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Peds Rotation > Stupid Cardiology > Flashcards

Stupid Cardiology Flashcards

1
Q

What is the 3rd most common ~cyanotic~ heart lesion

A

Tricuspid atresia

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2
Q

After an arterial switch operation for transposition of the great arteries, is there a good survival rate?

A

Yes over 95%

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3
Q

Where do you best hear pulmonary flow murmur?

A

ULSB

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4
Q

What treatment is ESSENTIAL AND LIFE SAVING before a patient with hypoplastic left heart syndrome has surgery?

A

Prostaglandin E1

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5
Q

What is meant by the “honeymoon period” of hypoplastic left heart syndrome?

A

When the baby is first born, he’s pretty stable while the ductus is patent.

(Crashes rapidly as soon as ductus closes)

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6
Q

What are some other findings you may see with atrial septal defect?

A

Failure to thrive

Fatigue

RV heave

Wide fixed split S2

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7
Q

What is this:

aorta and pulmonary artery fail to separate, and a single artery arises from the heart

A

Truncus arteriosus

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8
Q

What are the conditions under cyanotic congenital heart disease?

A

Tetralogy of Fallot

Transposition of the great arteries

Tricuspid atresia

Truncus arteriosus

Total anomalous pulmonary venous return

Hypoplastic left heart syndrome

(5 T’s plus hypoplastic left heart)

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9
Q

What extra heart sound may be heard with hypertrophic cardiomyopathy?

A

S4

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10
Q

What does a ventricular septal defect sound like?

A

Blowing

Harsh

Holosystolic

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11
Q

What causes the foramen ovale to close?

A

Pressure increase in left atrium

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12
Q

What is the most common ~cyanotic~ cardiac lesion?

A

Tetralogy of fallot

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13
Q

What should you think if peripheral pulse are bounding?

A

Patent ductus arteriosus (PDA)

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14
Q

What is this:

Absence of tricuspid valve. NO communications between Right atrium and right ventricle

A

Tricuspid atresia

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15
Q

What are the treatment options for a patent ductus arteriosus?

A

Prostaglandin E1 or Indomethacin to keep it open/close it

Surgical ligation

Percutaneous transcatheter occlusion

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16
Q

How do you best diagnose a ventricular septal defect?

A

Echocardiogram. Can tell you where it is, how big it is, and what the presssure gradient is like.

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17
Q

What is the leading cause of sudden cardiac death in young people

A

Hypertrophic cardiomyopathy

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18
Q

Does transposition fo the great arteries have a murmur

A

No

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19
Q

What is eisenmenger syndrome?

A

This is when a patient has a patent ductus arteriosus, and due to high pulmonary presssures, it switches directions and shunts blood from the pulmonary artery to the aorta (bypassing the lungs)

EMERGENCY

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20
Q

Wat is the major cardiac complication of Kawasaki disease

A

Coronary artery aneurysms

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21
Q

What ages get stills murmur

A

2-7

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22
Q

What does an atrial septal defect sound like?

A

Midsystolic pulmonary ejection murmur

Fixed and widely split S2 at pulmonary area***

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23
Q

What is another diagnostic study you could do to diagnose an atrial septal defect? (In addition to echo)

A

Chest X Ray- can help you see an enlarged heart (Right side dilation), as well as increased pulmonary vascularity

*THIS SLIDE HAD A HEART AT THE BOTTOM WHATEVER THAT MEANS

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24
Q

What other murmur can pulmonary flow murmur mimic?

A

ASD

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25
Q

How many extremities should we take BP in?

A

All 4

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26
Q

What does stills murmur sound like?

A

Musical

Short

High pitch

(Loudest supine)

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27
Q

What illness do you have before you get acute rheumatic fever?

A

Group A Strep throat infection

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28
Q

What is the mnemonic to know what is included in Kawasaki disease

A

Warm CREAM

NEEDS: warm- fever more than 5 days

PLUS 4 of these:
Conjunctivitis

Rash

Erythema on hands and soles

Adenopathy

Mucous membrane-strawberry tongue

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29
Q

What are the other findings you will see with tricuspid atresia?

