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PEDS final > Peds cardiology > Flashcards

Peds cardiology Flashcards

1
Q

what is the most common congential heart defect?

A

ventricular septal defect

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2
Q

murmur associated with ventricular septal defect

A

holosystolic

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3
Q

large ventricular septal defect present with

A
  • failure to thrive
  • tachypnea
  • hepatomegaly
  • GERD
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4
Q

what is the most common heart defect in Trisomy 21 (down syndrome)

A

ventricular septal defect

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5
Q

ventricular septal defect is what type of shunt

A

L to R shunt

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6
Q

medication based treatment of ventricular septal defect

A
  • diuretic
  • ACE inhibitor
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7
Q

what is the most common type of atrial septal defect

A

secundum ASD

  • failure of septum primum and septum secundum to overlap
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8
Q

atrial septal defect is what type of shunt? What changes are made to the heart because of it?

A
  • L to R shunt
  • enlarged RA, increased pulmonary flow
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9
Q

symptoms associated with atrial septal defect

A
  • usually asymptomatic, may have fatigue, palpitations, or exercise intolerance
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10
Q

what size of atrial septal defect usually close on thier own

A

< 8 mm

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11
Q

septation of the atrioventricular canal usually occurs when? How?

A

end of 4th week

  • superior and inferior cushions grow toward each other and eventually fuse seperating AV canal into a right and left channel
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12
Q

what is a complete atrioventricular septal defect

A
  • large VSD and ASD
  • common AV valve
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13
Q

what type of shunt is atrioventricular septal defect

A

L-R shunt

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14
Q

complete atrioventricular septal defect is repaired in infancy to prevent what

A

pulmonary vascular obstructive disease

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15
Q

What is a partial atrioventricular septal defect

A
  • Large ASD, no VSD
  • two seperate AV valves
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16
Q

repair of partial atrioventricular septal defect is usually delayed until

A

18-24 months old

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17
Q

patent ductus arteriosus is what type of shunt

A
  • L-R shunt (aorta to pulmonary artery)
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18
Q

medical treatment of patent ductus arteriosus

A
  • indomethacin
  • ibuprofen
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19
Q

surgical treatment of patent ductus arteriosus for premies

A

left thoracotomy: clip

20
Q

surgical treatment of patent ductus arteriosus for neonates, infants

A

left thoracotomy, ligate

21
Q

surgical treatment of patent ductus arteriosus for toddlers and older

A

left thoracotomy: divide and over sew

22
Q

catheter based treatment of patent ductus arteriosus

A

coil closure

23
Q

what is still’s murmur

A
  • innocent murmur
  • vibratory systolic LSB
  • decreases with expiration/standing
24
Q

physiologic peripheral pulmonic stenosis

A
  • innocent murmur
  • soft, harsh systolic ejection murmur
  • usually disappears by 12 months
25
Q

the 5T’s that causes cyanotic congenital heart defect

A
  • Truncus arteriosus
  • Transposition
  • Tricuspid Atresia
  • Tetralogy of Fallot
  • TAPVR: total anomalous pulmonary venous return
26
Q

cyanotic CHD are due to R to L shunt. Name the 2 broad categories

A
  • intracardiac defects and obstruction to pulmonary flow
    • mixing fo oxygenated and deoxygenated blood
  • admixture of pulmonary and system venous return
    • single chamber recieves total systemic and pulmonary venous return
27
Q

Name the three CHD that fall into the intracardiac defects and obstruction to pulmonary flow catagory

A
  1. tetralogy of fallot
  2. tricuspid atresia
  3. pulmonary atresia
28
Q

tetralogy of fallot presents with what 4 abnormalities

A
  • right ventricular outflow tract obstruction
  • VSD
  • overriding aorta
  • right ventricular hypertrophy
29
Q

tet spell hyper-cyanotic spell seen in tetralogy of fallot is precipitated by what 3 factors

A
  1. dehydration - decreased heart volume
  2. anesthesia - vasodilation
  3. crying
30
Q

tet spell hyper-cyanotic spell seen in tetralogy of fallot is relieved by

A
  1. squatting (baby increases SVR to force more blood flow through pulm artery)
  2. volume resuscitation
  3. administer vasoconstrictors
31
Q

truncus arteriosus

A
  • a single blood vessel (truncus arteriosus) comes out of the right and left ventricles, instead of the normal two vessels (pulmonary artery and aorta
  • have large VSD
32
Q

babies with truncus arteriosus commonly have what gene mutation

A

22q11 deletion (DiGeorge)

33
Q

repair for truncus arteriosus

A
  • VSD closure
  • RV-PA conduit
  • usually operate in first two weeks of life
34
Q

if baby is blue, what medication should be given

A

prostaglandins

35
Q

Transposition of great vessels

A
  • cyanotic
  • the aorta and the pulmonary artery are switched
36
Q

treatment of Transposition of great vessels

A
  1. prostaglandins to keep ductus open
  2. BAS: balloon atrial septostomy
  3. arterial switch operation
37
Q

Total Anomalous Pulmonary Venous Return: supracardiac

A

pulmonary vein to Brachiocephalic vein (25-50% can be obstructed)

38
Q

Total Anomalous Pulmonary Venous Return

A

child’s pulmonary veins don’t connect normally to the left atrium. Instead they’re re-directed to the right atrium by way of an abnormal (anomalous) connection

39
Q

Total Anomalous Pulmonary Venous Return: cardiac

A
  • pulmonary vein to coronary sinus
40
Q

Total anomalous pulmonary venous connection: infracardiac

A
  • pulmonary vein drains via descending vein into liver
  • usually obstructed
  • presents: very sick with wet lungs, cyanotic, pulmonary hypertension
  • emergency/urgent repair
41
Q

unexplained HTN in children could be a result of

A

coarctation of aorta

42
Q

coarctation of aorta

A

is a narrowing of the aorta, the large blood vessel that branches off your heart and delivers oxygen-rich blood to your body. When this occurs, your heart must pump harder to force blood through the narrow part of your aorta.

43
Q

coarctation of aorta is associated with what genetic condition

A

turners syndrome

44
Q

CXR findings with coarctation of aorta

A
  • cardiomegaly
  • rib-notching- takes several years to develop
45
Q

gold standard to diagnosis coarctation of aorta

A

CT-angio or MRA

46
Q

list acyantoic congential heart defects

A
  1. VSD
  2. ASD
  3. atrio-ventricular canal
  4. patent ductus arteriosis
  5. coarctation of aorta

PEDS final (3 decks)

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