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362 Final Exam > Ped Heart > Flashcards

Ped Heart Flashcards

1
Q

What happens to heart rate as one ages?

A

It slows down.

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2
Q

Is the blood pressure of children higher or lower than adults?

A

It is lower.

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3
Q

A neonate has a nosebleed and is sweating heavily. What do u suspect?

A

Heart problems

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4
Q

At what point in a neonate’s life does the foramen ovale close? what causes the foramen ovale to close?

A

It closes at birth (ideally). It closes because of the rise in BP as baby breathes air.

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5
Q

At what point in the neonates’s life does the ductus arteriousis close?

A

At about 4 days of life

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6
Q

Where in the chest does a child’s heart lie, relative to an adults?

A

Children’s hearts lie higher in the chest, and more horizontally, than an adults.

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7
Q

Where is the apex of the heart found in a child?

A

At the 3rd or 4th intercostal space

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8
Q

What effect does the clamping of the umbilical cord in a neonate have on systemic vascular resistance?

A

Systemic vascular resistance increases.

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9
Q

What is the purpose of the ductus venosa?

A

Shunts oxygenated blood past the fetal liver (shortcut from umbilical vein to inferior vena cava.

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10
Q

Where is the foramen ovale?

A

A portal between the right and left atria

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11
Q

What is the purpose of the foramen ovale?

A

It allows blood to bypass the high pressure and resistance of the fetal lungs which aren’t oxygenating blood anyway, because the beb is basically underwater.

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12
Q

Where does blood go after passing thru the foramen ovale?

A

It proceeds to the aorta, and then to brain and body.

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13
Q

When during gestation do congenital heart defects develop?

A

Between 6-8 weeks gestation.

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14
Q

Is it possible to detect congenital heart defects before infant is born?

A

Yes, in utero

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15
Q

When during a woman’s pregnancy should rubella vaccine be given?

A

Trick question NEVER because rubella is a live vaccine.

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16
Q

Should keppra (an anti-seizure medication) be given to pregnant women?

A

Anti-seizure medications can cause congenital heart anomalies.

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17
Q

What is a functional/innocent heart murmer?

A

benign

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18
Q

A baby with a congenital heart defect may start to show cyanosis on what day of life?

A

About 2nd day of life or after

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19
Q

What are 2 MAJOR signs of conjenital heart defects in the neonate?

A

1) Poor Feeding 2) Diaphoresis

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20
Q

What is the major complication of congential heart deformities?

A

CHF/crackles

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21
Q

What is an organic heart murmur?

A

Not benign

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22
Q

What happens to oxygenation with acyanotic heart defects?

A

There is increased pulmonary blood flow.

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23
Q

What happens to oxygenation with cyanotic heart defects?

A

There is decreased pulmonary blood flow.

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24
Q

What happens to oxygenation with obstructive systemic blood flow?

A

Blood cannot get to where it needs to go, whether to the lungs or the body.

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25
Q

Should you restrict fat/salt in the diet of a person with acyanotic heart disease?

A

Nope

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26
Q

Patent Ductus arterious (PDA) –acyanotic or cyanotic?

A

Acyanotic. Failure of ductus arteriosis to close soon after birth.

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27
Q

What does the ductus arteriousis do?

A

It connects the pulmonary artery to the aorta

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28
Q

What drug should be given to pediatric patients with PDA (Patent ductus arteriosis)?

A

Indocin

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29
Q

Why should indocin be given to pediatric with PDA (Patent ductus arteriosis)?

A

It blocks prostaglandins, and causes the PDA to close.

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30
Q

What is the second resort if Indocin cannot be used to close the PDA in a pediatric patient?

A

Surgery, for term infants or infants who indocin did not close the PDA.

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31
Q

Does a (Patent ductus arteriosis) cause left or right sided heart failure? Why?

A

Right sided heart failure, because R side is pumping and pumping and blood is just leaking out to the aorta instead of going to the pulmonary arteries and lungs.

32
Q

Atrial septal defect (ASD) – acyanotic or cyanotic heart problem?

A

Acyanotic

33
Q

Is Atrial septal defect (ASD) the same as patent forament ovale?

A

No but symptoms are the same. Oxygenated blood flows from L atrium to R atrium.

34
Q

What is the treatment of an asymptomatic Atrial Septal Defect?

A

Monitor to see if spontaneous closure occurs.

35
Q

Does Atrial septal defect (ASD) cause right sided or left sided heart failure?

A

Right sided heart failure from increased blood going to the right side of the heart.

36
Q

Ventricular septal defect (VSD) – acyanotic or cyanotic heart problem?

A

Acyanotic

37
Q

How large is the opening between ventricles in a pediatric patient with Ventricular septal defect (VSD)?

A

It varies from size of pinhole to almost no septum at all.

38
Q

What is the most common congenital defect?

A

Ventricular septal defect (VSD)

39
Q

Does Ventricular septal defect (VSD) cause right sided or left sided heart failure?

A

Right sided heart failure

40
Q

What is the tx for an asymptomatic Ventricular septal defect (VSD)?