A

Atrial septal defect

RV hypoplasia

(Also YOU must keep ductus arteriosus open)

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30
Q

When is stills murmur loudest?

A

When patient is supine

Disappears when they sit up or inhale

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31
Q

What are the Jones criteria used for

A

Diagnosis rheumatic fever

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32
Q

What are some other findings you may see with patent ductus arteriosus?

A

Wide pulse pressure

Hyper-dynamic apical pressure

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33
Q

What does the ductus arteriosus do?

A

Connects the aorta with the pulmonary artery. Shunts blood away from lungs

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34
Q

What can cause a wide S2 split?

A

ASD

Pulmonary stenosis

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35
Q

What are the pathognomic chest x ray findings in a baby with transposition of the great arteries?

A

“Egg on a string”

Globular heart, and a narrow mediastinum

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36
Q

What heart defects are common with fetal alcohol syndrome?

A

VSD

ASD

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37
Q

What can cause a narrow S2 split?

A

Pulmonary HTN

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38
Q

What is the most common innocent murmur of early childhood?

A

Stills

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39
Q

What does a pulmonary flow murmur sound like and when is it loudest?

A

Soft

Loudest supine

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40
Q

What defect is associated with the term “blue babies”

A

Transposition of the great arteries

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41
Q

What is the #1 most helpful and important tool for diagnosis cardiac problems

A

Echocardiogram*******

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42
Q

What does coarctation of the aorta sound like?

A

Blowing systolic murmur in the back or left armpit

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43
Q

What drug can we give to make a patent ductus arteriosus close?

A

IV Indomethacin- will lead to closure in up to 80% of premature babies
(Indomethacin is a prostaglandin inhibitor)
*******

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44
Q

What are the two classifications of atrial septal defect?

A

Ostium primum

Ostium secundum (most common)

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45
Q

What is always present when there’s truncus arteriosus?

A

A ventricular septal defect

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46
Q

What are the 4 conditions in acyanotic congenital heart disease?

A

VSD

ASD

PDA

Coarctation of the aorta

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47
Q

What is coarctation of the aorta?

A

Narrowing in the aortic arch, usually in the proximal descending aorta near the ductus arteriosus

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48
Q

What is total anomalous pulmonary venous return?

A

Abnormal configuration of the pulmonary vein, leading to cyanosis

49
Q

What is hypoplastic left heart syndrome?

A

Hypoplasia of the Left ventricle

+stenosis or atresia of mitral and aortic valves

50
Q

What does a patent ductus arteriosus sound like?

A

Continuous machinery

51
Q

What will be interesting about a patient’s blood pressure if they have coarctation of the aorta?

A

Femoral pulses diminished

Systolic pressures in the upper extremities will be at least 20mm higher than the ones in the legs

52
Q

What murmur can venous hum mimic?

A

Patent ductus arteriosus

53
Q

How will a baby with transposition of the great arteries present?

A

Profoundly cyanotic WITHOUT respiratory distress or murmur

“Blue babies”

54
Q

What will you see on chest X ray of someone with tetralogy of fallot?

A

Boot shaped heart

RV gets so thick, the apex becomes upturned

55
Q

Which type of ASD is always large: secundum or primum?

A

Primum.

Secundums vary in size

56
Q

What drug can we give to keep a patent ductus arteriosus open?

A

IV Prostaglandin E1*****

57
Q

Where is stills murmur best heard?

A

LLSB

58
Q

What makes venous hum go away?

A

Laying down

59
Q

Where is a ventricular septal defect heard best?

A

Left lower sternal border

60
Q

What will you hear with truncus arteriosus?

A

Narrow S2 split**

Systolic ejection murmur at LLSB

Loud single S2

Prominent ejection click

61
Q

What chromosome abnormality is associated with coarctation of the aortA?

