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Cardiology 2 > Pediatric Cardiac Exam > Flashcards

Pediatric Cardiac Exam Flashcards

1
Q

What should be included in the Gestational and Natal History?

A 
Birth Weight and Gest Age
Infections
Medication
Smoking/Alcohol 
Maternal Conditions
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2
Q

What should be included in the Post-natal History?

A 
Weight Gain and Development
Cyanosis
Tachypnia and Dyspnia
Exercise intolerance
Heart Murmur
Chest Pain
Palpitations
Medications
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3
Q

What should be included in the Familyl History?

A

Hereditary Diseases and Synd

Congenital Heart Disease

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4
Q

What should be included in the Physical Exam?

A

Inspection
Palpation
Blood Pressure
Stethoscope

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5
Q

What are Palpitations?

A

Subjective feeling of Rapid Heart Beats

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6
Q

What are the Hereditary Diseases and Syndromes to be aware of?

A 
Marfan Syndrome
Noonan Syndrome
Williams Syndrome(Lead Pipe, Arteries not as extensible as they should be)
Long QT synd
Mucopolysaccharidosis
Muscular Dystrophy
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7
Q

What is dangerous about Long QT syndrome?

A

Increases Probability of Torsades

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8
Q

What do you want to be aware of in inspection of the patient?

A 
General Appearance and Nutritional State
Chromosomal Synd
Hereditary Syndromes
Color
Clubbing
Resp. rate, dyspnea, retractions
Chest
-precordial bulge
-Chest deformities
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9
Q

What do you want to be aware of in palpation of the patient?

A 
Peripheral Pulses
Apical impulse
Point of maximal impulse
Precordial Activity
Thrill- vibration you can feel with your hands
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10
Q

What do you want to be aware of in Reading Blood Pressure of the patient?

A

Use the correct cuff size
Use the normal values based on Gender, age, and height
Look for difference between arm and leg (leg BP higher than arm)
unless Coarctation

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11
Q

What do you want to be aware of in Auscultation of the patient?

A 
Bell is for low frequency, diaphragm is for high frequency
Heart rate and regularity
Heart sounds
Systolic And diastolic sounds
Heart Murmurs
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12
Q

What do you want to be aware of in Auscultation of the First Heart sound?

A 
Closure of Mitral and Tricuspid valve
Best heard at APEX or LLSB
Splitting may be normal 
Splitting of S1 vs systolic ejection click (Aortic Click)
Does NOT vary with respirations
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13
Q

What do you want to be aware of in Auscultation of the Second Heart sound?

A

Aortic and Pulmonary valves
P2 slightly after A2 moves with respiration
Audible at LUSB
Single S2 or fixedly split S2 is abnormal
Intensity of P2 important

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14
Q

What are the 3 impacting factors of a heart murmur?

A 
Flow
-CO
Viscosity
-Anemia vs. Polycythemia
Orifice Size
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15
Q

What are the 6 elements of Murmurs?

A 
Intensity Grade 1-6
Timing: S1 and S2
Shape: diamond, decrescendo
Location: max intensity
Radiation: Axillae, neck, back
Quality: Vibratory, harsh, blowing
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16
Q

What are the types of murmurs?

A 
Systolic
-Ejection
-Regurgitation
-Vibratory
Diastolic 
Continuous
17
Q

What are the Considerations with Systolic Murmurs?

A

Most are systolic
Depends on timing in relation to S1
Ejection murmur
Regurgitant Murmur

18
Q

What can cause Systolic Ejection murmurs?

A 
Aortic Stenosis
Subvalar of supravalvar aortic stenosis
Pulmonary Stenosis
Branch Pulmonary artery stenosis
Tetrology of Fallot 
Coarction of the aorta
19
Q

What can cause Systolic Regurgitant murmurs?

A

VSD
Atrioventricular septal defect
Miral Regurg
Tricuspid Regurg(only if pulm HTN)

20
Q

What are the causes of Diastolic Murmurs?

A

Aortic Insufficiency
Pulmonary Insufficiency(Pulm HTN)
Mitral Stenosis

21
Q

What are the Causes of Continuous Murmurs?

A 
Aortopulmonary or Arteriovenous connection
-PDA
-Systemic to PA shunt
Disturbed venous flow
-Common in kids
Disturbed arterial flow
-Rare in kids
22
Q

What is different about the ECG in kids?

A

RV dominance in infants

Rates, axes, intervals all change with age

23
Q

What is the Purpose of Exercise testing in Peds?

A 
Quantify the severity of an abnormality
Assess effectiveness of management
Helpful for:
-structural HD
-functional HD
-Arrhythmias
-Adolescents with Chest Pain
24
Q

What are the reasons for Catheter interventions in kids?

A 
Baloon Atrial Septostomy
Baloon valvuloplasty
Baloon angioplasty and stent place 
CLosure of ASD 
Closure of PDA
CLosure of VSD
Embolization of Collateral vessels

Cardiology 2 (16 decks)

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