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Clin Med IV Exam III > Pedi Cards > Flashcards

Pedi Cards Flashcards

1
Q

Thrills suggest what in peds

A

anatomic abnormality

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2
Q

RV heave= what in peds

A

RV hypertension

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3
Q

Differential pulses, weak in the lower extremities=

A

CoArc

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4
Q

Bounding pulse= ???

A

bounding pulse

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5
Q

Weak pule=

A

cardiogenic shock or CoArc

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6
Q

Pulsus paradoxus (exaggerated SBP drop with inspiration)= ???

A

tamponade or severe asthma

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7
Q

Pulsus alternans= ??

A

LV mechanical dysfunction

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8
Q

What must you identify when listening to heart sounds in kids

A

S1 and S2

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9
Q

Mid-systolic click= ???

A

MVP

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10
Q

Loud S2= ??

A

pulmonary HTN

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11
Q

Fixed, splits S2= ??

A

ASD, PS

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12
Q

S3 gallop—>

A

may be due to cardiac dysfunction/volume overload

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13
Q

Muffled heart sounds and/or a rub—>

A

pericardial effusion +/- tamponade

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14
Q

What are the types of murmurs

A
  • systolic ejection murmur= turbulence across a valve
  • holosystolic murmur- turbulence begins w/ systole
  • continuous murmur= pressure difference in systole and diastole
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15
Q

Shunts present in the fetus and where they shunt blood

A
  • ductus venosus: bypasses liver
  • foramen ovale: R to L arterial shunt
  • ductus arteriosus: R to L arterial shunt
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16
Q

Holosystolic murmurs in babies have what

A

palpable thrill

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17
Q

What happens when you clamp the umbilical cord

A

systemic vascular resistance is increased

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18
Q

Ductus venousus connects what

A

umbilical vein to inferior vena cava, bypassing the liver

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19
Q

Why does the ductus venosus close

A

due to fall in umbilical vein pressure

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20
Q

What promotes lung expansion at birth

A

the alveoli filling with air instead of fluid

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21
Q

Aeration of lungs at birth leads to what

A
  • decreased pulmonary vein resistance

- increased pulmonary blood flow

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22
Q

How does the foramen ovale close

A

proliferation of enothelial and fibrous tissue

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23
Q

What does the ductus arteriosus do

A

protects the lungs against circulatory overload

24
Q

What aid in the closing of the ductus arteriosus

A
  • increased O2 sat
  • decreased pulmonary resistance
  • decreased prostaglandin E2 levels
25
Q

Fetal structures that correspond to adult structures

A

foramen ovale–> fossa ovalis

umbilical vein–> ligamentum teres

ductus venosus–> ligamentum venousus

ductus arteriosum–> ligamentum arteriosum

26
Q

Still’s murmur?

A

vibratory, twangy, systolic murmur best hear at LSB and apex

27
Q

In what population is a Still’s murmur most commonly heart

A

children 3-5 years

28
Q

When is a Still’s murmur loudest

A

supine position

*changes with position

29
Q

If a murmur has a thrill–>

A

NOT NORMAL

30
Q

What causes a Still’s murmur

A

vibration of the great vessels and/or LVOT

31
Q

How does a pulmonary flow murmur change

A
  • increases with supine position
  • decreases upright
  • increased by high output states
32
Q

Venous hum?

A

low pitched continious murmur often heard best in infraclavicular area, normal heart sound

33
Q

Positional changes with a venous hum

A
  • loudest uprught

- diminishes with supine or compression of jugular vein

34
Q

Murmur red flags!

A
  • diastolic murmur (venous hum ok)
  • loud murmurs, especially thrills
  • little or no effect with change in position
  • symptoms, especially cyanosis
35
Q

Ways to classify congenital heart disease

A
  • acyantotic
  • cyanotic
  • obstructive lesions
36
Q

L—> R shunts, “acyanotic”

A
  • VSD
  • PDA
  • ASD
37
Q

VSD

A

blood flows from high pressure left ventricle to low pressure right ventricle

38
Q

PDA

A

blood flows from high pressure aorta to low pressure pulmonary artery

39
Q

ASD

A

blood flows from high pressure left atrium to lower pressure right atrium

40
Q

VSD and PDA present how

A

in infant w/ heart failure, murmur and poor growth/ feeding

*left heart enlargement

41
Q

ASD present how

A

in childhood w/ murmur or exercise intolerance, typically asx

*right heart enlargement if severe

42
Q

Most common heart malformation

A

VSD

43
Q

Murmur in VSD

A

holosystolic murmur at lower left sternal border with a heave

44
Q

Clinical features of VSD

A
  • failure to thrive
  • tachypnea
  • diaphoresis with feeding
45
Q

Where is an ASD mumur heard

A

pulmonary area

*large shunts cause a diastolic flow murmur at left lower sternal bored

46
Q

Clinical features of PDA

A
  • failure to thrive
  • diaphoresis with feeds
  • bounding pulse
47
Q

How can PDA be treated

A

indomethacin

48
Q

Cyanotic CHD is what kind of shunt

A

R–> left shunt

49
Q

Tetralogy of Fallot is what things

A
  • rt ventricular outflow tract obstruction
  • VSD
  • overriding aorta
  • right ventricular hypertrophy
50
Q

Tetralogy of fallot on xray

A

boot shaped heart with concave pulmonary segment

51
Q

What is the murmur is tetralogy of fallot from

A

pulmonic stenosis, not from VSD

52
Q

Treatment of tetralogy of fallot

A

systemic pulmonary artery shunt in early infancy with later relief of the right ventricular outflow tract obstruction and closure of the ventricular defect

53
Q

Rheumatic fever is what

A

a post infectious connective tissue disease

*follow GAS pharyngitis by several weeks

54
Q

Earliest and most common feature of rheumatic fever

A

painful migratory arthritis

55
Q

Presentation of acute rheumatic fever

A
  • chorea
  • erythema marginatum
  • subcutaneous nodules

Clin Med IV Exam III (8 decks)

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