A

Turner syndrome

45, XO

62
Q

What does an S4 indicate?

A

Hypertrophic cardiomyopathy

Other diastolic dysfunction

63
Q

Can cardaic catheterization be diagnostic and interventional?

A

Yes, you can use it to visualize or you can use it to place stents/balloons

64
Q

How do you treat tetralogy of fallot?

A

They get heart surgery by age 1, but in the meantime:

Give prophylactic antibiotics to prevent endocarditis

For ACUTE Tet spells: give O2, put them in knee-chest position, IV morphine, IV fluids, IV beta-blockers, IV phenylephrine

65
Q

Do you have to treat asymptomatic ventricular septal defect right away?

A

No, you can wait and see, as it may spontaneously close

66
Q

What does the foramen ovale do?

A

Shunts blood from the R atrium into the L atrium

67
Q

90% of Kawasaki disease patient are less than ___ years of age

A

5

68
Q

What is the range of grades for heart murmurs?

A

1-6

69
Q

What does a tetralogy of fallot sound like>?

A

Harsh systolic ejection

Crescendo-decrescndo

Upper left sternal border

70
Q

Are males or females more likely to have coarctation of the aorta?

A

Males 3:1

BUT it is seen in 5-15% of patients with Turner syndrome (XO females)

71
Q

What will you see on a chest X ray of a patient with coarctation of the aorta?

A

Figure 3 sign

Rib notching
*******

72
Q

What valves are most affected by acute rheumatic fever?

A

Mitral and aortic

73
Q

What heart defects are common with maternal rubella?

A

PDA

Pulmonary stenosis

74
Q

What grades of murmur are associated with a palpable thrill?

A

4, 5, and 6

**

75
Q

If a pt has weak/absent femoral pulses, what should you think?

A

Coarctation of aorta

76
Q

Where is an atrial septal defect heard best?

A

Upper left sternal border

VSD was in LLSB duh

77
Q

What are the jones criteria?

A 
Major:
Pancarditis
Polyarteritis
Sydenham chorea
SubQ nodules
Erythema marginatum
Minor:
Fever
Arthralgia
Prolonged PR interval
Increased ESR
Leukocytosis

Two major or 1 major and 2 minor must be present to diagnose rheumatic fever.

(Idk about this slide the only thing that was circled was pancarditis and the thing about how many criteria must be present)

78
Q

What are Tet spells?

A

Hyper cyanotic episodes in kids with tetralogy of fallot:

Sudden onset or worsening of cyanosis

Dyspnea

Alterations in consciousness

Decrease of systolic murmur as the RV outflow tract becomes completely obstructed

79
Q

When does the ductus arteriosus close?

A

7-14 days of age in normal babies

80
Q

Innocent or pathological murmur:

Holosystolic or diastolic

Grade 3 or more

Harsh/blowing

Abnormal pulses, hepatomegaly, MSK abnormalities

Possible family history

A

Pathological lol

81
Q

How tf does a baby with transposition of the great arteries get oxygen before it gets corrective surgery?

A

Patent ductus arteriosus

Cardiac catheterization to make a hole between the atria

82
Q

What heart defects are common with trisomy 21

A

AtrioVentricular septal defect

Tetralogy of Fallot

Patent ductus arteriosus

83
Q

What are the 3 innocent murmurs discussed?

A

Stills

Pulmonary flow

Venous hum

84
Q

Innocent or pathological murmur:

Short systolic

Grade 2 or less

Musical

A

Innocent

85
Q

What will your see on chest X-ray of truncus arteriosus?

A

Boot shaped heart

Also was on tetralogy of fallot

86
Q

What is necessary for someone to survive with total anomalous pulmonary venous return?

A

A R –> L shunt

You may have to create an ASD

87
Q

What is the 2nd most common ~cyanotic~ congenital heart defect?

A

Transposition of the great arteries

88
Q

What are the 4 things you see in tetralogy of fallot?

