Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Mid Comp > Peds & CV > Flashcards

Peds & CV Flashcards

1
Q

The Cyanotic defects

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pulmonary flow with acyanotic vs cyanotic lesions

A

acyanotic (L→R) increased pulmonary blood flow

acyanotic (R→L) = decreased pulmonary blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

most common congenital defect in children

A

VSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tetralogy of Fallot

A
  • RV outflow obstruction [pulmonary stenosis]
  • right ventricular hypertrophy
  • overriding aorta
  • VSD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Complex Shunts

A

mixing of pulmonary and systemic blood flow with cyanosis

  • Transposition of the great arteries
  • Truncus arteriosus
  • Total anomalous pulmonary venous connection (TAPVR)
  • Double outlet right ventricle
  • Hypoplastic left heart syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Only true neonatal surgical emergency

A

Total anomalous pulmonary venous connection (TAPVR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Total anomalous pulmonary venous connection (TAPVR

A

All 4 pulmonary veins drain into RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Transposition of the great arteries

A

Deoxygenated blood circ through systemic

Oxygenated blood circ through pulmonary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hypoplastic left heart syndrome

A
  • Left ventricle is small or absent
  • Mitral and aortic valves are small or absent
  • Ascending aorta is small
  • Often an atrial septal defect (ASD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Diaphragmatic hernia
most cases develop like this…

A

a portion of the posterior diaphragm fails to close on the left = triangular defect, foramen of Bochdalek

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do Hernias through the Foramen of Bochdalek affect respiratory status and anesthesia care?

A

those occurring early in fetal life usually cause respiratory failure immediately after birth d/t pulmonary hypoplasia

avoid BMV – immediate ETT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

foramen of Bochdalek
vs.
Tracheoesophageal fistula

airway considerations

A

foramen of Bochdalek- do not mask; ETT right away

TEF- Avoid masking and ETT (may worsen gastric distention & further compromise respirations)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

TEF:
Atresia v. Fistula
clinical signs

A
  • Atresia: Drooling and occasional aspiration
  • Fistula: Choking with feeding; possible breathing problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

TEF

Where is the fistula usually located?

A

one to two tracheal rings above the carina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

TEF is usually a/w this condition

A

VACTERL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

VACTERL

A

vertebral, anorectal, cardiac, tracheal, esophageal, renal, and/or limb defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What confirms a TEF?

A

OG tube cannot be advanced more than ~7cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pyloric Stenosis

A

hypertrophy and hyperplasia of the muscularis layer of the pylorus (sphincter muscle) = gastric outlet obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pyloric Stenosis
and Acid/Base Balance

A
  • hypoK, hypoCl metabolic alkalosis
  • severe cases may progress to a metabolic acidosis
  • kidneys pH compensate by excreting bicarb
  • kidneys also excrete H and K, while retaining Na to maintain euvolemia and charge neutrality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Gastroschisis results from….

A

occlusion of the omphalomesenteric artery during gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

T/F:
Gastroschisis is commonly a/w VACTERL syndrome.

A

False
Gastroschisis is usually not a/w other congential issues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Gastroschisis
how is the bowel affected?

A
  • herniated viscera and intestines are periumbilical, usually on the right
  • exposed to amniotic fluid in utero and to air after delivery
  • inflammation
  • edema, and dilated
  • foreshortened
  • functionally abnormal bowel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Infant vs Adult
Epiglottis

