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MD3 > Paediatric cardiology > Flashcards

Paediatric cardiology Flashcards

1
Q

Commonest congenital heart defect

A

VSD

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2
Q

Small VSD symptoms

A

Asymptomatic

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3
Q

Small VSD physical examination findings

A

Pansystolic murmur

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4
Q

Where is a VSD best heard?

A

LLSB

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5
Q

Large VSD symptoms

A

Delayed growth

Decreased exercise tolerance

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6
Q

Large VSD physical examination findings

A

Pansystolic, loud harsh and high pitched murmur at LLSB
Hepatomegaly
CHF symptoms

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7
Q

What investigations are done for VSD? What would you expect on investigations?

A

Echocardiogram to estimate pressure gradient

ECG prominent L and R ventricular forces

CXR pulmonary plethora and cardiac enlargement

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8
Q

What is the Eisenmenger complex

A

irreversible pulmonary vascular disease due to lofnstading shunt with reversal of flow

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9
Q

What is chance of closure if VSD is muscular?

A

High chance of spontaneous closure

Difficult surgical closure

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10
Q

What is chance of closure if doubly committed VSD?

A

Low change spontaneous closure

Risk aortic valve regurgitation

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11
Q

Management of small VSD

A

close on their own

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12
Q

Management of large VSD

A

Surgical closure by 1 yo

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13
Q

When do symptoms of ASD develop?

A

Asymptomatic in childhood

Symptoms develop in 3rd, 4th decade

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14
Q

Murmur heard in ASD

A

Ejection systolic murmur
Fixed splitting of S2
Parasternal heave

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15
Q

Where is an ASD heard?

A

Pulmonary area

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16
Q

What percentage of murmurs are ASD?

A

8%

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17
Q

Where is the ASD defect?

A

ostium primum - common in Down syndrome

ostium secundum in region of fossa ovalis- commonest one

sinus venous in region of SVC or IVC

18
Q

What are the complications of ASD?

A

Pulmonary HTN
HF
Arrhythmia

19
Q

What is the natural history of ASD?

A

ƒƒ80-100% spontaneous closure rate if ASD diameter

20
Q

how do you manage ASD that has not closed?

A

Surgical closure

Between 2-5 yo

21
Q

When does the ductus arteriosus normally close?

A

After 10-15 hours of life

22
Q

Up to when can a preme’s PDA close?

A

Can take up to 3 months

23
Q

What are the symptoms and physical fundings in a small PDA?

A

No symptoms

Continuous murmur

24
Q

When does a medium PDA develop?

A

2-6 months

25
Q

What are the examination findings of a medium PDA?

A

Slow growth

Continuous flow murmur murmur

26
Q

When does a large PDA develop?

A

First 4 weeks

27
Q

What are the examination findings of a large PDA?

A

Poor weight gain
Tachypnoea
Continuous flow murmur
Full/collapsing pulse

28
Q

How do you manage a PDA in premature child?

A

Indomethacin

29
Q

How do you manage a PDA in a symptomatic child?

A

Surgical closure

30
Q

What are the symptoms of an obstructive cardiac lesion?

A

Reduced urine output
Pallor
Cool extremities and poor pulses
Shock or sudden collapse

31
Q

Definition of coarctation of aorta?

A

narrowing of aorta usually at level of ductus arteriosus

32
Q

What are CoA associated with?

A 
Turner Syndrome (35%)
Bicuspid aortic valve (50%)
33
Q

What kind of cardiac conditions do Down’s Syndrome patients have?

A

ASD

Atrioventricular defect

34
Q

Is a VSD cyanotic or acyanotic

A

Acyanotic

L–>R shunt

35
Q

Examination findings for CoA

A

Tachypnoea

Absent femoral pulses

36
Q

Management of CoA

A

Prostaglandins

37
Q

Cyanotic lesions

A

Tetralogy of Fallot

Transposition of great arteries

38
Q

Commonest cyanotic heart lesions?

A

Tetralogy of Fallot

39
Q

Definition of tetralogy of fallot?

A
  • VSD
  • RVH
  • RVOTO (pulmonary stenosis)
  • Over-riding aorta
40
Q

Examination findings of tetralogy of fallot

A

Harsh ejection systolic murmur

Radiates to back

MD3 (2 decks)

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