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(3) Cardio-Pulmo-Renal Rehabilitation > S2 L6.1 Congenital Heart Disease Part 1 > Flashcards

S2 L6.1 Congenital Heart Disease Part 1 Flashcards

1
Q

Adult patient who have CHD fall under three types namely:

A

Mild, Undergone correction, uncorrected

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2
Q

When an adult patient who has CHD undergone correction, they either had it surgically corrected or underwent __

A

Percutaneous Intervention

Catherters into femoral artery or vein and that’s the way doctors introduce gadgets to take care of congenital defects

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3
Q

An adult who has CHD present with symptoms like:

A
  1. Heart chambers are big, increased
    pressures inside the heart
  2. Already beyond correction even with surgery
  3. Hemodynamic problems inside heart cannot be corrected
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4
Q

2 Most Common Cardiac Anomalies

A
  1. Congenital, functionally normal bicuspid aortic valve
  2. Prolapse of the mitral valve
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5
Q

Statement 1: The aortic valve has 2 leaflets
Statement 2: Congenital malformation will manifest a person to only have 3 leaflets in the aortic valve. This will lead to aortic stenosis

a. TF
b. FT
c. TT
d. FF

A

d. FF

  1. 3 Leaflets
  2. 2 Leaflets
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6
Q

Statement 1: With present advances in medicine, >85% of patients with CHD reach adulthood
Statement 2: Identified in infancy by the presence of heart murmurs, cyanosis, poor feeding, etc

a. TF
b. FT
c. TT
d. FF

A

c. TT

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7
Q

CHD common in Male or Female?

Ebstein anomaly of the tricuspid valve

A

Females

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8
Q

CHD common in Male or Female?

Aortic Valve Stenosis

A

Males

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9
Q

CHD common in Male or Female?

Coarctation of the Aorta

A

Males

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10
Q

CHD common in Male or Female?

Atrial Septal Defect (ASD)

A

Females

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11
Q

CHD common in Male or Female?

Pulmonary and Tricuspid Atresia

A

Males

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12
Q

CHD common in Male or Female?

Transposition of the Great Arteries (TGA)

A

Males

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13
Q

CHD common in Male or Female?

Patent Ductus Arteriosus

A

Females

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14
Q

CHD common in Male or Female?

Hypoplastic Left Heart

A

Males

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15
Q

Occur in about 25% of infants with significant cardiac disease where heart defect is really severe and is symptomatic at birth - infancy

A

Extracardiac Anomalies

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16
Q

Statement 1: The etiology of Extracardiac Anomalies is genetic or environmental
Statement 2: Under environmental, it can be caused by maternal rubella and ingestion of thalidomide and isotentinoin

a. TF
b. FT
c. TT
d. FF

A

c. TT

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17
Q

This condition has these manifestations:
Deafness
Microcephaly
Congenital Cataracts

A

Rubella Syndrome

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18
Q

Statement 1: Had measles during pregnancy in the second trimester
Statement 2: Can develop multiple heart defects like Persistent Ductus Arteriosus (PDA), pulmonary valve and/or arterial stenosis, and ASD

a. TF
b. FT
c. TT
d. FF

A

b. FT
1: First trimester

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19
Q

Associated with major limb deformities and, occasionally, with cardiac malformations without a predilection for a specific lesion.

A

Thalodomide Exposure

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20
Q

Associated with ingestion of lithium during pregnancy (anti-psychotic drug)

A

Tricuspid Valve Anomalies

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21
Q

For mothers who drink alcohol during pregnancy, thic condition can arise.

Prenatal growth retardation
Developmental delay can be expected d/t growth retardation

A

Fetal Alcohol Syndrome

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22
Q

Other vein in the human body that carries oxygenated blood

A

Umbilical vein

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23
Q

the source of food of the fetus whle it’s still inside the womb

A

Placenta

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24
Q

Located in the interatrial septum: it is an opening where blood from the right atrium would go directly to left atrium

A

Foramen Ovale

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25
Q

Fetal Circulation

Another opening is the shortcut or duct that allows blood going from the pulmonary artery to the left side of the heart specifically the aorta

A

Ductus arteriosus

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26
Q

Classification

Determined by the chambers of the heart with more pressure

27
Q

Statement 1: It is called shunt because blood with flow from one
chamber to another
Statement 2: if more volume goes (accumulates) to the right side of the heart, the pressure on the right becomes higher compared to the left. Shunt reverses going from the usual right to the left.

a. TF
b. FT
c. TT
d. FF

28
Q

Classification

Determines the location of the defect (Location of the defect would determine the hemodynamic effects/consequences)

A

Right-sided vs. Left-sided

29
Q

○ Less blood goes into the lungs for oxygenation
○ There is a problem with the conduits, leading used blood to the lungs for oxygenation purposes

A

Cyanotic vs. Acyanotic

30
Q

Presence of cyanosis tells us the possibilities like:

