S2 L6.2: Congenital Heart Disease Part 2

Question 1

One of the most common anomalies of the great vessels 8/10,000 births

Answer 1

Patent Ductus Arteriosus

Question 2

From the bifurcation of PA to aorta just distal to the left subclavian artery

Answer 2

Ductus Arteriosus

Question 3

Statement 1: Patent Ductus Arteriosus has a maternal history of rubella
Statement 2: If no CHF by age 10, most likely symptomatic in adulthood

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

Answer 3

a. TF
2: Asymptomatic

Question 4

Membranous type is most common congenital cardiac defect
12/10,000 births
F:M = 1:1

Answer 4

Ventricular Septal Defect

Question 5

In ventricular septal defect it may occur in isolation.
May occur in isolation
Small defects may undergo ___ (do not
need intervention)

Answer 5

Spontaneous Closure

Question 6

Clinical Features of Ventricular Defect

Answer 6

Exertional dyspnea, chest pain, syncope, hemoptysis (coughing out of blood)

Question 7

VS is divided into three major components:

Answer 7

Inlet, Trabecular, Outlet

Question 8

○ Found in the muscular septum
○ Bordered entirely by myocardium
○ Can be trabecular, inlet, or outlet in location

Answer 8

Muscular VSDs

Question 9

○ Often have inlet, outlet, or trabecular extension
○ Bordered in part by fibrous continuity between the leaflets of an AV valve and an arterial valve

Answer 9

Membranous VSDs

Question 10

○ More common in Asian patients
○ Situated in the outlet septum
○ Bordered by fibrous continuity of the aortic and pulmonary valves

Answer 10

Doubly committed subarterial VSDs

Question 11

● Most common cyanotic congenital heart disease
● Due to unequal division of the conus resulting from anterior displacement of the conotruncal system

Answer 11

Tetralogy of Fallot

Question 12

Reversal of the shunting from usual L→R to R→L and develop a R sided heart failure

Answer 12

Eisenmenger Syndrome

Question 13

Statement 1: Eisenmengerization could either be an equalization of pressure or flow reversal
Statement 2: Final consequence is flooding or inundating of the lungs d/t increased blood flow

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

Answer 13

c. TT

Question 14

Development of pulmonary HTN in the presence of increased pulmonary blood flow

Answer 14

Eisenmenger Reaction

Question 15

Association of VSD with pulmonary HTN and shunt
reversal

Answer 15

Eisenmenger Complex

Question 16

D/t lack of O2, there will be an increase in production of vehicles that carry O2

Answer 16

Compensatory erythrocytosis

Question 17

Failure of the conotruncal septum to follow its normal spiral course and runs straight down

Answer 17

Transposition of the Great Arteries

Question 18

T/F: In the transposition of the Great Arteries displays cyanosis at birth which worsens shortly therafter when ductus closes

Answer 18

True

Question 19

Failure of conotruncal ridges to fuse and to descend toward the ventricles

Answer 19

Persistent Truncus Arteriosus

Question 20

In Persistent Truncus Arteriosus:
Statement 1: Pulmonary artery arises some distance above the origin of the divided truncus
Statement 2: Always with a VSD to redirect the blood flow

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

Answer 20

b. FT
Undivided Truncus

Question 21

Symptoms of heart failure and poor physical development usually appear in the __

Answer 21

First weeks or months of life

Question 22

Facial dysmorphism, a high incidence of extracardiac malformations, atrophy or absence of the thymus gland, Tlymphocyte deficiency, and a predilection to infection

Answer 22

DiGeorge syndrome

Question 23

Prevalence of truncal valve regurgitation increases with age, causing __ and increasing susceptibility to __

Answer 23

1. biventricular heart failure
2. endocarditis

Question 24

Involves obliteration of the right AV orifice
Absence or fusion of tricuspid valve
Severe cyanosis due to obligatory admixture of systemic and pulmonary venous blood in the left ventricle

Answer 24

Tricuspid Artresia

Question 25

If there is no tricuspid valve, how will the blood in the right atrium reach the lungs?

Answer 25

Have to open the PFO and then blood will flow into the left atrium

Question 26

If there is no tricuspid valve, how will blood in the left atrium reach the pulmonary bed?

Answer 26

There must be an opening, VSD, so that it can flow into the lungs via the pulmonary artery

Question 27

Can pts with CHD exercise or do sports?

Answer 27

Yes and No, if pt is then corrected and the pt stamina or physical status/functional capacity is poor, then definitely you can’t allow them to do sports

Question 28

Why do heart defects predispose an individual to infection?

Answer 28

● Bacteria loves to thrive in abnormal places
● Like in valvular heart diseases and mitral stenosis, pathogens love to live in these abnormal areas

Question 29

6-STEP APPROACH TO EXERCISE IN CHD

Answer 29

1. Know your patient
2. Assess functional parameters
3. Decide statis component of exercise
4. Do CP stress testing
5. Execute exercise program
6. Followup

Question 30

Pathway of Circulation in the Blood

a. Right Ventricle
b. Bicuspid Valve
c. Lungs
d. Tricuspid Valve
e. Left Ventricle
f. IVC & SVC
g. Pulmonary Semilunar Valve
h. Left Atrium
i. Pulmonary arteries
j. Aortic Semilunar Valve
k. Right Atrium
l. Pulmonary veins
m. Aorta

Answer 30

F
K
D
A
G
C
L
H
B
E
J
M