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DT3- EXAM 1 > Mary's- Congenital Defects > Flashcards

Mary's- Congenital Defects Flashcards

1
Q

ASD:

High Risk Population

impulse

S2 sound

Murmur

A

Premies; BPD

RV impulse

Widely split& fixed S2

P/T stenosis murmur (Right sided stenosis)

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2
Q

ASD:

Symptoms

EKG (3)

A

asymptomatic

  1. R axis deviation
  2. R. A/V enlargement
  3. rSR’ in Lead V1
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3
Q

ASD: Management

A
  1. Spontaneous closure of Sm/Med defects
  2. Cardio Cath
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4
Q

VSD: Symptoms (6)

A
  1. Tachypnea
  2. Irritability
  3. Diaphoresis
  4. Failure to thrive 4-8wks
  5. Hyperdynamic precordium
  6. Hepatomegaly
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5
Q

VSD:

murmur

EKG

A

Holosystolic Murmur at LLSB

Biventricular Hypertrophy

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6
Q

VSD: management(3)

A
  1. max nutrition
  2. diuretics, ACEi, Digoxin
  3. Surgery (4-6mo)
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7
Q

PDA: symptoms

A
  1. Tachypnea
  2. Diaphoresis
  3. Diff Feeding
  4. Hyperdynamic precordium
  5. Hepatomegaly
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8
Q

PDA: Murmur EKG

A

Machine-like around pulm region

EKG: LA/LV (sometimes biV) hypertrophy

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9
Q

PDA:

management

Do we give indomethacin to all?

A

No indomethacin for Term Babies

  1. diuretic, ACEi, digoxin
  2. Cardio Cath
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10
Q

AVSD: High Risk Population

A

Downs

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11
Q

Partial AVSD:

characteristics

What congenital defect does it mimic?

A
  1. ASD
  2. 2 AV valve annuli
  3. cleft mitral valve

* similar to ASD: RV impulse, split S2, P/T stenosis

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12
Q

Partial AVSD: management

A

observe and manage CHF

elective surgery at 2yo

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13
Q

Complete AVSD:

characteristics

What congenital defect does it mimic?

A
  1. ASD
  2. inlet VSD
  3. 1 AV valve annuli

* similar to VSD: hyperdynamic precordium, Holosystolic murmur at LLSB

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14
Q

Complete AVSD:

S2

EKG (2)

A

*Loud S2 from 1 valve

  1. long PR
  2. superior QRS
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15
Q

Complete AVSD: management

A

surgery at 3-6mo

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16
Q

CoA: High Risk Population

A

Turners (45XO)- 50% have bicuspid aortic valve

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17
Q

CoA: Result of ductus closure–>

Symptoms (3)

A
  1. CHF (pulm edema, upper HTN, lower HypoTN)
  2. Resp. Distress w/ poor perfusion
  3. diminished femoral pulses
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18
Q

CoA:

Murmur

EKG

A

Gallop rhythm

R axis Deviation (from RVH)

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19
Q

CoA: management

A
  1. PGE1
  2. correct met. acidosis
  3. inotropic supprot
  4. Neonates: surgical repair/ Child: angioplasty
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20
Q

Hypoplastic L. Heart Syndrome: Result of ductus closure–> Symptoms (3)

A
  1. shock w/ mild cyanosis
  2. increase work of breathing
  3. decreased perfusion
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21
Q

Hypoplastic L. Heart Syndrome:

S2

murmur

A

single loud S2

non-specific systolic ejection murmur/gallop

22
Q

Hypoplastic L. Heart Syndrome: management

A
  1. PGE1
  2. correct met acidosis
  3. inotropic support
  4. hypovent and sub ambient air
  5. surgery (norwood->bidir Glenn-> Fontan)
23
Q

TOF:

Symptom

X-ray finding

A
  1. tet spells w/ progressive pulm stenosis

* BOOT shaped heart

24
Q

TOF:

S2

murmur

A

single S2

Harsh pulm stenosis murmur (masks VSD murmur)

25
Q

TOF: management

A

surgical repair and later pulm valve replacement

26
Q

Tricuspid Atresia= dimple in floor of RA:

What defects must be present?

