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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
TOF: management
surgical repair and later pulm valve replacement
26
Tricuspid Atresia= dimple in floor of RA: What defects must be present?
1. ASD 2. VSD 3. Hypo RV \* systemic mixed w/ pulmonic
27
Tricuspid Atresia: of impulses S2 murmur
2 ventricular impulses single S2 systolic murmur
28
Tricuspid Atresia: EKG size of heart
1. RAH 2. LVH--\>Left axis deviation \* normal heart size
29
Tricuspid Atresia: management
1. PGE1 2. Blalock-Taussig Shunt--\>Bidir Glenn--\>Fontan
30
Transpositon of Great Arteries: commonly associated w/ what 3 defects
1. Patent foramen ovale 2. VSD 3. CoA
31
Transpositon of Great Arteries: symptom S2 murmur
- cyanosis w/ RVH - single S2 - possible murmur from blood mixing
32
Transpositon of Great Arteries: Xray
egg on a string
33
Transpositon of Great Arteries: management
1. PGE1 2. balloon atrial septum to increase mixing 3. arterial switch operation
34
Truncus Arteriosus: over nonrestricted VSD High risk population
Digeorge Syndrome
35
Truncus Arteriosus: over nonrestricted VSD Symptom
1. HF w/ mild cyanosis
36
Truncus Arteriosus: over nonrestricted VSD S2 murmur
- single S2 - holosystolic VSD murmur w/ ejection click
37
Truncus Arteriosus: over nonrestricted VSD Xray
25% show R. aortic arch
38
Truncus Arteriosus: over nonrestricted VSD management
1. treat CHF 2. patch VSD 3. separate pulm from truncal and place to RV
39
Total Anomalous Pulm VR (TAPVR): 4 types, which can cause obstruction?
1. supracardiac 2. infra cardiac--\>can cause obstruction at liver 3. cardiac 4. mixed
40
Total Anomalous Pulm VR (TAPVR): For blood flow, what defects must occur?
either PFO or ASD
41
Total Anomalous Pulm VR (TAPVR)-UNOBSTRUCTED: symptoms (4)
1. feeding problems 2. tachypnea 3. poor growth 4. respiratory infections
42
Total Anomalous Pulm VR (TAPVR)-UNOBSTRUCTED: S2 Impulse/Murmur
wide S2 1. RV impulse 2. Pulmonic Stenosis murmur
43
Total Anomalous Pulm VR (TAPVR)-UNOBSTRUCTED: management
surg. pulm VR--\>LA and close atrial communication
44
Total Anomalous Pulm VR (TAPVR)-OBSTRUCTED: symptom and response
1. resp distress Day 1 MEDICAL EMERGENCY: mech. vent, PGE1, correct acidosis, inotropic support
45
Total Anomalous Pulm VR (TAPVR): Xray(2)
1. Snowman sign 2. pulm congestion/edema
46
Hypercyanotic episodes: warning symptoms (5) 4 severe symptoms
irritable pale blue,lethargic baby who's breathing deeply 1. limp 2. seizure 3. stroke 4. death
47
Hypercyanotic episodes: #1 congenital defect associated w/
Tetralogy of Fallot
48
Hypercyanotic episodes: average age timing 2 factors which increase risk
- 2-4mo -after crying, feeding, bowel movement - 1. anemia 2. hypovol
49
Hypercyanotic episodes: management
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
Single S2 (6)
1. AVSD 2. HLHS 3. TOF 4. Tricuspid Atresia 5. Transposition of Great Arteries 6. Truncus Arteriosus
51
PGE1 use (5)
1. CoA 2. HLHS 3. Tricuspid Atresia 4. Transposition of Great Arteries 5. Obstructive TAPVR

DT3- EXAM 1 (26 decks)

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