A

■ Tetralogy of fallot
■ Pulmonary atresia

31
Q

Conditions under Without Shunt Right-sided

A

○ Pulmonary Stenosis
○ Ebstein Anomaly

32
Q

Conditions under Without Shunt Left-sided

A

○ Coarctation of the Aorta

33
Q

Conditions under With Shunt Acyanotic

A

○ Atrial Septal Defect (ASD)
○ Patent Ductus Arteriosus (PDA)
○ Ventricular Septal Defect (VSD)

34
Q

Conditions under With Shunt Cyanotic

A

○ Tetralogy of Fallot (TOF)
○ Eisenmenger Syndrome
○ Transposition of Great Arteries
○ Ebstein Malformation
○ Truncus Arteriosus
○ Tricuspid Atresia

35
Q

■ When shunt is reversed; pressure reverses
■ Expect less oxygenation leading to cyanosis

A

Eisenmenger Syndrome

36
Q

Which Congenital Heart Defect has the highest incidence?

A

Ventricular septal defect (VSD) (28.3)

37
Q

Complications of Congenital Heart Disease (4)

A

Congestive Heart Failure
Hypoxemia
Growth retardation
Pulmonary vascular disease

38
Q

(8) Squelae of Hypoxemia

A
  1. Cyanosis
  2. Clubbing
  3. Polycythemia
  4. Squatting
  5. Exercise Intolerance
  6. Hypoxic Spells
  7. Brain abscess
  8. Cerebrovascular accident
39
Q

SEQUELAE OF HYPOXEMIA: spooning, sign of extreme hypoxia in pulmonary physical examination

40
Q

SQUELAE OF HYPOXEMIA: If infant has chronic hypoxemia adaptive mechanism of body is to produce more erythrocytes

A

Polycythemia

41
Q

SQUELAE OF HYPOXEMIA: Laro nang laro then pt may faint or exp shortness of breath

A

Hypoxic spells

42
Q

CHD where the Pulmonary trunk is narrow or even atretic (did not develop at all)

A

Pulmonary Stenosis

43
Q

This form the only outlet for blood from the right side of the heart

A

Patent Foramen Ovale

44
Q

This is the only access route
to the pulmonary circulation

A

Patent Ductus Arteriosus

45
Q

Statement 1: Thanks to the PDA, blood from the aorta can enter the pulmonary system through this conduit
Statement 2: Without the PDA and PFO, used blood can never reach the lungs for oxygenation

a. TF
b. FT
c. TT
d. FF

46
Q

Statement 1: Pulmonary Stenosis often coexists with ASD, VSD, PDA, TOF
Statement 2: It is also the third most common form of CHD in adult

a. TF
b. FT
c. TT
d. FF

A

a. TF
2: Second

47
Q

This CHD is a downward displacement of the tricuspid valve into the right ventricle (Results in tricuspid regurgitation)

A

Ebstein Anomaly

48
Q

In ebstein anomaly, the right ventricle is ___ which leads to pump failure

A

Hypoplastic

49
Q

Increase in volume and
pressure on the right side causing shunt reversal

A

Eisenmengerization

50
Q

Patients with severe Ebstein anomaly will have __ and __

A

Dyspnea and exercise tolerance

51
Q

■ Heart has extra conducting systems
■ May promote by-pass tracts(abnormal) to produce arrhythmias
■ Can be deadly

A

Wolff-Parkinson-White Syndrome

52
Q

Aortic lumen below the origin of the left subclavian artery is significantly narrowed

A

Coarctation of the Aorta

53
Q

Narrowing of the aorta at the:

A
  1. Descending aorta (more common)
  2. Aortic Arch
54
Q

2 Types of Coarctation of the Aorta

A

○ Preductal - PDA persists
○ Post-ductal - more common

55
Q

Statement 1: ↑SBP and ↑DBP below the coarctation
Statement 2: ↓SBP and sl. ↓DBP above the coarctation

a. TF
b. FT
c. TT
d. FF

A

d. FF

  1. Above
  2. Below
56
Q

○ D/t increased risk of harboring bacteria
○ Infection of the endocardium or myocardium

A

Risk of infective endocarditis

57
Q

Mortality without surgical correction:
○ __ by 30 years of age
○ __ by 60 years of age

A

○ 50% by 30 years of age
○ 90% by 60 years of age

58
Q

Large opening between LA and RA
○ Foramen ovale remains patent (PFO) after birth

A

Atrial Septal Defect

59
Q

Causes of Atrial Septal Defect

A
  1. Excessive cell death and resorption of the septum primum
  2. Inadequate development of septum secundum
60
Q

○ Occurs high in the atrial septum near the entry of the superior vena cava into the right atrium
○ Depends on anatomic placement

A

Sinus Venosus

61
Q

Lie adjacent to the atrioventricular valves common in Down’s syndrome
Depends on anatomic placement

A

Ostium Primum

62
Q

Most common
Involves the fossa ovalis
Midseptal in location

A

Ostium Secundum

63
Q

Beyond 4th decade, it will manifest:

A
  1. Atrial Arrhythmias
  2. Pulmonary Arterial Hypertension
  3. Bidirectional and then right-to-left shunting of blood
  4. Cardiac Failure

(3) Cardio-Pulmo-Renal Rehabilitation (34 decks)

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