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1. Disciplines 2 > Peds Cardiac > Flashcards

Peds Cardiac Flashcards

1
Q
  • Closure of AV valves
  • Mitral > Tricuspid
  • Apex or LLSB
A

S1 sound: systole

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2
Q
  • closure of semilunar valves
  • aortic > pulmonic
  • Base or LUSB
  • most important component
A

S2 Sound: end systole

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3
Q

What causes physiologic splitting of S2?

A

Respiratory inspiration

  • increase blood to R heart
  • increase blood into RV
  • delays emptying of RV
  • prolongs closure of S2
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4
Q

Widely split S2

A

electrical delay (RBBB)- VSD repair (TOF)

= inspiratory and expiratory split

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5
Q

Fixed split S2

A

volume overload (ASD) = inspiratory and expiratory split

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6
Q

Narrowed split S2

A

Pulmonary HTN (loud S2)

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7
Q

Paradoxical split S2

A

electrical delay (LBBB) =expiration only split

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8
Q

Single S2

A

complex heart defect (TGA) or Single ventricle defect (only 1 semilunar valve)

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9
Q
  • Low frequency sound in early diastole
  • Apex
  • from rapid ventricular filling/volume overload
  • common variant in children
A

S3

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10
Q
  • Low frequency sound in late diastole
  • Apex
  • Obstruction > decreased ventricular compliance
A

S4

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11
Q

Pulmonary stenosis:

what sound is heard?

Where?

change with respiration?

A
  • ejection click
  • LUSB
  • intensity change with expiration
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12
Q

Aortic stenosis:

what sound is heard?

Where?

change with respiration?

A
  • Ejection click
  • Apex (early systole)
  • no change w/ respiration
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13
Q

2 causes of friction rubs?

A
  • pericarditis
  • post pericardiotomy syndrome
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14
Q

How are pulses in Patent ductus arteriosus?

A

Increased in UE and LE

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15
Q

How are pulses in Aortic stenosis, HLHS?

A

Decreased weak, thready

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16
Q

How are pulses in pt w/ coarctation

A

UE > LE (LE= poor, absent, delay)

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17
Q

Is the BP in the legs normally lower or higher than it is in the arms?

A

Legs > arms

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18
Q

If you get a referral for HTN in a child, what do you need to first check?

A

where the BP was taken from if taken from the LE, it is higher

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19
Q

3 types of innocent heart murmurs

A
  • Stills murmur (systolic)
  • Venous Hum Murmur (continuous)
  • Peripheral pulmonary stenosis (systolic)
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20
Q

If a murmur radiates into the neck, what is causing the murmur?

A

aortic stenosis

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21
Q

If a murmur radiates into the back, what is causing the murmur?

A

pulmonary valve stenosis

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22
Q

If a murmur radiates into the axilla, what kind of murmur is it?

A

peripheral pulmonary murmur

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23
Q

When grading murmurs, what is the difference between 3/6 compared to 4/6?

A

3/6= loud w/o thrill

4/6= loud, w/ palpable thrill

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24
Q

Are diastolic or continuous heart murmurs considered innocent or pathologic?

