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CORE > Peds Cardiac > Flashcards

Peds Cardiac Flashcards

1
Q

congenital heart dz –> CXR –> eval which structures? (2)

A
  • pulm vasculature

- heart size

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2
Q

congenital heart dz –> CXR –> eval pulm vasc –> 3 types?

A
  • increased pulm venous flow
  • increased arterial flow
  • decreased arterial flow
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3
Q

congenital heart dz –> CXR –> pulm vasc –> increased pulm venous flow –> imaging appearance?

A

peripheral 1/3 –> indistinct vessels & septal markings

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4
Q

congenital heart dz –> CXR –> pulm vasc –> increased pulm venous flow –> can be seen in what conditions? (4)

A
  • hypoplastic L heart
  • aortic coarctation
  • congestive heart failure
  • neonatal sepsis
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5
Q

congenital heart dz –> CXR –> pulm vasc –> increased arterial flow –> imaging appearance?

A

peripheral 1/3 –> distinct lrg-caliber vessels

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6
Q

congenital heart dz –> CXR –> pulm vasc –> increased pulm arterial flow –> can be seen in what conditions? (4)

A

L-to-R shunt:

  • atrial septal defect
  • VSD
  • patent ductus arteriosus
  • endocardial cushion defect (AV canal defect)
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7
Q

congenital heart dz –> CXR –> pulm vasc –> decreased arterial flow –> imaging appearance?

A

peripheral 1/3 –> decreased vasculature

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8
Q

congenital heart dz –> CXR –> pulm vasc –> decreased pulm arterial flow –> can be seen in what conditions? (2)

A

RV outflow tract insuff:

  • Tetralogy of Fallot
  • Ebstein anomaly
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9
Q

increased pulm venous flow –> aka?

A

pulm edema

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10
Q

extra-cardiac AV shunt –> 2 examples? (2)

A
  • vein of Galen malformation

- infantile hepatic hemangioma

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11
Q

neonatal CHF –> etiology? (2)

A
  • primary cardiac anomaly

- extra-cardiac arteriovenous shunt

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12
Q

endocardial cushion defect (AV canal defect) –> assoc synd? (1)

A

Down synd

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13
Q

congenital heart dz:

  • increased pulm venous flow
  • increased arterial flow
  • decreased arterial flow

cyanotic vs acyanotic?

A
  • increased pulm venous flow: acyanotic
  • increased arterial flow: acyantoic
  • decreased arterial flow: cyantoic
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14
Q

congenital heart disease:

  • decreased pulm vasc
  • cardiomeg

what condition? (2)

A
  • Ebstein anomaly

- pulm atresia w intact septum

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15
Q

congenital heart disease:

  • decreased pulm vasc
  • normal heart size

what condition?

A

Tetralogy of Fallot

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16
Q

congenital heart disease:

  • increased pulm vasc
  • normal heart size

what condition? (5)

A

5 Ts:

  • transposition of great arteries
  • truncus arteriosus
  • tricuspid atresia
  • total anomalous pulm venous return (TAPVR)
  • single ventricle
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17
Q

hypoplastic L heart –> spectrum of anomalies –> which L heart struct can be involved? (5)

A
  • LA
  • LV
  • mitral valve
  • aortic valve
  • aorta
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18
Q

hypoplastic L heart –> fatal –> unless have what condition?

A

R-to-L shunt:

  • patent ductus arteriosus
  • ASD
  • patent foramen ovale
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19
Q

what is ductus arteriosus? natural progression after birth?

A

short connection bw proximal left pulmonary artery and aortic arch –> blood bypass the non-ventilated lungs in the fetus

after birth –> decrease prostaglandins & decrease pulm art pressure –> ductus close 2 days after birth –> blood into pulm vasculature –> ligamentum arteriosum

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20
Q

hypoplastic L heart –> tx?

A

Norwood procedure

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21
Q

what is Blalock-Taussig shunt?

A

graft –> connect R subclavian A –> R pulm A

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22
Q

what is bidirectional Glenn shunt?

A

SVC connect to R pulm A

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23
Q

what is modified Fontan?

