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Paediatric Cardiology Flashcards

1
Q

In the foetal circulation, is the resistance in the lungs high or low?

A

High

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2
Q

In the foetal circulation, is the resistance in the systemic circulation high or low?

A

Low

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3
Q

Oxygenated blood from the placenta travels to a foetus via what vessel?

A

The umbilical vein

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4
Q

Blood from the umbilical vein bypasses the liver as a result of what anatomical structure?

A

Ductus venosus

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5
Q

Blood from the umbilical vein drains into where?

A

IVC

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6
Q

In the foetal circulation, most blood from the IVC passes straight into the left atrium as a result of what anatomical structure?

A

Foramen ovale

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7
Q

In the foetal circulation, there is shunting of blood in what direction?

A

Right to left

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8
Q

In the foetal circulation, blood can pass from the pulmonary artery into the aorta as a result of what anatomical structure?

A

Ductus arteriosus

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9
Q

What happens to the pulmonary vascular resistance at birth?

A

It decreases

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10
Q

What happens to the systemic vascular resistance at birth?

A

It increases

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11
Q

Congenital heart disease is an umbrella term for abnormalities in the structure of the heart that develop when in embryogenesis?

A

Days 20-50

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12
Q

A high maternal alcohol consumption in pregnancy gives an increased risk of which congenital heart defects?

A

VSD and ASD

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13
Q

Maternal use of lithium in pregnancy increases the risk of what congenital heart defect in the foetus?

A

Ebstein’s anomaly

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14
Q

Apical displacement of tricuspid valve leaflets describes what congenital heart defect?

A

Ebstein’s anomaly

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15
Q

What congenital heart defects are likely to be seen in an individual with Turner’s syndrome?

A

Coarctation of the aorta and bicuspid aortic valves

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16
Q

Which congenital heart defects are likely to be seen in an individual with Down’s syndrome?

A

VSD or AVSD

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17
Q

There is an increased risk of which congenital heart disease in Down’s, Edward’s and Patau’s syndromes?

A

VSD

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18
Q

Name the acyanotic congenital heart defects which cause the formation of a left to right shunt?

A

ASD, VSD, AVSD and patent ductus arteriosus

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19
Q

Name the obstructive acyanotic congenital heart defects?

A

Aortic/pulmonary stenosis, coarctation of the aorta and hypoplastic left heart

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20
Q

Name the two cyanotic congenital heart defects?

A

Tetralogy of Fallot and transposition of the great arteries

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21
Q

What is the most common congenital heart defect?

A

VSD

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22
Q

In patent ductus arteriosus, blood is shunted from where to where?

A

Aorta to pulmonary artery

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23
Q

All babies with Down’s syndrome should undergo what investigation in the first few days of life to assess for congenital heart disease?

A

ECHO

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24
Q

A harsh pansystolic murmur heard best at the lower left sternal edge is heard in what congenital heart defect?