A
  1. ASD
  2. VSD
  3. Hypo RV * systemic mixed w/ pulmonic
27
Q

Tricuspid Atresia:

of impulses

S2

murmur

A

2 ventricular impulses

single S2

systolic murmur

28
Q

Tricuspid Atresia: EKG size of heart

A
  1. RAH
  2. LVH–>Left axis deviation

* normal heart size

29
Q

Tricuspid Atresia: management

A
  1. PGE1
  2. Blalock-Taussig Shunt–>Bidir Glenn–>Fontan
30
Q

Transpositon of Great Arteries:

commonly associated w/ what 3 defects

A
  1. Patent foramen ovale
  2. VSD
  3. CoA
31
Q

Transpositon of Great Arteries:

symptom

S2

murmur

A
  • cyanosis w/ RVH
  • single S2
  • possible murmur from blood mixing
32
Q

Transpositon of Great Arteries: Xray

A

egg on a string

33
Q

Transpositon of Great Arteries: management

A
  1. PGE1
  2. balloon atrial septum to increase mixing
  3. arterial switch operation
34
Q

Truncus Arteriosus: over nonrestricted VSD

High risk population

A

Digeorge Syndrome

35
Q

Truncus Arteriosus: over nonrestricted VSD

Symptom

A
  1. HF w/ mild cyanosis
36
Q

Truncus Arteriosus: over nonrestricted VSD

S2

murmur

A
  • single S2
  • holosystolic VSD murmur w/ ejection click
37
Q

Truncus Arteriosus: over nonrestricted VSD

Xray

A

25% show R. aortic arch

38
Q

Truncus Arteriosus: over nonrestricted VSD

management

A
  1. treat CHF
  2. patch VSD
  3. separate pulm from truncal and place to RV
39
Q

Total Anomalous Pulm VR (TAPVR):

4 types, which can cause obstruction?

A
  1. supracardiac
  2. infra cardiac–>can cause obstruction at liver
  3. cardiac
  4. mixed
40
Q

Total Anomalous Pulm VR (TAPVR):

For blood flow, what defects must occur?

A

either PFO or ASD

41
Q

Total Anomalous Pulm VR (TAPVR)-UNOBSTRUCTED: symptoms (4)

A
  1. feeding problems
  2. tachypnea
  3. poor growth
  4. respiratory infections
42
Q

Total Anomalous Pulm VR (TAPVR)-UNOBSTRUCTED:

S2

Impulse/Murmur

A

wide S2

  1. RV impulse
  2. Pulmonic Stenosis murmur
43
Q

Total Anomalous Pulm VR (TAPVR)-UNOBSTRUCTED: management

A

surg. pulm VR–>LA and close atrial communication

44
Q

Total Anomalous Pulm VR (TAPVR)-OBSTRUCTED:

symptom and response

A
  1. resp distress Day 1

MEDICAL EMERGENCY: mech. vent, PGE1, correct acidosis, inotropic support

45
Q

Total Anomalous Pulm VR (TAPVR):

Xray(2)

A
  1. Snowman sign
  2. pulm congestion/edema
46
Q

Hypercyanotic episodes:

warning symptoms (5)

4 severe symptoms

A

irritable pale blue,lethargic baby who’s breathing deeply

  1. limp 2. seizure 3. stroke 4. death
47
Q

Hypercyanotic episodes: #1 congenital defect associated w/

A

Tetralogy of Fallot

48
Q

Hypercyanotic episodes: average age timing 2 factors which increase risk

A
  • 2-4mo -after crying, feeding, bowel movement
    1. anemia
      1. hypovol
49
Q

Hypercyanotic episodes: management

A
  1. calm
  2. knee to chest (decrease preload, increase afterload)
  3. O2
  4. IV bolus
  5. Morphine (stop hyperpnea)
  6. correct acidosis
  7. Ketamine (sedate/increase afterload)
  8. Beta-blocker IV (improve Right ventricular outflow)
  9. Phenylephrine (increase afterload)
  10. surgery
50
Q

Single S2 (6)

A
  1. AVSD
  2. HLHS
  3. TOF
  4. Tricuspid Atresia
  5. Transposition of Great Arteries
  6. Truncus Arteriosus
51
Q

PGE1 use (5)

A
  1. CoA
  2. HLHS
  3. Tricuspid Atresia
  4. Transposition of Great Arteries
  5. Obstructive TAPVR

DT3- EXAM 1 (26 decks)

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