TCVS

Question 1

______ produces symptoms of pressure on the tracheobronchial tree and pressure on
the esophagus

Answer 1

Vascular ring

Question 2

SSx of patients with vascular ring

Answer 2

The first include stridor and episodes of respiratory distress with “crowing” respiration, during which the baby assumes a hyperextended position

Question 3

Morphologic cardiac anomalies (congenital or acquired) are best diagnosed with an _____

Answer 3

echocardiogram.

Question 4

________has a very minor, low-pressure, low-volume shunt. Patients typically grow into late infancy before they are recognized

Answer 4

An atrial septal defect

Question 5

PE of ASD

Answer 5

A faint pulmonary flow systolic murmur

and fixed split second heart sound are characteristic

Question 6

_______ low in the muscular septum produce a heart

murmur, but otherwise few symptoms. They are likely to close spontaneously within the first 2 or 3 years of life

Answer 6

Small, restrictive ventricular septal defects

Question 7

A ventricular septal defect (VSD) in the more typical location __________
leads to trouble early on

Answer 7

high in the membranous septum)

Question 8

__________becomes symptomatic in the first few days of life. There are bounding peripheral pulses and a continuous “machinery-like” heart murmur

Answer 8

Patent ductus arteriosus

Question 9

In premature infants who have not gone into CHF, closure can be achieved with ______

Answer 9

indomethacin.

Question 10

______ share the presence of a murmur, diminished vascular markings in the lung, and cyanosis

Answer 10

Right-to-left shunts

Question 11

TOF components

Answer 11

Tetralogy of Fallot (VSD, pulmonary stenosis, overiridng aorta, and right ventricular
hypertrophy),

Question 12

Murmur of TOF

Answer 12

There is a systolic ejection murmur in the left third intercostal space, a small heart

Question 13

TGA

Children are kept alive early on by:

Answer 13

atrial septal defect, ventricular septal defect, or patent ductus (or a combination), but die very soon if not corrected

Question 14

_______ produces angina, syncope, and dyspnea. There is a harsh midsystolic heart murmur best heard at the right second intercostal space and along the left sternal border.

Answer 14

Aortic stenosis

Question 15

When to do Sx in AS

Answer 15

Surgical valvular replacement is indicated if there is a

gradient >50 mm Hg, or at the first indication of CHF, angina, or syncope.

Question 16

Murmur of AI

Answer 16

new, loud diastolic murmur at the right second intercostal space

Question 17

Mitral stenosis is caused by a ______

Answer 17

history of rheumatic fever many years before presentation.

Question 18

Murmur of MS

Answer 18

There is a low-pitched, rumbling diastolic apical heart murmur

Question 19

TX of MS

Answer 19

mitral valve repair becomes necessary with

a surgical commissurotomy or mitral valve replacement

Question 20

______ is most commonly caused by valvular prolapse. Patients develop exertional dyspnea, orthopnea, and atrial fibrillation.

Answer 20

Mitral regurgitation

Question 21

Mitral regurgitation murmur

Answer 21

There is an apical, high-pitched, holosystolic

heart murmur that radiates to the axilla and back

Question 22

Indication for cardiac catheterization

Answer 22

Intervention is indicated if ≥1 vessels
have ≥70% stenosis and there is a good distal vessel. Preferably, the patient should still have
good ventricular function (you cannot resuscitate dead myocardium).

Question 23

The general rule for coronary disease is that the simpler the problem, the more it is amenable to _____and
stent; whereas more complex situations do better with _____

Answer 23

angioplasty

surgery

Question 24

A solitary “coin” lesion found on a chest x-ray has an _____ chance of being malignant in
people age >50, and even higher if there is a significant history of smoking

Answer 24

80%

Question 25

Diagnosis of cancer of the lung, if not established by cytology, requires ______ or ______

Answer 25

bronchoscopy and biopsies (for central lesions) or percutaneous biopsy (for peripheral lesions).

Question 26

_______ is treated with chemotherapy and radiation, and therefore assessment of operability and curative chances of surgery are not applicable

Answer 26

Small cell cancer of the lung

Question 27

A minimum FEV1 of_____ is mandatory for a patient to undergo lung resection, as the worst case scenario is that a pneumonectomy will need to be performed and could potentially leave a marginal patient ventilator dependent.

Answer 27

800 mL