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DRT PEDS > Pediatrics Cardiovascular > Flashcards

Pediatrics Cardiovascular Flashcards

1
Q

S1 is?

A

Lub sound
small valves close
Mitral/Tricuspid (AV) valves close

Aortic/ pulmonic (semilunar) valve open

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2
Q

S2 is?

A

Dub sound
large valves closeAortic/ pulmonic (semilunar) valves close

Mitral/Tricuspid (AV) valves open

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3
Q

S3

A

Kentucky sound

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4
Q

S4

A

not usual sound
-further investigation needed

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5
Q

Auscultation Areas

A

Aortic: RUSB
Pulmonic: LUSB
Aortic/ Mitral: Erbs points/ 3rd intercostal space
Ventricular Septal defect or tricuspid: LLSB

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6
Q

Murmur loudness scale

A

grades
1- soft, barely audible
2-clearly audible but faint
3-MODERATELY LOUD
4-loud w/ thrill
5-Loud, heard w/ part stethoscope on chest and thrill palpable
6-Very loud, heard W/OUT stethoscope, thrill palpable and visible

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7
Q

Most common of all congenital heart defects?

A

Ventral Septal defect (VSD)
-THRILL
-LLSB

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8
Q

Types of Herat defects in pediatrics

A

-Acyanotic (left to right shunting)
-Cyanotic (right to left shunting)
-obstructive lesions

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9
Q

Types of Acyanotic Defects

A

ASD
VSD
PDA

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10
Q

Atrial Septal Defect (ASD)

A

Acyanotic Septal Defect
left to right shunting

-LUSB
-some small ASDs close w/out intervention
-medium to large require sx intervention

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11
Q

Ventricular Septal Defect (VSD)

A

Acyanotic Septal Defect
left to right shunting

-ThriLL=LLSB

-a holosystolic thrill may be felt at LLSB

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12
Q

Patent Ductus Arteriosus (PDA)

A

Acyanotic Septal Defect
left to right shunting

PDA = PREMATURE DUCTUS ARTERIOSUS
-PDA usually closes right by delivery, so premies are at high risk

Murmus: LUSB
grade 2 II to IV holosystolic
-“machinery” sound

-for premature. infants, prostaglandin. inhibitors (ibuprofen, indomethacin)

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13
Q

Transposition of the Great Arteries

A

Cyanotic Defects
(right to left shunting)

XR shows “egg on a string”, w/ cardiomegaly and increased pulmonary vascular markings

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14
Q

Tetralogy of Fallot

A

Cyanotic Defects
(right to left shunting)

Four Defects
1-large VSD
2-Pulmonary Stenosis
3-Overriding Aorta
4-RVH

-Murmur: loud systolic ejection click
-heard middle and upper left sternal border M-LUSB

XR- boot shaped heart

tet spells- child running and then squats=increases vascular resistence

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15
Q

Obstructive Lesion for heart defects in pediatics

A

Aortic Stenosis
Pulmonic Stenosis
Coarctation of the Aorta

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16
Q

Aortic Stenosis

A

Obstructive Lesion
-murmur, systolic thrill at RUSB
-systolic ejection click that does not vary with respirations

17
Q

Pulmonic Stenosis

A

Obstruction Lesion

-Murmur loudest at LUSB
Intensity of ejection click decreases with inspiration and increases with expiration

18
Q

Coarctation of the aorta

A

Obstruction Lesion
*Trisomy 21

Cardinal sign: decreased of absent pulses
BP in lower extremities will by lower than upper extremities

-may have ejection click at apex and RUSB if bicuspid valve is involved

19
Q

DiGeorge Syndrome and which heart defect?

A

Aortic Arch anomalies

20
Q

Trisomy conditions and which heart defect?

A

Trisomy 18/ Edwards
Trisomy 21/ Down syndrome

Atrioventricular septal defect, VSD

21
Q

Marfans syndrome and which heart defect?

A

Aortic root disease
mitral valve prolapse

*give Beta Blocker to prevent aneurysm rupture

22
Q

Turner Syndrome and which Heart defect?

A

Coarctation of the aorta
bicuspid aortic valve

23
Q

innocent murmurs?

A

a.k.a functional murmurs/ benign murmurs/ physiological murmurs

-no associate symptoms
-thin chest wall
-no radiation to neck/back/ axilla

24
Q

Most common innocent murmur

A

Stills Murmur
*musical systolic/ vibratory murmur
-heard LLSB and apex
-loudest when supine
-d/t turbulence in left ventricular outflow tract

25
Q

Venous hum.

A

continuous humming murmur
-RUSB
*obliterated by turning head and/ or compressing neck ipsilaterally

26
Q

S/S of Heart Failure in Pediatrics

A

Infant/ very young
*poor feedings/ prolonged feeding
*lethargy or irritabilty
- chronic cough

Older child/ adolescent
*exercise intolerance
*Abdominal pain
*chest pain
*Syncope
-jugular vein distention

27
Q

HTN in pediatrics

A

-Persistent elevation of systolic/ diastolic BP on *at least three separate occasion

S/S
-HA
-Visual Problems
-Dizziness
-Resp distress
-irritability
-nosebleeds
*S4 may be present
*peripheral edema may be present

28
Q

Rheumatic Fever/ Heart Disease in. pediatrics

A

Post infectious inflammatory disease, that affects heart, joints, and CNS

-follows a group “A” beta-hemolytic streptococcus (GABHS)
*Mitral valve is most commonly affected

29
Q

S/S to Diagnose Rheumatic Fever

A

Jones Criteria
-plus 2 major or
-one major and two minor

Major:
Carditis
Polyarthritiis
Chorea
Erythema Marginatum
Subcutaneous Nodules

Minor”
Arthralgia w/out objective. inflmmation
fever>102.2F (39C)
Elevated levels of acute phase reactants (ESR/CRP)
Prolonged PR interval on EKG w/ GABHS infections

30
Q

Acute febrile syndrome causing vasculitis

A

Kawasaki Disease

31
Q

Diagnostic criteria for Kawasaki Disease

A

Patient must have fever and at least four other
1-fever for at least 5 days
*fever has 5 letters = 5 days
2-bright conjunctival injection w/ out exudate
*bright red eyes
3-Polymorphous rash (urticarial or pruritic)
4-Inflammatory changes in lips and oral cavity
*peeling lips
5- changes in extremities
*erythema of palms/soles, edema, peeling skin
6-cervical lymphadenopathy

32
Q

How to manage Kawasaki Disease

A

-Immediately Cardio referral

-IVIG 2g/kg as a single infusion over 10-12hours
-*high-dose ASA therapy (worried about coagulopathy, usually no ASA w/ kids bc it can cause Reys Syndrome)

-ASA- 80-100mg/kg/day until afebrile for 48hours
then lower ASA dose 3-5mg/kg/day for anti platelet response
-D/C ASA therapy with Cardiologist collaboration

DRT PEDS (11 decks)

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