A

infant: narrow, omega shaped, and angled away from tracheal axis

adult: flat, broad, axis is parallel to the trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Peds Suxx dosing
1-2 mg/kg IV 4-5 mg/kg IM
26
Pros and Cons to giving NonDNMB before Suxx
may minimize increase in ICP (which is minimal) but this may make succinylcholine less effective, even if succinylcholine dose is increased
27
Succinylcholine is contraindicated when it may induce life-threatening hyperkalemia in these conditions...
* severe head trauma * crush injury * burns * spinal cord dysfunction * encephalitis * multiple sclerosis * muscular dystrophies * stroke * tetanus
28
Suxx has no impact on the serum potassium concentration in children with ____
cerebral palsy
29
Your pt with aortic stenosis has converted from sinus to AFIB with RVR. Wyd?
immediate cardioversion ## Footnote Loss of a normally timed atrial systole often leads to rapid deterioration, esp with tachycardia. This combo seriously impairs ventricular filling and necessitates immediate cardioversion.
30
Many aortic stenosis pts behave as though they have a fixed ____ despite adequate hydration. Thus, cardiac output becomes....
stroke volume very rate dependent
31
Aortic Stenosis Goal HR
60-90 Avoid <50
32
Aortic stenosis critical vs normal valve area
0.5-0.7 cm2 normal: 2.5–3.5
33
Hallmark S/S of aortic stenosis
**SAD** Syncope, angina, dyspnea on exertion
34
Aortic Stenosis may acquire this blood dyscrasia
vWd if von willebrand molecule gets damaged passing through stenotic valve
35
How does the art line waveform change in aortic stenosis?
* pulsus tardus: slower systolic upstroke w/ delayed peak * SV is reduced – narrow PP w/ small amplitude * Dicrotic notch may be absent (looks dampened)
36
Atrial kick is ___% of CO
20-30%
37
Coronary perfusion pressure =...
aortic DBP - LVEDP
38
DBP = pressure on loop where ...
aortic valve opens
39
Coronary flow is ___% of CO and can autoregulate within a MAP of...
4-5% 60-140
40
Law of Laplace -principle -equation
* how afterload affects myocardial wall stress * thicker wall = less wall stress
41
most common surgeries that trigger the baroreceptor reflex
Carotid endarterectomy & mediastinoscopy
42
What senses BP changes centrally and peripherally?
centrally: hypothalamus and brainstem peripherally: baroreceptors (common carotid arteries & aortic arch)
43
# Baroreceptor reflex Decreases in arterial blood pressure result in...
* increased sympathetic tone * increased adrenal secretion of epinephrine * reduced vagal activity
44
How does BP affect baroreceptor discharge and vagal tone?
↑ BP = ↑ Br discharge = ↓ systemic constriction = ↑ vagal tone
45
How do impulses from baroreceptors travel?
Afferent: - carotid: Nerve of Hering (CN IX) - aortic: Vagus Control center: NTS & Medulla Efferent pathway: SNS & Vagus
46
Of the two peripheral sensors, the ___ baroreceptor is physiologically more important and minimizes BP changes d/t acute events, such as a change in posture.
carotid
47
Carotid baroreceptors sense MAP most effectively between pressures of
80-160 mm Hg
48
Adaptation to acute changes in blood pressure occurs over ...
1-2 days
49
T/F: Reflex is effective for long-term blood pressure control.
False is not effective
50
Drugs that impair baroreceptor reflex
* All volatiles (iso the least) * Propofol * Beta blockers * CCB * ACE inhibitors (not alone; w/ PDEi or hypovolemia) * PDE inhibitors
51
attempts to preserve cardiac output during acute blood loss and shock
baroreceptor reflex
52
Counterbalance to the baroreceptor reflex
bainbridge
53
The bainbridge is what type of reflex?
low-pressure cardiopulmonary baroreceptor reflex ## Footnote uses low-pressure (volume) receptors in atria and lung vasculature
54
T/F: You can saturate the bainbridge reflex.
True increases in HR are most notable in low baseline
55
The brainbridge reflex increases HR, but its effects on (2) are INsignificant
stroke volume contractility
56
The triad of the BJ reflex
bradycardia, hypoTN, coronary art. dilation
57
What stimulates the BJR? Examples?
low venous return myocardial ischemia -profound hypoTN -massive hmrg -cardiac arrest d/t spinal
58
effectors of the BJR
* SA node decreases HR * AV node decreases conduction velocity
59
pathway for BJR
* afferent: Vagus unmyelinated C * control center: medulla's vasomotor center * efferent: stimulates vagus
60
the isoelectric line
PR segment
61
The J point
Where the QRS ends and the ST segment begins
62
Leads and Coronary artery for -anterior -inferior -lateral
* Anterior (LAD): V1-V4; septum V1,V2 * Inferior (RCA): II, III, aVF * Lateral (Ccx): I, V5, V6, aVL
63
How does the CVP waveform correlate to EKG and cardiac phases?
64
# CVP What happens at each event?
65
# CPB Cardioplegic solutions
* myocardial preservation: minimizing cellular energy requirements * reducing energy expenditure and preserving the availability of high-energy phosphate compounds
66
Potassium cardioplegia initial dose & maintenance
initial: hypothermic -or- warm to cold (“hot shot”) Maintenance: systemic and topical cardiac hypothermia (ice slush)
67
How do hypoT and K work during CPB?
* hypothermia: reduces basal metabolic O2 consumption * potassium: minimizes energy expenditure by arresting both electrical & mechanical activity
68
desired myocardial temp for CPB
10-15 C
69
Cardioplegic administration (2)
Antegrade: catheter in proximal aorta (between aortic clamp & aortic valve Retrograde: catheter through the right atrium into the coronary sinus
70
Which route of cardioplegic administration requires the patient has a competent aortic valve?
Antegrade ## Footnote catheter placed in the proximal aorta between the aortic clamp and the aortic valve
71
Coronary steal -definition -agents
reduced perfusion to ischemic myocardium while perfusion to nonischemic tissue increases * dipyridamole * NTG * Isoflurane * Sodium NTP * adenosine

Mid Comp (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions