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AANP FNP: Pediatrics > Pediatric Cardiology > Flashcards

Pediatric Cardiology Flashcards

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1
Q

What makes the S1 sound?

A

Closure of the AV valves (mitral/tricuspid)

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2
Q

What makes the S2 sound?

A

Closure of the semilunar valves (aortic/pulmonic)

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3
Q

What is systole?

A

ventricular contraction

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4
Q

What is diastole?

A

ventricular relaxation

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5
Q

What is S3?

A

“Ken-tuck-y”

increased fluid states (pregnancy, CHF)

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6
Q

What is S4?

A

“Ten-nes-see”

Ventricular wall hypertrophy (chronic hypertension, young athletes)

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7
Q

What are the three main types of congenital heart defects?

A

Acyanotic (left to right shunting)

Cyanotic (right to left shunting)

Obstructive

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8
Q

Atrial Septal Defect (ASD)

A

acyanotic

LUSB

EKG shows RVH

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9
Q

Ventricular Septal Defect (VSD)

A

acyanotic

LLSB, thrill

EKG shows LVH

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10
Q

When does PDA normally close in full term babies?

A

2 days to 2 weeks

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11
Q

What is the ductus arteriosus?

A

Vessel that goes from pulmonic artery to aorta that allows blood to go around the baby’s lungs before birth

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12
Q

Patent ductus arteriosus (PDA)

A

acyanotic

LUSB, “machinery” sound

EKG shows LVH

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13
Q

What is transposed in “The Transposition of the Great Vessels”?

A

Aorta comes from the right ventricle, and pulmonary artery comes from the left ventricle.

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14
Q

Transposition of the Great Vessels

A

cyanotic as soon as PDA closes

mirrors VSD (LLSB, thrill, EKG shows RVH)

X-ray shows “egg on a string”

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15
Q

What are the 4 defects of Tetralogy of Fallot?

A
  1. Ventral septal defect (VSD)
  2. Pulmonary artery stenosis
  3. Overriding aorta
  4. Right ventricular hypertrophy
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16
Q

Tetralogy of Fallot

A

cyanotic

systolic ejection click at M-LUSB

thrill at LLSB

EKG shows RVH

X-ray shows “boot shaped heart”

17
Q

“Tet spell”

A
  • related to Tetralogy of Fallot
  • hypercyanotic episode where child stops and squats to bring blood back to the brain
18
Q

Aortic stenosis

A

obstructive

ejection click and thrill at RUSB

EKG shows LVH

19
Q

Pulmonic stenosis

A

obstructive

LUSB ejection click with less intensity on inspiration

LUSB thrill that radiates to back and sides

EKG shows RVH

20
Q

Coarctation of the aorta

A

obstructive

ejection click at apex

EKG shows RVH progressing to LVH

X-ray shows “rib notching”

BP and pulse ox differs from upper to lower extremities

21
Q

What are some characteristics of innocent murmurs?

A

no associated signs/symptoms

low intensity (grades I-III of VI)

may change with position

no thrill or radiation

22
Q

Still’s murmur

A

innocent murmur

“musical” between LLSB and apex

23
Q

Venous Hum

A

innocent murmur

continuous humming at RUSB

  • heard best sitting, then disappears with laying or with turning head and compressing neck ipsilaterally
24
Q

Diagnosis of pediatric hypertension

A

SBP and/or DBP greater than 95th percentile measured on 3 separate occasions

25
Q

Rheumatic Fever

A

after group A strep infection

mitral valve is most commonly affected (permanent)

Jones Criteria

26
Q

Jones’ major and minor criteria

A
  • Major: carditis, polyarthritis, chorea, erythema marginatum (sandpaper rash), subcutaneous nodules
  • Minor: arthralgia, fever greater than 102.2, increased acute phase reactants, prolonged PR on EKG
27
Q

Lab diagnostics for rheumatic fever/heart disease

A

positive for strep, rising strep antibody (by titer), EKG, echo

28
Q

Kawasaki disease

A

life-threatening vasculitis, most common in Asian kids under 2 years old

can lead to coronary artery disease

29
Q

Diagnostic criteria for Kawasaki’s disease

A

FIERY- fever x5 days

C- conjunctival injection, bilateral, without exudate

R- rash, polymorphic

A- adenopathy, cervical

S- “strawberry tongue” and lips

H- hands with desquamation

30
Q

Lab diagnostics for Kawasaki disease

A
  • CBC
  • ESR, CRP
  • EKG changes (prolonged PR or QT)
31
Q

Management of Kawasaki disease

A

cardiology referral

high dose aspirin therapy (the only kids that ever get aspirin)

32
Q

Management of rheumatic fever

A

cardiology referral

aggressive treatment of strep infection

bed rest of acute carditis

33
Q

Levine Scale (Murmurs)

A

I. Very difficult to hear
II. Faint but audible
III. Easily audible, no thrill
IV. Thrill
V. Audible with only part of stethoscope touching chest, thrill
VI. Audible with stethoscope off the chest, thrill

AANP FNP: Pediatrics (18 decks)

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