Pediatric Cardiology

Question 1

What are 3 things that close AFTER BIRTH in the newborn’s heart?

Answer 1

1. Foramen ovale
2. Ductus Arteriosus
3. Ductus Venosus

Question 2

What does Foramen Ovale connect and why?

Answer 2

Connects the right atrium to the left atrium so that blood can bypass the lungs in utero

Question 3

What does the Ductus Arteriosus connect and why?

Answer 3

Connects the pulmonary trunk to the aorta so that blood bypasses the developing lungs in utero

Question 4

Once Ductus Arteriosus closes, what does it become?

Answer 4

Ligamentum Arteriosum

Question 5

Describe the blood flow through the Ductus Venosus?

Answer 5

Oxygen rich from placenta -> Umbilical vein -> ductus venosus -> inferior vena cava -> heart

Question 6

Once Ductus Venosus closes, what does it become?

Answer 6

Ligamentum Venosum

Question 7

When does foramen ovale, ductus arteriosus and ductus venosus close?

Answer 7

After birth

Question 8

What is the purpose of the newborn pulse oximetry screening test?

Answer 8

Identify babies at risk for sudden death from critical congenital heart disease

Question 9

The newborn pulse oximetry screening test is NOT a diagnostic test. If the baby fails the screening, what is required?

Answer 9

Further hypoxemia work up

Question 10

What is the purpose of the newborn pulse oximetry screening test?

Answer 10

Identify babies at risk for sudden death from critical congenital heart disease – hypoxemia

Question 11

When will a baby fail the newborn pulse oximetry screen?

Answer 11

1. O2 sats are less than 90%

2. Right hand sat. is between 90-95% OR difference between right hand and foot is greater than 3%

Question 12

When will a baby fail the newborn pulse oximetry screening test?

Answer 12

1. O2 sats are less than 90%

2. Right hand sat. is between 90-95% OR difference between the right hand and foot is greater than 3%

Question 13

If a baby fails the newborn pulse oximetry screening, when should it be repeated?

Answer 13

1 hour later

Question 14

What are the symptoms of a newborn with significant cardiac disease?

Answer 14

Cyanosis, tachypnea, cough, diaphoresis, cannot finish a bottle with failure to gain weight and developmental delay

Question 15

What will be seen on physical exam with a newborn that has significant cardiac disease?

Answer 15

Hypoxia, wheeze/crackles, murmur, abnormal pulses, edema

Question 16

What are the symptoms of an adolescent with significant cardiac disease?

Answer 16

Syncope, easy fatigue/exercise intolerance, palpitations or chest pain, diaphoresis, asthma-like

Question 17

What will be seen on physical exam of an adolescent with significant cardiac disease?

Answer 17

Hypoxia, wheeze/crackles, murmur, abnormal pulses, edema

Question 18

A baby with tachypnea means the RR is > than?

Answer 18

60 breaths/minute

Question 19

What can tachypnea in a newborn be a sign of?

Answer 19

Congenital heart disease

Question 20

What are some differential diagnoses for a baby with a RR > 60?

Answer 20

Congenital heart disease, RDS, infection, meconium aspiration, pneumothorax

Question 21

What are the 6 components of a cardiac murmur?

Answer 21

1. Grade 1-6
2. Timing
3. Character
4. Location
5. Radiation
6. Change with position of patient

Question 22

What are the 6 components of a cardiac murmur?

Answer 22

1. Grade 1-6
2. Timing
3. Character
4. Location
5. Radiation
6. Change with position of patient

Question 23

What are the 7 S’s of INNOCENT murmurs in children?

Answer 23

1. Sensitive to position change
2. Short duration
3. Single sound
4. Small and non-radiating
5. Soft (grade <3)
6. Sweet (not harsh)
7. Systolic

Question 24

What are the 7 S’s of INNOCENT murmurs in children?

Answer 24

1. Sensitive to position change
2. Shorter duration
3. Single sound
4. Small (non-radiating(
5. Soft (grade <3)
6. Sweet
7. Systolic

Question 25

Innocent murmurs in children often change with _____ while pathologic murmurs do NOT

Answer 25

Child's position

Question 26

What is an exception to a pathologic murmur that changes with a child's position and when does it change?

Answer 26

Idiopathic Hypertrophic Sub-aortic Stenosis | -- Gets louder from supine -> upright

Question 27

What is an exception to a pathologic murmur in children that DOES change with the child's position and when does it change?

Answer 27

Idiopathic Hypertrophic Sub-aortic Stenosis | -- gets louder from supine -> upright

Question 28

_____ murmurs need further evaluation

Answer 28

Diastolic

Question 29

BP range varies with what 2 things?

Answer 29

Age and height

Question 30

If the BP cuff is too small, the BP will be?

Answer 30

High

Question 31

If the BP cuff is too big, the BP will be?

Answer 31

Low

Question 32

BP cuff should cover ____ of the child's arm

Answer 32

2/3

Question 33

BP range in a child varies with?

Answer 33

Age and height