Paeds cardio condensed

Question 1

Name 3 maternal disorders and cardiac abnormalities caused

Answer 1

SLE - Complete heart block

DM - TGA

RUbella - PDA / PS

Question 2

Name 2 maternal drugs and their cardiac abnormalities

Answer 2

FAS - VSD / ASD / ToF

Cannabis - Septal defects

Question 3

Name 4 chromosomal abnormalities and cardiac presentations

Answer 3

Turners - Bicuspid aortic valve / Co-arctation

Downs - AVSD / ASD / VSD

Noonans - Pulmonary stenosis

Edwards - septal defects

Patau - dextrocardia

Question 4

What do all patients with downs require at birth

Answer 4

Echo - AVSD

Question 5

Heart failure presentation

Answer 5

Poor feeding 
Breathlesness 
sweating on feeding 
SOB - feeding and exertion 
recurrent infections 
FTT
Gallop murmur 
tachycardia 
cool peripheries

Question 6

Heart failure management

Answer 6

Fluid restriction
Calories - feeding plan
Diuretics
Surgery - CHD correction

Question 7

L –> R shunt

Answer 7

ASD
VSD
PDA

Question 8

Describe ASD

• Murmur
• associations
• presentation
• investigations

Answer 8

Ejection systolic

FAS / Downs

Recurrent infections / arrhythmias / wheeze / palpitations

CXR / ECG / Echo

Question 9

What does the ECG in ASD show

Answer 9

RVH

RBBB

Question 10

Describe VSD

• Murmur
• Presentation
• Management

Answer 10

Pansystolic - Lower left sternal edge

poor feeding / infections / FTT / HF

Diuretics - Catopril
Additional calories
Surgery with Abx prophylaxis

Question 11

Describe PDA

• Murmur
• Associations
• Presentation
• Management

Answer 11

Continuous machinery

Preterm / Rubella

Large defect –> CCF / Persistent pulmonary HTN

Indomethacin

Question 12

Describe TGA 
Murmur 
Associations 
presentations 
investigations

Answer 12

No murmur - Loud S2

Diabetic mother

tachycardia / Increased RR / Cyanosis

CXR / Echo - associations with other shunts

Question 13

Describe the CXR findings in TGA

Answer 13

Egg on side

Narrow upper mediastinum

Question 14

Describe ToF 
Murmur 
Associaitons 
Presentations 
Investigations

Answer 14

Ejection systolic - Left sternal edge

Downs

Cyanotic spells / breathless / poor feeding / easy tiring on breastfeeding / crying / squatting

CXR / Echo

Question 15

CXR findings in ToF

Answer 15

Up tilted boot shape

Small heart

Question 16

Presentation of Eisenmenger syndrome

Answer 16

Cyanosis
Plethoric complexion - Polycythameia
Increased blood clot risk

Question 17

Pulmonary stenosis

• murmur
• presentation

Answer 17

Ejection systolic

R.V heave and thrill

Question 18

Pulmonary stenosis

• murmur
• presentation

Answer 18

Ejection systolic

R.V heave and thrill

Question 19

Co-arctation

• murmur
• presentation
• investigations

Answer 19

Ejection systolic - radiation to scapula

Grey pale floppy / poor feeding / claudication

ABD - Metabolic acidosis
CXR - Cardiomegaly
BP - HTN

Question 20

What is Hypoplastic left heart

Answer 20

Underdeveloped left side of heart

Question 21

What is rheumatic fever

Answer 21

Hypersensitivity reaction to Group A strep - Strep pyogenes
Pharyngitis
2-4 weeks post infection

Question 22

How does rheumatic fever present

Answer 22

JONES CAFE PAL

J - Joints red and inflamed 
O - Myocarditis 
N - SC nodules 
E - Erythema marginatum (trunk things and arms)
S - Chorea 

C - CRP
A - Arthralgia
F - Fever
E - ESR

P - Prolonged PR
A - Anameia
L - Leukocytosis

Question 23

What is sydonems chorea

Answer 23

Muscular weakness
emotional disturbance
ceases with sleep

Question 24

What is the diagnostic criteria

Answer 24

2 major

OR

1 Major + 2 Minor

Question 25

What investigations can be used

Answer 25

Throat cultures growing GABHS

Elevated anti-streptolysin o titres

Question 26

Rheumatic fever management

Answer 26

Eradication - IV BenPen + 10 days phenoxymethylpenicillin

Analgesia - Aspirin / Ibuprofen

Question 27

Rheumatic fever complications

Answer 27

Heart failure