A

Spontaneously closes 30-50% of the time; monitor and wait. If non-closing, needs to be surgically closed.

41
Q

When the patient recieves an umbrella in the heart how long does the patient need antibiotics?

A

For the rest of life

42
Q

Transposition of the Great Vessels – cyanotic or acyonatic heart defect?

A

Cyanotic

43
Q

What happens to circulation with Transposition of the Great Vessels?

A

Circulation is reversed – the pulmonary vessels come out of the left ventricle and the aorta comes out of the right ventricle.

44
Q

What is the prognosis for untreated Transposition of the Great Vessels? With treatment?

A

Not conducive to life, without intervention. With surgical repair, 90-95% survival rate.

45
Q

What is the treatment for Transposition of the Great Vessels?

A

Give PGE_1 infusion to keep the PDA open. Create a septal defect. Correct vessels surgically later.

46
Q

What is the most common cyanotic heart lesion?

A

Tetrology of Fallot

47
Q

Is Tetrology of Fallot a cyanotic or acyanotic heart defect?

A

Cyanotic

48
Q

What are the heart defects in a pediatric patient with Tetrology of Fallot?

A

1) Pumonic stenosis
2) VSD
3) Overriding aorta
4) Right ventricular hypertrophy

49
Q

What happens to oxygenation during a “Tet spell”??

A

Hypercyanotic; O2 drops drastically.

50
Q

What position should a person having a “tet spell” be in?

A

Knee to chest

51
Q

What is the purpose of the knee to chest position during a tet spell?

A

It decreases systemic vascular resistance. It prevents leg blood from getting back up to the heart and overwhelming the heart.

52
Q

What is the first line of treatment for a tet spell?

A

Get in knee-chest squat position.

53
Q

What does a baby with tetralogy of fallot look like while crying or feeding?

A

Cyanotic at extremities and mouth.

54
Q

Does obstructed systemic blood flow cause left or right sided heart failure?

A

Left sided heart failure

55
Q

Will a person with obstructed systemic blood flow have bounding peripheral pulse?

A

No, diminished peripheral pulse, delayed capillary refill…low bp in LE

56
Q

When does coarctation of the aorta develop?

A

The 2nd week of life

57
Q

What happens to the heart during coarctation of the aorta?

A

The aortic arch narros, either before or after the ductus arteriosis.

58
Q

When the aorta narrows during coarctation of the aorta, does the narrowing usually occur before or after the ductus arteriosis?

A

After the ductus arteriousis is more common.

59
Q

What are the 2 risks with coarctation of the aorta?

A

CVA, AAA (abdominal aortic anyeurism)

60
Q

Which is more life-threatening: coarctation of the aorta BEFORE the ductus arteriosis, or AFTER?

A

BEFORE is more dangerous, because blood is obstructed from flowing to the carotids (and brain).

61
Q

What drug is used to keep the Patent Ductus Arteriosis open, used in coarctation of the aorta and transposition of the great vessels?

A

Prostaglandin E1.

62
Q

A child shows epitaxis, high bloodpressure in the upper extremities, low blood pressure in the lower extremities, CHF, and headaches. What do you suspect?

A

coarctation of the aorta

63
Q

What type of infection causes rheumatic fever?

A

group A strep infection

64
Q

What is painful/tender joints called?

A

Polyarthritis

65
Q

Rheumatic fever is an _________________ disease.

A

Autoimmune.

66
Q

Painful and tender joints
Chest pain
Chorea (like dyskinesia)
Erythema Marginatum

A

Major symptoms of Rheumatic fever

67
Q

What are four major symptoms of rheumatic fever?

A

Painful/tender joints
Erythema marginatum
Chorea
Chest Pain

68
Q

What are the consequences to the heart of Rheumatic fever?

A

Valve stenosis, regurgitation, damage to heart muscle, a-fib, heart failure

69
Q

What labs might indicate that a child has rheumatic fever?

A

Eleveted Sed Rate (indicating inflammation)
Elevated C-reactive protein
Leukocytosis

70
Q

What interval on an EKG will be prolonged in a child with Rheumatic fever?

A

prolonged PR interval

71
Q

How long are prophylactic antibiotics given in a child with Rheumatic fever?

A

Every day until 18 years of age, and with dental care and surgery as adults.

72
Q

What labs will be elevated in a person with Kawasaki disease?

A

Elevated sed rate, indicating inflammation.

73
Q

What are initial s/s of the first stage of Kawasaki disease?

A

V red hands and feet, lethargy, high fever unresponsive to tx for >5 days, strawberry tongue

74
Q

What are the s/s of the second stage of Kawasaki disease?

A

Cracking lips, peeling fingers/toes, joint pain POSSIBLY MI or CVA d/t coronary blood vessel inflammation.

75
Q

What is the cardiac consequence of Kawasaki disease?

A

Coronary blood vessel inflammation, can cause Aneurysms, MI, or CVA.

76
Q

What is the tx for Kawasaki disease?

A

Salycilate (aspirin) therapy, IV gamma globulins to assist immune system, Coumadin for the clots, steroids for inflammation

362 Final Exam (4 decks)

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