paeds cardio/gastro/surgery/neuro Flashcards
RF of PDA
high altitude, maternal rubella, prem
signs of PDA
heaving apex beat, subclavicular thrill, continuous machinery murmur
when does west syndrome (infantile spasm) present (progressive mental handicap/developmetal regression)
4-8 months of life
Tx with vigabatrin firstline then ACTH
what metabolic disturbance do you get with pyloric stenosis
hypocholoraemic, hypokalaemia metabolic alkalosis
what might you find O/E of intussusception
pain, baby (normally 5-7months) bringing knees up to chest, red current jelly stool, right upper quadrant mass (sausage shaped)
RF of intussusception
lead point (meckles), concurrent viral infection, boys, CF
what are the features of innocent murmurs
soft, systolic, no radiation, varies with posture, no heaves or thrill, come with viral infection, no symptoms
Investigations for TOF
ECG - right axis deviation
microarray - if genetic syndrome
CXR - boot shaped heart
Echo
O/E of TOF
central cyanosis, thrill or heave, pan systolic murmur heard best at the left sternal edge
complications of TOF
pulmonary regurg, SCD, infective endocarditis, arrhythmias
what’s the role of the umbilical vein
carries oxygenated blood from the placenta to the babies liver
what does the umbilical artery do
returns deoxygenated blood to the placenta
what do the ductus arterioles and the ductus venous become In the adult
ligamentum arteriosum and ligamentum venosum
what causes TGA
failure of the aorticopulmonary septum to spiral in septation
O/E of TGA
RV heave, loud S2 and centrally cyanosed
what does CXR of TGA show
egg on string
Mx of TGA
1) PGE2
2) emergency atrial balloon septostomy
3) surgery
what kind of VSD are most common
perimembranous
MX of eisenmengers
heart-lung transplant
what murmur do you get in VSD
pan systolic heard best on left lower sternal border
Mx of VSD
-if large –> need surgery
-medical Mx –> diuretics and ACEi to reduce after load (reduce pressure in L heart to prevent eisenmengers)
complications of VSD
endocarditis, growth failure and sudden death
is epstein anomaly cyanotic ?
it can be as often associated with a ASD and a R–>L shunt
O/E of Epstein anomaly
gallop rhythm, cyanosis, tachypnoea, signs of heart failure