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CPR Exam 1 > Pediatric Cardiology > Flashcards

Pediatric Cardiology Flashcards

1
Q

what is the most common isolated birth defect in newborns?

A

cardiac structural defects

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2
Q

what maternal factors put the baby at risk for cardiac defects?

A

family hx of CHD
maternal diabetes
maternal teratogen exposure (alcohol, dilantin, rubella)

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3
Q

what chromosomal abnormalities are at higher risk for CHD?

A

Trisomy 21
Trisomy 18
DiGeorge Syndrome
Turner Syndrome

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4
Q

when a baby is diagnosed with a CHD, what should the next step be?

A

check chromosomes

look for other dysmorphic features or congenital abnormalities (possible syndrome)

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5
Q

what are the left-to-right shunt defects?

A

VSD
ASD
PDA

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6
Q

what are the right-to-left shunt defects?

A

pulmonary atresia

tricuspid atresia

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7
Q

what are the obstructive defects?

A

pulmonary stenosis

aortic stenosis

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8
Q

what are the mixed defects?

A

ToF
Ebstein’s anomaly of the tricuspid valve
hypoplastic left heart syndrome

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9
Q

what are the “innocent murmurs”?

A

Stills murmur
pulmonary flow murmur
venous hum
carotid bruit

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10
Q

what is the presentation of an ASD?

A

RA and RV enlargement
pulmonary over-circulation –> pulm HTN
usually asymptomatic

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11
Q

what is heard on auscultation with ASD?

A

Grade 2-3 systolic ejection murmur
heard best at LUSB
wide fixed split S2
may have grade 1 or 2 diastolic flow murmur at LLSB

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12
Q

what is the presentation of VSD?

A

surgical repair required if hemodynamically significant
smaller defects are louder and harsher
can cause CHF
may close spontaneously

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13
Q

what is heard on auscultation with VSD?

A

grade 2-5 holosystolic murmur at LLSB

thrill at LLSB

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14
Q

what is the presentation of PDA?

A

possibly asymptomatic

may cause fatigue, CHF and resp symptoms

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15
Q

what is heard on auscultation with PDA?

A

continuous murmur
crescendo-decrescendo
grade 1-5
normal S1 and S2 may be buried in the murmur

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16
Q

what is the presentation of tricuspid atresia?

A

single LV
pulmonary flow restricted
obligate ASD and VSD
early onset cyanosis or CHF

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17
Q

what is heard on auscultation with tricuspid atresia?

A

holosystolic murmur at LLSB or midsternal border

murmur may be absent

18
Q

what is the presentation of pulmonary atresia?

A

obligate ASD and VSD

PDA dependent until flow can be established

19
Q

what is the presentation of aortic stenosis?

A

dyspnea, fatigue, syncope
can develop CHF
sudden death may occur

20
Q

what is heard on auscultation with aortic stenosis?

A

systolic ejection murmur at RUSB
grade 2-5
radiates to carotids
thrill at ULSB or suprasternal notch with grade 4

21
Q

what is the presentation of pulmonary stenosis?

A

usually asymptomatic

may have sx of pulmonary congestion

22
Q

what is heard on auscultation with pulmonary stenosis?

A

systolic ejection murmur at LUSB
grade 2-5
radiates to axilla
systolic ejection click may be heard at LSB

23
Q

what is the presentation of Tetralogy of Fallot?

A

VSD
overriding aorta
RVH
pulmonic valve stenosis

24
Q

what is heard on auscultation with ToF?

A

grade 3-4 long systolic ejection murmur at LUSB
may have holosystolic murmur at LLSB
systolic thrill at LUSB if 4/6
single S2

25
Q

what is Ebstein’s anomaly?

A 
displaced, leaking tricuspid valve
small RV
enlarged RA
ASD
PDA
26
Q

what is hypoplastic left heart syndrome?

A

underdeveloped LV
underdeveloped aorta
ASD
PDA

27
Q

what are the staged surgeries for hypoplastic left heart syndrome?

A
  1. Norwood procedure: new aorta + BT shunt
  2. Bidirectional Glenn procedure; redirection of blood, BT shunt removed, ASD patched
  3. Fontan procedure: ASD patch removed, baffle build in R atrium with small hole
28
Q

what is a still’s murmur?

A

low-pitched “musical”
LSB or between apex and LLSB
normal S2

29
Q

what is a pulmonic flow murmur?

A

mid-frequency
LUSB
normal S2

30
Q

what is a venous hum?

A

continuous, high frequency
loudest while sitting/standing
heard around clavicle/base of neck
goes away when supine

31
Q

who should receive a complete cardiac exam?

A

any child w/ murmur

infant features of CHD:
FTT
cyanosis
feeding intolerance
respiratory sx
child features of CHD:
CP on exertion
syncope
exercise intolerance
fam hx of sudden death in young people
32
Q

what is a complete cardiac exam?

A 
vitals
pulses
perfusion
precordial inspection/palpation
auscultation
33
Q

is splitting of heart sounds normal?

A

yes
S1 split in 40-70% of people
S2 split with inspiration

34
Q

is a fixed S2 split normal?

A

no - indicative of ASD

35
Q

you are examining a child for suspected CHD, when auscultating, their murmur increases in intensity when standing and again when they cough. what is your diagnosis?

A

hypertrophic cardiomyopathy

36
Q

what will you hear at the RUSB?

A

aortic stenosis

venous hum

37
Q

what will you hear at the LUSB?

A

pulm stenosis
pulm flow murmurs
ASD
PDA

38
Q

what will you hear at LLSB?

A 
Still's murmur
VSD
tricuspid valve regurgitation
hypertrophic cardiomyopathy
subaortic stenosis
39
Q

what will you hear at the apex?

A

mitral valve regurgitation

40
Q

what are the 7 S’s of innocent murmurs?

A 
sensitive - change with position or respiration
short duration
single
small
soft
sweet
systolic
41
Q

when should you refer to a cardiologist?

A 
grade 4 murmur or above
diastolic murmur
increased intensity with standing
symptomatic murmur
obscure heart sounds
weak femoral pulses
clicks
hyperactive precordium
hx of sudden death
42
Q

what are the 5 cyanotic congenital heart defects?

A

One big trunk: truncus arteriosus
Two interchanged vessels: transposition of great vessels
Three: tricuspid atresia
Four: Tetralogy of Fallot
Five words: Total Anomalous Pulmonary Venous Return

CPR Exam 1 (19 decks)

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