Pediatric cardiology Flashcards

1
Q

what is the etiology of rheumatic fever

A

Group A beta hemolytic strep (GABHS)

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2
Q

what is the characteristic histologic finding in the myocardium of rheumatic fever

A

aschoff body

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3
Q

what is the MC valve effected by rheumatic fever

A

mitral valve

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4
Q

what is the presentation of rheumatic fever

A

febrile illness 2-4 weeks following strep infection

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5
Q

what is the major criteria for rheumatic fever

A
  • polyarthritis
  • carditis
  • subcutaneous nodules
  • erythema marginatum
  • chorea
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6
Q

what are the minor criteria for rheumatic fever

A
  • fever
  • polyarthralgia
  • previous rheumatic fever/RHD
  • elevated ESR/CRP
  • prolonged PR interval
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7
Q

what is the diagnostic criteria for rheumatic fever

A
  • 2 major criteria OR
  • 1 major and 2 minor AND
  • documented strep infection
  • confirmation with echo
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8
Q

what is the treatment of rheumatic fever

A
  • PCN
  • prophylaxis for up to 10 years
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9
Q

what is the MC atrial septal defect

A

ostium secondum

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10
Q

what is the pathophysiology of atrial septal defects

A
  • L to R shunt allowing oxygenated blood to pass from the LA to the RA causing the blood to mix
  • eventually the R side pressure can become too much, causing it to reverse and patient becomes cyanotic
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11
Q

what are the s/s of ASD

A
  • split S2 heart sound
  • systolic ejection murmur radiating to the back at the LSB
  • diastolic murmur at LSB
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12
Q

what would be seen on imaging for ASD

A

cardiac enlargement

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13
Q

what is the treatment o ASD

A
  • small: closes on its own
  • symptomatic or large: transcatheter closure
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14
Q

what is the pathophysiology of coarctation of the aorta

A
  • narrowing of the aortic arch causing blockage of blood flow
  • leads to LVH
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15
Q

Most paients with coarctation of the aorta also have (…)

A

turners syndrome

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16
Q

what are the s/s of coarctation of the aorta

A
  • pulse discrepancy between arms and legs
  • diminished femoral pulses
  • blowing harsh murmur in the back or left axilla
17
Q

what would you see on chest xray of coarctation of the aorta

A
  • figure 3 sign
  • rib notching
18
Q

what is the treatment for coarctation of the aorta

A
  • prostaglandins to keep PDA open
  • corrective repair once stable
  • balloon angioplasty
19
Q

what is the pathophysiology of HCM

A

Thickened LV wall, particularly along the septum

20
Q

what is the presentation of HCM

A
  • CP
  • syncope
  • SCA
  • mid-systolic harsh murmur, louder when valsalva and standing, quieter with squatting
21
Q

how do you manage HCM

A
  • avoid volume depletion
  • activity restriction
  • BB
  • septal myectomy or alcohol septal ablation
22
Q

what is the presentation of kawasaki disease

A

-fever more than 5 days
-lip or oral cavity changes
-bilateral conjunctivitis
-cervical lymphadenopathy
-polymorphous exanthema
-redness and swelling of hands

23
Q

what are the possible complications of kawasaki disease

A
  • myocarditis
  • pericarditis
  • valvular heart disease
  • MI
24
Q

what is the treatment of kawasaki disease

A

aspirin and IVIG

25
Q

what is patent ductus arteriosus

A

an opened connection between the aorta and the pulmonary artery found at birth

26
Q

what is the pathophysiology of PDA

A

increased levels of prostaglandins keep the PDA open

27
Q

when should PDA close

A

within 24 hours of birth but may persist up to 8 days

28
Q

what are the s/s of PDA

A
  • Clubbing of toes but not fingers
  • FTT
  • tachypnea
  • continuous, machinery like murmur
  • bounding peripheral pulses
29
Q

what is the treatment of PDA

A

indomethacin

30
Q

what are the components of tetralogy of fallot

A
  • large VSD
  • pulmonary stenosis
  • overriding aorta
  • RVH
31
Q

what are the s/s of tetralogy of fallot

A
  • cyanosis
  • systolic murmur at LSB radiating to the back
  • tet spells
32
Q

what is the treatment of tet spells

A
  • knee to chest position
  • oxygen
  • if spell continues: fentanyl then morphine
33
Q

what is the treatment of tetralogy of fallot

A

surgical repair

34
Q

what is Blalock-Taussig shunt

A
  • when babies are outside of the newborn period and have lost the PDA
  • creates a shunt to replace the PDA and allow some blood flow
  • Used in ToF
35
Q

what is the MC congenital heart defect

A

VSD

36
Q

what is the MC type of VSD

A

membranous

37
Q

what is the pathophysiology of VSD

A
  • L to R shunt allowing oxygenated blood to pass from the LV through the septum
  • eisenmengers syndrome can occur
38
Q

what is the presentation of VSD

A
  • FTT
  • tachypnea
  • respiratory distress
  • systolic murmur at LSB
39
Q

what is the treatment of VSD

A
  • surgical closure
  • diuretics and high calorie feeds