Pediatric Cardiac Disorders

Question 1

What type of heart defect is Tetralogy of Fallot?

Answer 1

Cyanotic (decreases pulmonary blood flow)

Question 2

What are the 4 heart defects found in Tetralogy of Fallot?

Answer 2

“RAPS”

1) Right Ventricular Hypertrophy
2) Aorta Displacement
3) Pulmonary Stenosis
4) Septal Defect (ventrical)

Question 3

What is a “tet” spell and how is it relieved?

Answer 3

An hypoxic episode relieved by squatting or being placed in knee/chest position.

Question 4

What blood disorder is common in children with cyanotic heart disorders?

Answer 4

Polycythemia (increased red blood cells)

Question 5

What kind of murmur is heard in Tetralogy of Fallot?

Answer 5

Loud systolic murmur and thrill heard over the left sternal border at the 2nd intercostal space.

Question 6

What are classic symptoms of Cyanotic Heart Disorders?

Answer 6

Squatting
Cyanosis
Clubbing
Syncope

Question 7

What are classic symptoms of Acyanotic Heart Disorders?

Answer 7

Fatigue
Murmur
Increased risk of endocarditis
CHF
Growth retardation

Question 8

What are the cyanotic heart disorders?

Answer 8

Tetralogy of Fallot (decreased pulmonary flow)
TGV (mixed pulmonary flow)
TA (mixed pulmonary flow)

Question 9

What are the acyanotic heart disorders?

Answer 9

ASD
VSD
PDA (all increased pulmonary flow)
Coarctation/stenosis of aorta (obstructive pulmonary flow)

Question 10

What is a condition that causes blood to seep from the aorta through the ductus arteriosus and into the pulmonary artery?

Answer 10

Patent Ductus Arteriosus

Question 11

What does the left-to-right shunting of blood in PDA cause?

Answer 11

pulmonary hypertension

Question 12

What is Indomethacin?

Answer 12

A prostaglandin inhibitor given to pre-term infants to help treat Patent Ductus Arteriosus.

Question 13

What condition causes a continuous machine-like heart murmer?

Answer 13

Patent Ductus Arteriosus

Question 14

What causes high BP in upper extremities but low BP in lower extremities?

Answer 14

Coarctation of the Aorta

Question 15

What causes strong, bounding pulses in the upper body and absent or weak femoral pulses and cool lower extremities?

Answer 15

Coarctation of the Aorta

Question 16

Which condition causes rib notching?

Answer 16

Coarctation of the Aorta

Question 17

What is a condition caused by failure of an embryonic structure to divide into two separate arteries? What are those arteries?

Answer 17

Truncus Arteriosus

Pulmonary Artery and Aorta

Question 18

Truncus Arteriosus usually occurs with another defect that allows survival past birth. What is that defect?

Answer 18

Ventricular Septal Defect (VSD)

Question 19

What is Transposition of the Great Vessels?

Answer 19

The Pulmonary Artery and Aorta are reversed. Each side has its own circulation with no communication. It is LIFE THREATENING.

Question 20

What medication is given to prevent closure of ductus arteriosus in a child with Transposition of the Great Vessels?

Answer 20

Prostaglandin E (PGE)

Question 21

What is the therapeutic range for Digoxin?

Answer 21

0.8 -2.0 ng/mL

Question 22

When to administer Digoxin?

Answer 22

1 hour before meal or 2 hours after meal. Do not mix with formula or food.

Question 23

When to hold Digoxin?

Answer 23

When pulse is below is 70 in children and 90-100 in infants.