Lec 21 : Acquired Heart Diseases (Pediatrics)

Question 1

T/F: Most acquired heart diseases in children are non-inflammatory and may be infectious or non-infectious

Answer 1

F

Most are INFLAMMATORY.

Question 2

Kawasaki disease is also known as

Answer 2

mucocutaneous lymph node syndrome

Question 3

The following is/are true of Kawasaki disease

a. self-limited vasculitis caused by Streptococcus
b. usually seen in children

Answer 3

b. children

Question 4

This is the most feared complication of Kawasaki disease.

Answer 4

coronary artery aneurysm

Question 5

The following are diagnostic criteria of Kawasaki disease EXCEPT

a. fever more than 3 days
b. bilateral non-purulent conjunctivitis
c. cervical lymphadenopathy
d. polymorphous exanthem
e. strawberry tongue

Answer 5

a. fever should be >5 days

Question 6

This phenomenon is the change in fingertip color from white to blue to red.

Answer 6

Raynaud’s phenomenon

Question 7

The following are laboratory findings in Kawasaki disease EXCEPT

a. hypoalbuminemia
b. polycythemia
c. neutrophilia
d. elevated ESR
e. thrombocytosis

Answer 7

b. polycythemia

KD rather presents with anemia due to increased lysis of RBCs.

Question 8

This if the first line treatment for Kawasaki disease.

Answer 8

intravenous immunoglobulin

Question 9

True about IV Ig therapy for Kawasaki disease

a. current recommended dose is 2 g/kg single infusion
b. given after the 5th day and before the 12th day
c. can be given again if patient is still febrile
d. improvement in heart function seen within 24 hours
e. AOTA

Answer 9

b.

… should be given before the 10th day to prevent damage.

Question 10

Aspirin use in treatment of KD may lead to this syndrome characterized by fatty liver and severe encephalopathy.

Answer 10

Reye’s syndrome

Question 11

This is the most common cause of infective endocarditis.

Answer 11

viridans-type Streptococcus

Question 12

The following are manifestations of infective endocarditis EXCEPT

a. prolonged fever
b. heart failure
c. anemia
d. hematuria
e. NOTA

Answer 12

e. NOTA

Question 13

Which is/are true of the diagnostic criteria for IE EXCEPT?

a. definite diagnosis in presence of 5 minor criteria
b. major criteria include 3 positive culture for atypical bacteria
c. minor criteria include vascular phenomena like Roth spots
d. new valvular regurgitation is an echocardiographic major criteria
e. NOTA

Answer 13

c.

Roth spots is an IMMUNOLOGIC phenomena

Question 14

What is the classic radiographic finding in pericarditis?

Answer 14

water bottle sign

Question 15

The following are clinical manifestations of pericarditis EXCEPT

a. precordial pain
b. vomiting
c. abdominal pain
d. friction rub
e. NOTA

Answer 15

e. NOTA

Question 16

True of management of pericarditis EXCEPT

a. antibiotics for 2-4 weeks
b. 4 anti-Koch’s for 6 months for TB pericarditis
c. drainage for pleural effusion
d. needle inserted 15 degrees above skin at paraxiphoid area in pericardiocentisis
e. NOTA

Answer 16

b.

Anti-Koch’s should be given for 1 year.

Question 17

This results in the fibrosis and thickening of the pericardium with resultant restriction in ventricular filling.

Answer 17

constrictive pericarditis

Question 18

This refers to a decrease in systolic BP of > 10 mm upon inspiration.

Answer 18

pulsus paradoxus

Question 19

This is the most common cause of myocarditis.

Answer 19

Coxsackie B virus infection

Question 20

T/F: Myocarditis may be secondary to coronary artery disease.

Answer 20

F

Myocarditis is almost always secondary to infection (especially viral infection).