pediatric cardio

Question 1

3 things age-dependant problem based approach is on

Answer 1

1. cyanosis
2. hearth failure
3. arrythm/syncope/chest pain

Question 2

things to ask on Hx

Answer 2

• failure to thrive
• chest infecitons
• dev. delays
• joint pain/rashes/sore throat
• Sx of heart failure
• chest pain/syncope

Question 3

3 important maternal Qs to ask

Answer 3

1. maternal infections
   - myocardidits
   - rubella
2. maternal meds
3. illnesses

Question 4

4 things to look for on inspection

Answer 4

1. appearance
2. dysmorphism
3. cyanosis
4. resp. distress

Question 5

5 things on auscultation

Answer 5

1. location and streght of murmur
2. systolic/diastolic
3. brachial/femoral discrepancy
4. widely split heart sounds
5. clicks mid systole - mitral valve prolapse

Question 6

2 things to palpate for

Answer 6

1. feel pulses to help determine perfusion

2. palpate heart for murmur or heart strain

Question 7

why are L sided issues not apparent right away

Answer 7

babies dependent on the R side for first few days

Question 8

what cause cyanosis

Answer 8

• not anemia

- de-satuated Hb (50g/L)

Question 9

4 possible causes of cyanosis

Answer 9

1. cardiac
   - abnormal mixing of blood
2. pulm.
   - poor oxygneation
   - VQ mismatch
3. persistent pulm. HT
4. CNS depression

Question 10

** DDx for cyanotic heart disease (7)

Answer 10

5 Ts

1. Transposition of great arts.
2. Teratlogy of fallot
3. tricuspid atresia
4. truncus arteriosus
5. total anomalous peulm venous drainage
6. Pulm atresia
7. Ebstein abnormality

Question 11

2 CXR clues

Answer 11

1. pulm blood flow

2. heart size

Question 12

what are most heart murmurs

Answer 12

innocent

Question 13

features of innocent murmurs

Answer 13

• vibratory
• muscial
• harmonic
• systolic
• ejection
• gr 1-2

Question 14

features of patho murmurs

Answer 14

• harsh
• non-musical
• systolic and diastilic
• ejection/pnasystolic/ cont.
• over gr2

Question 15

what is still’s murmur

Answer 15

• innocent
• flow of blood into LV sets into vibration the chordae
• 2/6 with medium pitch

Question 16

what is venous hum

Answer 16

• innocent

- flow of blood from the head and neck into thorax

Question 17

2 add. feature of innocent murmur

Answer 17

1. accentuated in high output states

2. children well otherwise

Question 18

2 tachy’s and megaly’s of heart failure

Answer 18

tach
1. tachycardia
2. tachypnea
meh
1. cardiomegaly
2. hepatomegaly

Question 19

5 signs of infant HF

Answer 19

1. tachy
2. failure to thrive
3. hepatomegaly
4. cardiomegaly
5. gallop rhythm

Question 20

5 sings of older child HF

Answer 20

1. tachy
2. SOB, cough, fatigue
3. bibasilar rales, hepatomegaly, cardiomegaly
4. gallop rhyth
5. high JVP, edema

Question 21

2 DDx for heart failure

Answer 21

1. low O2 content

2. high output circ. state

Question 22

4 general Tx of HF

Answer 22

1. cause
2. dietary
3. digoxin,diuretics
4. vasopressors

Question 23

what are palpitations in children

Answer 23

• present as extra beats, chest hurts, feel weird
• red flags - syncope, chest pain, fam Hx, Hx of sudden death
• tachy, irreg rhythm

Question 24

most common arrythmias in children

Answer 24

• tachy most common - SVT through WPW

- vent may be associted with sudden death

Question 25

best thing for chest pain

Answer 25

ECG