?
a. Noonan syndrome
b. Klinefelter syndrome
c. Down syndrome
d. Turner syndrome
e. Castillo syndrome
c. Down syndrome / trisomy 21
T/F: Pulmonary stenosis causes pressure overload of the right ventricle.
T
Differentiate overload caused by stenosis and regurgitation.
Stenosis causes pressure overload.
Regurgitation causes volume overload.
Characterize the murmur of typical pulmonary stenosis.
systolic ejection murmur at LUSB
Pulmonary stenosis may present with the following findings.
a. tall R in V1, deep S in V6
b. decreased pulmonary markings
c. normal cardiothoracic ratio
d. A & B only
e. AOTA
e. AOTA
tall R in V1, deep S in V6 = RVH
CT ratio may be normal but have uplifted apex.
Give the two surgical treatment options for PS.
percutaneous balloon valvuloplasty
open heart valvotomy
Coarctation of the aorta is commonly associated with what syndrome?
a. Noonan syndrome
b. Klinefelter syndrome
c. Down syndrome
d. Turner syndrome
e. Castillo syndrome
d. Turner syndrome / XO
This radiographic finding is associated with the development of collaterals due to obstructed aortic flow.
rib notching
The following are finding in CoA EXCEPT
a. weak pulses on lower extremities
b. hypotension of upper extremities
c. systolic murmur at L infraclavicular area
d. A & B
e. NOTA
b. hypotension of upper extremities
There is hypertension of UE and hypotension of LE.
What is the ‘figure 3’ sign?
The figure 3 is a sign of CoA. It includes:
(1) pre-stenotic dilation of aortic arch and left subclavian artery
(2) indentation at the coarctation site (the tuck or notch)
(3) poststenotic dilatation of the descending aorta
Which type of VSD is an infidelity type?
a. membranous VSD
b. perimembranous VSD
c. supracristal VSD
d. muscular VSD
e. NOTA
c. supracristal VSD (because it is doubly committed)
Hahahahaha.