A
  1. Right ventricle hypertrophy
  2. Ventricular septal defect
  3. Overriding aorta (aorta is straddles over the VSD)
  4. Right ventricle outflow obstruction (a narrowed pulmonary artery)
89
Q

What is the most common cause of hypertrophic cardiomyopathy

A

Familial

90
Q

What must ABSOLUTELY be present for survival with hypoplastic left heart syndrome?

A

A patent ductus arteriosus**

91
Q

What murmur can Stills sound like?

A

VSD

92
Q

What is the most common innocent murmur in older children and adults?

A

Pulmonary flow murmur

Ages 3+

93
Q

What ages get a venous hum?

A

2 and up

94
Q

What medications do you use to treat the congestive heart failure caused by ventricular septal defect?

A

Diuretic***

ACE inhibitor

+/- Digoxin

95
Q

What are the treatment options for atrial septal defect?

A

Percutaneous transcatheter closure

Surgical repair

96
Q

What could cause HTN in the upper extremities only?

A

Coarctation of the aorta

97
Q

What ages get pulmonary flow murmur?

A

3+

98
Q

What does it mean if an S3 sound does not go away when the kid lays down?

A

Poor cardiac function

99
Q

Where is venous hum heard?

A

Right or Left upper sternal border

Or low anterior neck

100
Q

What might you see a kid do to try to get relief if he’s having a tet spell

A

Squat**

Increases systemic vascular resistance and pushes blood into the pulmonary artery

101
Q

What heart defects are commonly associated with turner syndrome

A

Bicuspid aortic valve

VSD

ASD

Coarctation of the aorta***

Dilated aortic root

HTN

102
Q

How do you diagnose tricuspid atresia?

A

Echo**

103
Q

How many heart sounds do you hear with tricuspid atresia?

A

Just one (S2)

104
Q

What direction does blood flow with tetralogy of fallot?

A

R —> L

Not much blood goes to lungs

105
Q

What is the cardinal sign of right heart failure?

A

Hepatomegaly

Ascites too

106
Q

What medication do you HAVE to give to your patient with transposition of the great arteries?

A

Prostaglandin E1

*** must keep ductus arteriosus patent until they get surgery (by their 7th day of life)

107
Q

Any murmur in diastole is _____

A

Pathological

Except for venous hum

108
Q

Which type of atrial septal defect is associated with having other defects: ostium primum or secundum?

A

Primum

109
Q

What is the most common of all congenital heart defects?

A

Ventricular septal defect

110
Q

What is the most important major criteria in the “Jones criteria” used to diagnose acute rheumatic fever?

A

Pancarditis

Pericarditis, endocarditis, myocarditis

111
Q

When is venous hum loudest?

A

Diastole

And when sitting with head extended

112
Q

What does a venou hum murmur sound like?

A

Continuous musical hum

113
Q

What is the main tool used to diagnose heart problems in babies even in utero?

A

Echocardiography

114
Q

At what age do kids with tetralogy of fallot start experiencing tet spells

A

4-6 months

115
Q

What is the test of choice to diagnose an atrial septal defect?

A

Echocardiogram (TTE/TEE)
-establishes size and type of defect

  • measures shunt volume and ratios
  • measures pulmonary artery pressures
  • detects other anomalies

*THIS SLIDE HAD A HEART AT THE BOTTOM

116
Q

What does the ductus venosus do?

A

Takes blood for the umbilical vein and puts it in the IVC (liver bypass)

117
Q

Does the size of the defect matter in ventricular septal defect?

A

Yes. Small VSDs may be asymptomatic, while large ones can cause failure to thrive, shortness of breath, and frequent respiratory infections

118
Q

How do you diagnosis hypoplastic left heart syndrome?

A

ECHO

(You will see hypoplastic aorta and LV with stenosis/atresia of mitral and aortic valves)

***** this was put in big bold letters

119
Q

How do you treat tricuspid atresia?

A

Initial: prostaglandin E1 to maintain PDA**

Definitive: 3 surgeries done from birth to age 3

Peds Rotation (13 decks)

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