pediatric cardio 3

Question 1

vegatations of RHD

Answer 1

small, warty vegetations along the lines of closure of the valve leaflets

Question 2

small, warty vegetations along the lines of closure of the valve leaflets

Answer 2

RHD

Question 3

vegetations of infective endocarditis

Answer 3

large, irregular masses on the valve cusps that can extend onto the chordae

Question 4

large, irregular masses on the valve cusps that can extend onto the chordae

Answer 4

infective endocarditis

Question 5

vegetations of nonbacterial thrombotic endocarditis

Answer 5

small bland vegetations, usually attached at the line of closure

Question 6

small bland vegetations, usually attached at the line of closure

Answer 6

NBTE

nonbacterial thrombotic endocarditis

Question 7

vegetations of libman-Sacks endocarditis

Answer 7

small- or medium- sized vegetaions on either or both sides of the valve leaflets

Question 8

small- or medium- sized vegetaions on either or both sides of the valve leaflets

Answer 8

libman-sacks endocarditis

Question 9

criteria for “possible” infective endocarditis

Answer 9

1 major, 1 minor

3 minor

Question 10

blood culture timing for infective endocarditis

Answer 10

2 separate sites 12 hours apart

3 or more 1 hour apart

Question 11

grading of murmurs

Answer 11

1 - soft, difficult to hear
2 - easily heard
3 - louder, but no thrill

4 - thrill
5 - trhill and audible with edge of stethoscope
6 - thrill and audible with stethoscope just off the chest

after 3, you have thrill!

Question 12

cause of infective endocarditis in a patient post-open heart surgery

Answer 12

fungal

Question 13

treatment of IE

Answer 13

total of 4-6 weeks is recommended

vanco + genta
or
aqueous Pen G
or 
cefazolin + genta

Question 14

2nd LICS systolic ejection murmur with radiation to the upper back

Answer 14

pulmonic stenosis

Question 15

2nd LICS systolic ejection murmur with widely split S2

Answer 15

ASD

Question 16

3rd-4th LICS systolic ejection murmur with radiation to the interscapular area

Answer 16

coarcatation of the aorta

Question 17

systolic regurgitant murmur at LLSB

Answer 17

vsd

MR (with radiation to the left anterior axillary line; located at apex din)

Question 18

valve %

Answer 18

mitral valve involvement in 3/4 of cases of valvular heart disease

1/4 involve aortic valve

tricuspid valve is rare

pulmonary valve almost never occurs

(Pediatric Cardiology for Practioners by Myung Park)

Question 19

murmur of aortic regurgitation

Answer 19

high-pitched diastolic murmur loudest at the 3rd-4th LICS more audible when sitting and leaning forward

*other findings: Corrigan pulse, hyperdynamic precordium, WIDE pulse pressure