Peds 2 part 2 Flashcards
Neonates with EA and TEF commonly have VACTERL syndrome. What is VACTERL?
Vertebral anomalies Anal atresia Cardiac involvement TracheoEsophageal fistula Renal malformations Limb malformations
Type C is the most common TEF (90%). What occurs in type C?
- esophagus ends in blind pouch
- distal esophagus forms a fistula w the trachea, usually above the carina
in EA and TEF, how should the bevel of the ETT be turned?
It should be turned anteriorly to allow the posterior surface of the ETT to occlude the fistula
What side are most congenital diaphragmatic hernia defects on?
Left-sided
The ipsilateral lung is affected the most.
When abdominal contents are in the abdominal space, which way are the cardiac shunts?
They can be right to left, left to right, or bidirectional
what are the signs of a congenital diaphragmatic hernia?
- dyspnea
- tachypena
- cyanosis
- absence of breath sounds on the affected side
- severe retractions
- scaphoid abdomen (sunken)
- barrel chest
cyanotic lesions
right to left shunt
- hypoplastic left heart syndrome
- pulmonary stenosis
- transposition of the great arteries
- tetralogy of fallout
- tricuspid atresia
- pulmonary atresia with intact ventricular septum
cyanotic
left to right shunt
VSD ASD AS CoA PDA complete common AV canal (CCAVC)
What happens over time if a VSD is not treated?
CHF
can be treated with dig, duirectics, and an ACE inhibitor while awaiting closure
ASDs are generally asymptomatic but if left unprepared
paradoxical emboli decompression sickness migraines pulmonary HTN increased risk of meningitis
complete common atrioventricular Canal (CCAVC)
-almost always occurs w trisomy 21
-ASD and VSD
L to R shunt at atrial and ventricular levels
-CHF in early infancy
-pulm HTN can develop
what treatment triggers the PDA to constrict and close?
indomethacin.
-usually does not work in full term infants.
what does ligation mean?
to TIE not sever. so a PDA ligation is to connect the two ends together
neonate with critical AS relies on ____ for systemic blood flow.
PDA. If it closes, circulatory shock will occur.
What is a ROSS procedure?
when the child’s own pulmonary valve is moved into the aortic position, a right ventricle to pulmonary artery homograft conduit is placed, and coronary arteries are reimplanted. (for severe AS)