A

pathologic

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25
In supine position: innocent heart murmur will? HCM murmur?
innocent= increase hypertrophic cardiomyopathy murmur= decrease
26
In sitting position: Venous hum murmur? Innocent heart murmur?
Venous hum murmur= increase Innocent heart murmur= decrease
27
In standing position: HCM murmur? Mitral valve prolapse? Aortic stenosis?
HCM murmur= increase Mitral valve prolapse= increase Aortic stenosis= decrease
28
W/ Valsalva: innocent heart murmur will? HCM murmur?
innocent heart murmur= decrease HCM murmur= increase
29
With standing and valsalva, decrease in all murmurs except??
hypertrophic cardiomyopathy mitral valve prolapse
30
MC innocent heart murmur (age 3-6)
Stills
31
describe what a Stills murmur sounds like
low frequency musical vibratory sound
32
describe what a venous hum murmur sounds like
continuous murmur (R \> L) diastolic louder than systolic
33
What is Acrocyanosis?
- benign varient - peripheral cyanosis - no central cyanosis - nl pulses - no pathological murmur =give reassurance
34
What does tachypnea in a newborn indicate?
L \> R shunt - PVR needs to fall (higher L \> R shunt) - CXR, wet lungs, large heart
35
What does cyanosis in a newborn indicate?
R\>L shunt or obstruction to lungs - "blue" \> cyanosis - low saturation - CXR "Low PBF"
36
what does "grey baby" indicate in a newborn?
decreased of no systemic blood flow - poor perfusion (no pulse, cap refill) - lactic acidosis
37
Acyanotic characteristics
- L \> R shunt - nl O2 sats - volume overload - cardiomegaly - increase PBF - "wet lungs" - enlarged pulmonary artery
38
What does atrial septal defect cause?
- R heart volume overload - fixed or widened S2 pulmonary component - LUSB -SOB, fatigue
39
What does ventricular septal defect cause?
- L heart volume overload - decrease PVR and size - harsh, holosystolic murmur LSB
40
What does patent ductus arteriosus cause?
- L heart volume overload - sx of heart failure - LUSB - continuous, machinery murmur
41
Characteristic of arterioventricular canal defect?
- heart volume overload - Trisomy 21 - increase pulmonary HTN - HF sx
42
Central Cyanosis Characteristics
- blue lips, tongue - low sats - congenital heart defect
43
What maintains patency of PDA (patent ductus arteriosus)?
prostaglandins
44
If there is an obstruction to pulmonary blood flow: - color? - sats? - CXR?
- cyanosis, hypoxia, blue - low sats - CXR: low PBF (black lungs)
45
If there is an obstruction to systemic blood flow: - color? - pulse? - CO?
- pale, poor color - poor cap refill - poor pulses - cardiac shock (low CO)
46
Pink baby and relation to PDA?
- normal \> normal heart - PDA closed
47
Blue baby and relation to PDA?
- clue to congenital heart defect - PDA closing
48
Grey baby and relation to PDA?
(no mixing of blood) - poor prognosis \> intracardiac shunt closed - need PGE to open PDA
49
Blue/Purple baby and relation to PDA?
(mixing of blood) - PDA patency open - palliation to provide PBF or systemic blood flow - sats 75-90%
50
What are the normal pre-ductal and post-ductal sats in pulse ox screen for congenital heart defects?
pre-ductal \> 95% post-ductal \> 95% =red blood mixing w/ blue blood
51
What are the pre-ductal and post-ductal sats in pulse ox screen for congenital heart defects for a baby w/ cyanosis?
pre-ductal (hands purple) ~94% post-ductal (feet blue) ~85-90% - blue blood mixing red blood - elevated pulmonary pressures or increased PVR
52
Cyanotic heart defects (5 T's)
1. Truncus arteriosus 2. Transposition of the great arteries (TGA) 3. Tricuspid Atresia (TA) 4. Tetrology of Fallot (TOF) 5. Total Anomalous of the Pulmonary Venous Return (TAPVR)
53
What heart defect is a/w DiGeorge syndrome?
Truncus arteriosus
54
What are TET Spells "Cyanotic spells"?
spasms of the RVOT infundibular muscle -fussy, cyanotic
55
Classic description of CXR for Total Anomalous of the Pulmonary Venous Return (TAPVR)
snowman
56
Classic description of CXR for Transposition of the great arteries (TGA)
egg on string
57
Classic description of CXR for Tetrology of Fallot (TOF)
boot shaped
58
The only CXR that allows you to make a diagnosis. What is the dx?
Ebsteins Anomaly
59
Bicuspid aortic valve causes?
aortic stenosis - systolic ejection murmus
60
Coarctation is a/w what syndrome?
Turners syndrome
61
According to the AHA recommendations, are EKG or echocardiogram recommended as part of cardiac sports screening?
NOPE
62
A murmur that is louder when standing and quieter when squatting= what until proven otherwise
Hypertrophic cardiomyopathy
63
- Aortic root dilation - aortic root rupture - mitral valve prolase these are all a/w what condition?
Marfan syndrome
64
QTc longer than ??? is considered Long QT Syndrome?
\> 460

1. Disciplines 2 (11 decks)

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