A

tunneled conduit –> connect IVC –> pulm A

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24
Q

neonatal CHF –> 2 MCC?

A
  • vein of Galen malformation

- hepatic hemangioendothelioma

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25
Q

ASD –> RtoL or LtoR shunt?

A

L-to-R

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26
Q

ASD –> when present?

A

later childhood - early adult

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27
Q

ASD –> assoc condition? (1)

A

Holt-Oram synd

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28
Q

Holt-Oram synd –> synd? (2)

A
  • ASD

- UE bone deformity (ie absence/hypoplasia thumb)

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29
Q

ASD –> MC type? MOA?

A

ostium secundum

septum secundum –> incompletely cover ostium secundum

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30
Q

ASD –> 2nd MC type? MOA?

A

ostium primum

septum primum –> incompletely fuse to endocardial cushion

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31
Q

sinus venosus ASD –> assoc condition?

A

anomalous pulm venous drainage

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32
Q

ASD –> what structure(s) is enlarged?

A

RA –> RV –> pulm A

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33
Q

VSD –> when present?

A

1mo

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34
Q

VSD –> 2 types of location?

A
  • # 1 membranous

- muscular IV septum

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35
Q

VSD –> possible complication?

A

Eisenmenger synd

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36
Q

what is Eisenmenger synd?

A

pulm HTN –> reversal of shunt direction

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37
Q

VSD –> R or L heart is enlarged?

A

L

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38
Q

PDA –> classic clinical presentation?

A

premature –> 7-10 days of life –> CXR show CHF

39
Q

endocardial cushion defect –> spectrum of anomalies –> such as? (4)

A
  • ostium primum ASD
  • VSD
  • mitral anomaly
  • tricuspid anomaly
40
Q

endocardial cushion defect –> assoc condition?

A

trisomy 21

41
Q

what is Ebstein anomaly?

A

tricuspid valve –> severe malformation –> leaflets displaced apically –> obstruct pulm valve –> RV outflow tract obstruction –> atrialization of RV

42
Q

Ebstein anomaly –> what concurrent condition 100%?

43
Q

Ebstein anomaly –> CXR appearance?

A
  • huge heart –> enlrg RA –> “box shape”

- decreased pulm vasc

44
Q

CXR –> massive R atrial enlrg & decreased pulm vasc –> ddx? (2)

A
  • Ebstein anomaly

- pulm atresia w intact ventricular septum

45
Q

pulm atresia w intact ventricular septum –> what happens to…

  • RA
  • RV
  • pulm valve
A
  • RA: enlrg
  • RV: hypoplasia
  • pulm valve: atretic
46
Q

pulm atresia w intact ventricular septum –> how get pulm blood flow?

A

L-to-R shunt must be present (ie PDA)

47
Q

Tetralogy of Fallot –> 4 components?

A
  • pulm valve stenosis –> RV outflow tract obstruction
  • RV hypertrophy
  • VSD
  • aorta override VSD
48
Q

what is pentalogy of Fallot?

A

tetralogy of fallot + ASD

49
Q

pediatric –> MC cyanotic heart dz?

50
Q

adult –> MC cyanotic heart dz?

51
Q

Tetralogy of Fallot –> assoc synd? (3)

A
  • DiGeorge synd
  • VACTERL
  • trisomy 21
52
Q

DiGeorge synd –> synd? (3)

A
  • ToF
  • absent thymus
  • absent parathyroid
53
Q

Tetralogy of Fallot –> CXR appearance?

A
  • normal size heart –> RV hypertrophy –> cardiac apex uplifted –> “boot shape”
  • decreased pulm vasc
54
Q

Tetralogy of Fallot –> 25% have what other condition?

A

R aortic arch

55
Q

Tetralogy of Fallot –> severe form?

A

pulm atresia w VSD

56
Q

Tetralogy of Fallot –> tx?

A

surg:
- close VSD
- open RV outflow obstruct

57
Q

newborn –> MC cyanotic heart dz?

A

transposition of great A

58
Q

what is transposition of great A?

A
  • RV –> aorta

- LV –> pulm A

59
Q

transposition of great A –> what is required for survival?