A

VSD

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25
An ejection systolic murmur in the 2nd intercostal space is heard in what congenital heart defect?
ASD
26
A loud, low-pitched, continuous, machinery-like murmur is heard in what congenital heart defect?
Patent ductus arteriosus
27
Increased blood flow through the lungs as a result of a left-right shunt eventually leads to what irreversible complication?
Pulmonary hypertension
28
What is meant by Eisenmenger's syndrome?
When pulmonary pressure becomes higher than systemic pressure (causing a left to right shunt to become a right to left shunt)
29
What investigation is used to confirm a diagnosis of congenital heart disease?
ECHO
30
What complication of congenital heart disease with a left to right shunt may be seen on an ECG?
Right ventricular hypertrophy
31
How are small congenital heart defects with a left to right shunt treated?
ECHO every 6-12 months (they will usually close spontaneously)
32
How are large congenital heart defects with a left to right shunt treated?
Surgical repair
33
How are babies with congenital heart disease fed, in order to promote their growth?
High calorie formula via an NG tube
34
Congenital aortic stenosis causes hypertrophy of which heart chamber?
Left ventricle
35
Congenital pulmonary stenosis causes hypertrophy of which heart chamber?
Right ventricle
36
Strenuous exercise should be avoided in children with which congenital heart defect?
Severe aortic stenosis
37
Which obstructive congenital heart defects may present shortly after birth with a very unwell baby and no palpable femoral pulses?
Aortic stenosis or coarctation of the aorta
38
What is the most common finding of a) aortic stenosis and b) pulmonary stenosis in older children?
a) syncope b) breathlessness
39
A slow rising carotid pulse may be associated with which congenital heart defect?
Aortic stenosis
40
An ejection systolic murmur, loudest of the aortic area and radiating to the carotids is most suggestive of which congenital heart defect?
Aortic stenosis
41
What happens to the systolic BP in children with aortic stenosis?
It is low
42
A wide split second heart sound may be associated with which congenital heart defect?
Pulmonary stenosis
43
An ejection systolic murmur loudest over the pulmonary area is most suggestive of which congenital heart defect?
Pulmonary stenosis
44
Weak femoral pulses and a radio-femoral delay are both signs of which congenital heart defect?
Coarctation of the aorta
45
A pansystolic murmur in the left infraclavicular area radiating to the back is most suggestive of which congenital heart defect?
Coarctation of the aorta
46
Rib notching on a CXR is most suggestive of which congenital heart defect?
Coarctation of the aorta
47
What happens to the blood pressure of children with coarctation of the aorta?
Increased systolic BP in the upper body
48
What are the treatment options for severe cases of pulmonary or aortic stenosis?
Ballon valvoplasty or open valvotomy
49
How is coarctation of the aorta managed in neonates and infants?
Surgical resection
50
How is coarctation of the aorta managed in older children?
Balloon dilatation
51
What are the 4 features of Tetralogy of Fallot?
VSD, pulmonary stenosis, overriding aorta, right ventricular hypertropy
52
In which type of cyanotic congenital heart disease are babies usually pink at birth, with cyanosis developing over the first few weeks of life?
Tetralogy of Fallot
53
In which type of cyanotic congenital heart disease are babies cyanosed from birth?
Transposition of the great arteries
54
What type of murmur will be heard in Tetralogy of Fallot?
Ejection systolic murmur over the pulmonary area
55
In which type of cyanotic congenital heart disease is a murmur not heard?
Transposition of the great arteries
56
A 'boot shaped heart' on CXR is suggestive of what congenital heart defect?
Tetralogy of Fallot
57
An 'egg-on-side' appearance on CXR is suggestive of what congenital heart defect?
Transposition of the great arteries
58
Digital clubbing is associated with what type of congenital heart disease?
Cyanotic congenital heart disease
59
Should oxygen be given to babies with cyanotic congenital heart disease?
No
60
How is Tetralogy of Fallot managed?
Surgical correction at 6-12 months
61
How is transposition of the great arteries treated in the short term?
Prostaglandin infusion
62
What is the definitive treatment for transposition of the great arteries?
Balloon septostomy followed by 'arterial switch' procedure
63
What arrhythmia is most commonly encountered in paediatrics?
Supraventricular tachycardia
64
All children with collapse should undergo what investigation to exclude an arrhythmia?
ECG
65
What cardiac condition in children is caused by an accessory pathways between the atria and ventricles?
Wolff-Parkinson-White syndrome
66
What is the characteristic ECG feature of Wolff-Parkinson-White syndrome?
Delta wave (slurred upstroke before the QRS)
67
What happens to the PR interval in Wolff-Parkinson-White syndrome?
Shortened
68
What is the first line management of SVT?
Vagal manoeuvres
69
What is the second line management of SVT?
Rapid bolus of adenosine
70
How are accessory pathways causing SVT that are resistant to medical treatment managed?
Radiofrequency ablation
71
What are some anti-arrhythmic drugs that can be prescribed for children with recurrent SVTs?
Amiodarone or flecainide
72
What cardiac infection is encountered most commonly in children?
Pericarditis
73
The diagnosis of infective endocarditis is made on what investigation?
ECHO
74
How is infective endocarditis treated?
IV antibiotics for at least 6 weeks
75
Which arteries are particularly vulnerable in Kawasaki's disease?
Coronary arteries
76
Kawasaki's disease most commonly affects children under what age?
5 years
77
What diagnosis should be considered in any child presenting with more than 5 days of fever?
Kawasaki's disease
78
What is the most significant complication of Kawasaki's disease?
Coronary artery aneurysms
79
What is the most important investigation to perform in children with Kawasaki's disease?
ECHO
80
How is Kawasaki's disease treated?
IV immunoglobulins and aspirin
81
Acute rheumatic fever usually occurs around 2 weeks after what type of infection?
Group A beta haemolytic strep throat infection
82
How is acute rheumatic fever treated?
Antibiotics and analgesia
83
What investigation is used to diagnose cardiomyopathy?
ECHO
84
How are children with cardiomyopathies managed?
ECHO every 3-6 months

Child Health (10 decks)

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