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MTB 3 Flashcards

1
Q

Which cardiac malformation requires ASD, VSD, or PDA?

A

Transposition b/c otherwise no oxygenation of blood

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2
Q

Early and severe cyanosis, single S2?

A

Transposition

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3
Q

What heart defect ass’d with Grey cyanosis?

A

Hypoplastic left heart syndrome

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4
Q

What is seen with Hypoplastic left heart syndrome?

A

LV Hypoplasia
Mitral valve atresia
Aortic Valve lesions

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5
Q

What is seen on CXR with Hypoplastic left heart syndrome?

A

Globular shaped heart

Pulmonary edema

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6
Q

Most accurate test for Hypoplastic left heart syndrome?

A

Echo

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7
Q

Severe dyspnea, early & frequent resp infxn, Single S2, peripheral pulses are bounding during first few days of life?

A

Truncus arteriosus

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8
Q

Tx for Truncus arteriosus

A

Surgery

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9
Q

Most severe sequelae of Truncus arteriosus

A

Pulmonary HTN

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10
Q

Cardiac defect early in life w/respiratory distress and severe cyanosis?

A

TAPVR w/obstruction

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11
Q

Cardiac defect age 1-2 with right heart failure and tachypnea

A

TAPVR w/OUT obstruction

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12
Q

CXR shows snowman or figure 8 sign

A

TAPVR w/OUT obstruction

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13
Q

Most accurate dx test for TAPVR w/OUT obstruction?

A

Echo

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14
Q

Treatment for TAPVR?

A

Surgical intervention

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15
Q

MCC of cyanotic heart lesion in NB?

A

Transposition

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16
Q

MCC of cyanotic heart lesion in childhood?

A

Tet of Fallot

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17
Q

Healthy child presents with holosystolic murmur and sx’s of failure to thrive?

A

VSD

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18
Q

EKG findings of VSD?

A

RVH

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19
Q

High pitched holosystolic murmur over lower left sternal border

A

VSD

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20
Q

Loud pulmonic S2

A

VSD

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21
Q

Tx for VSD

A

Smaller lesions close in first 1-2 yrs
Diuretics
Digoxin

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22
Q

Untreated VSD progresses to

A

CHF
Endocarditis
Pulm HTN

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23
Q

Fixed wide splitting of S2

A

ASD

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24
Q

Most definitive test for ASD

A

Cardiac cath

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25
Q

Increased vascular markings on CXR

26
Q

Tx for ASD

A

Most close spontaneously

Dysrhythmias and paradoxical emboli from DVTs in adulthood

27
Q

When does PDA close?

A

PO2 above 50 mmHg

28
Q

When is PDA a normal finding?

A

First 12 hours of life

29
Q

PDA

A

Wide pulse pressure

Bounding pulses

30
Q

Most common complication in child w PDA

A

Resp Infxn

Infective endocarditis

31
Q

Best initial test PDA

32
Q

Most accurate test PDA

A

Cardiac cath

33
Q

Where do Tricuspid and Pulmonary lesions radiate to?

34
Q

Short girl w/webbed neck, shield chest, streak gonads, horseshoe kidneys, shortened 4th metacarpal

A

Coarctation of the aorta

35
Q

How does coarctation of aorta present?

A

Severe CHF
Respiratory Distress - first few months of life
Differential pulses LE and UE

36
Q

Reduces pules in LE + HTN in UE

A

Coarctation of aorta

37
Q

When is hyperbilirubinemia pathological?

A 
Appears on 1st day of life
BR Rises more than 5 mg/dL/day
BR rises above 19.5 mg/dL in term child
Direct BR over 2 mg/dL
Persists after 2nd week of life
38
Q

NB presents with hypotonia, seizures, choreoathetosis, hearing loss?

A

Kernicterus

39
Q

TX for Pathologic jaundice

A

Phototherapy

If BR 20-25 -> Exchange transfusion

40
Q

How does breastfeeding jaundice present?

A

1st week of life
Jaundice
Signs of dehydration

41
Q

What is breastfeeding jaundice present?

A

Lactation failure

  • Decreased BR elimination
  • Increased enterohepatic circulation
42
Q

Tx for breastfeeding jaundice present?

A

Alter breastfeeding to every 2-3 hours for > 10-20 mins per breast for 1st month

43
Q

How does breast milk jaundice present?

A

Starts at 3-5 days
peaks at 2 weeks
Normal exam
Adequate breast feeding

44
Q

How does esophageal atresia present?

A

Vomiting or choking, coughing, cyanosis with first feed

Hx of polyhydramnios

45
Q

Complications with esophageal atresia?

A

Aspiration pneumonia - recurrent

46
Q

What is seen on CXR with esophageal atresia?

A

Gastric air bubble
Esophageal air bubble
Coiling of NG tube

47
Q

What sign is seen with pyloric stenosis?

A

String sign on upper GI series

- Barium swallowed and passage observed under fluroscopy

48
Q

What sign is seen with Intussusception?

A

Doughnut sign

49
Q

Steeple sign?

50
Q

When do we see pyloric stenosis

A

First month of life - 6 months

51
Q

When is a succussion splash heard?

A

Pyloric stenosis

sound of stomach contents slapping into pylorus

52
Q

Succussion splash in adults (GI)?

A

When there is retained gastric contents

  • Gastric outlet obstruction
  • Gastroparesis
53
Q

Differential DX for nonbilious vomiting?

A

Pyloric stenosis - projective
GERD
Infx

54
Q

Metabolic derangement with pyloric stenosis?

A

Hypochloremic
Hypokalemic
Metabolic alkalosis

55
Q

Why do we see hypochloremia and hypokalemia in vomiting?

A

Hydrogen lost in vomitus

Potassium loss worsens b/c of aldosterone release b/c of hypovolemia

56
Q

What sign is seen on physical exam in pyloric stenosis

A

Olive sign - palpable mass size of olive

Epigastric

57
Q

Best initial test for pyloric stenosis

A

Abdominal US

- thickened pyloric sphincter

58
Q

Most accurate test for pyloric stenosis

A

Upper GI series

59
Q

What 4 signs are seen in upper GI series w pyloric stenosis

A
  1. String sign - thin column of barium that leaks thru a tightened muscle
  2. Shoulder sign
  3. Mushroom sign - hypertrophic pylorus against duodenum
  4. Railroad track sign- excess mucosa in pyloric lumen
60
Q

Tx for pyloric stenosis

A
  1. Replace IVF
  2. Replace electrolytes - esp K+ to decrease risk of post op apnea
  3. NGT to decompress bowel
  4. Surgical myotomy/pyloromyotomy

Peds (6 decks)

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