A

site for blood mixture –> ie ASD, VSD, PDA, LtoR shunt)

60
Q

transposition of great A –> US findings? (2)

A
  • aorta ant to heart

- great vessels exit heart in parallel (rather than cross)

61
Q

transposition of great A –> classic CXR finding? actual typical appearance?

A

classic: heart & narrow mediastinum –> “egg on a string”

typical:
- slightly narrow mediastinum
- increased pulm vasc

62
Q

transposition of great A –> why mediastinum narrow on CXR?

A
  • parallel config of great vessels
  • thymus involute d/t stress
  • lack of main pulm bulge
63
Q

transposition of great A –> tx?

A

Jatene procedure –> arterial switch

64
Q

tricuspid atresia + small VSD –> CXR appearance?

A
  • normal heart

- decreased pulm vasc

65
Q

tricuspid atresia + lrgVSD –> CXR appearance?

A
  • lrg heart

- increased pulm flow

66
Q

MC congenital heart dz w right arch?

A

truncus arteriosus

67
Q

what is truncus arteriosus?

A

single great art –> supplies:

  • systemic
  • pulm
  • coronary

overrides a VSD

68
Q

truncus arteriosus –> CXR appearance?

A
  • cardiomeg
  • narrow mediastinum
  • pulm edema
69
Q

what is total anomalous pulm venous return (TAPVR)?

A

pulm veins go to systemic venous circ instead of LA

70
Q

TAPVR –> types? (4)

A
  • supracardiac: L brachiocephalic V
  • cardiac: coronary sinus or RA
  • infracardiac: hepatic IVC/portal/hepatic V
  • mixed: combo of above
71
Q

TAPVR –> MC type?

A

supracardiac

72
Q

supracardiac TAPVR –> classic CXR finding?

A

snowman sign

73
Q

TAPVR –> typical CXR appearance?

A
  • normal heart

- pulm edema

74
Q

TAPVR –> what must be present for blood to reach L heart?

A

interatrial R-L comm –> ASD

75
Q

aortic coarctation –> locations? (3)

A
  • preductal
  • periductal
  • postductal
76
Q

aortic coarctation –> when present?

  • preductal
  • periductal
  • postductal
A
  • preductal: infant
  • periductal: teen-early adult
  • postductal: teen-early adult
77
Q

aortic coarctation –> assoc condition?

A

bicuspid aortic valve

78
Q

aortic coarctation –> assoc synd?

A

Turner synd

79
Q

aortic coarctation –> classic CXR finding in adult?

80
Q

tuberous sclerosis –> earliest sign in utero?

A

cardiac rhabdomyoma

81
Q

MC cardiac tumor?

A

rhabdomyoma

82
Q

pediatric cardiac tumors? (4)

A
  • rhabdomyoma
  • teratoma
  • fibroma
  • hemangioma
83
Q

2nd MC cardiac tumor detected in utero?

84
Q

cardiac teratoma –> MC location?

A

root of pulm A & aorta

85
Q

pericardial teratoma –> potential complication?

A

massive perinatal pericardial effusion

86
Q

cardiac fibroma –> MC location?

87
Q

cardiac hemangioma –> potential complication?

A

massive pericardial effusion

88
Q

asplenia –> type of heterotaxy?

A

R-sided isomerism

89
Q

polysplenia –> type of heterotaxy?

A

L-sided isomerism

90
Q

Kawasaki dz –> acute phase –> what conditions are seen? (2)

A
  • myocarditis

- heart fail

91
Q

Kawasaki dz –> subacute phase –> what conditions are seen? (2)

A

coronary A aneurysm –> thrombus

92
Q

hypoplastic L heart –> CXR findings?

A
  • normal heart or cardiomeg

- pulm edema

93
Q

transposition of great arteries –> D vs L?

A

D:

  • deoxy: RA –> RV –> aorta
  • oxy: LA –> LV –> pulm A

L: (congenitally corrected)

  • deoxy: RA –> LV –> pulm A
  • oxy: LA –> RV –> aorta

CORE (33 decks)

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