Test 4 part 3 Flashcards by Jackie O'Donnell

CCHD physiological consequences

Cyanosis
Hypoperfusion
Respiratory distress and failure to thrive

How well did you know this?

Not at all

Perfectly

Underdevelopment of the left side of the heart which can include the left ventricle, aortic valve and ascending aorta.
Most severe left sided obstruction lesion
All of RV is pumped to PA
Descending aorta and coronary arteries supplied by PDA

Hypoplastic left heart syndrome

How well did you know this?

Not at all

Perfectly

Hypoplastic left heart syndrome treatment

Prostaglandins
Norwood operation
Cardiac transplantation

How well did you know this?

Not at all

Perfectly

Small or absent pulmonary valve with no ability to shunt through VSD or ASD (septum is intact)
Affects ability to pump blood to lungs

Pulmonary artresia with intact septum

How well did you know this?

Not at all

Perfectly

A hole in the wall between the two lower ventricles of the heart
A narrowing of the pulmonary valve and main pulmonary artery
The aortic valves which opens to the aortas is enlarged and seems to open from both ventricles
The muscular wall of the lower right chamber of the heart (right ventricle) is thicker than normal

Tetralogy of Fallot (TOF)

How well did you know this?

Not at all

Perfectly

Blood returning from the body bypasses the lungs and is pumped back out to the body
This occurs because the main connections are reversed
Most common cyanotic CCHD
Associated with maternal diabetes

TGA (Transposition of the Great Arteries)

How well did you know this?

Not at all

Perfectly

A defect with multiple variations in which the veins carrying O2 rich blood do not connect with the left side of the heart
PV return to right side of heart
Snowman sign

Total anomalous pulmonary venous return (TAPVR)

How well did you know this?

Not at all

Perfectly

Treatment for TAPVR

Emergency surgery in patient with venous obstruction

Require eventual heart-lung transplant

How well did you know this?

Not at all

Perfectly

One large artery arises from the heart instead of a separate pulmonary artery and aorta
Always accompanied by VSD
Single loud heart sound
Diastolic murmur at LSB

Truncus arteriosus

How well did you know this?

Not at all

Perfectly

Male predominance and assoc. w/ Turner’s syndrome (XO) and PHACE syndrome (multiple defects- posterior fossa brain, large hemangioma, arterial lesions, coarctation, eye defects)
Obstruction occurring almost exclusively at the ductus arteriousus
Lower BP in lower body

Coarctation of aorta

How well did you know this?

Not at all

Perfectly

Treatment for coarctation aorta

PGE for short term PDA

Surgery

How well did you know this?

Not at all

Perfectly

Closure of PDA leads to

cariogenic shock

How well did you know this?

Not at all

Perfectly

atresia is

no opening

How well did you know this?

Not at all

Perfectly

Tricuspid valve is not open which leads to no flow of blood from R atrium to R ventricle

Tricuspid atresia

How well did you know this?

Not at all

Perfectly

When the valve that controls blood flow from the heart to the lungs doesn’t form at all. This valve controls blood flow from the right ventricle to the main pulmonary artery (the blood vessel that carries blood from the heart to the lungs). This can occur with a VSD.

Pulmonary atresia

How well did you know this?

Not at all

Perfectly

what is used to keep PDA open

prostaglandin E

How well did you know this?

Not at all

Perfectly

Treatment for pink baby defects, PDA, ASD, VSD (without other defects)

NSAIDS and CCB

How well did you know this?

Not at all

Perfectly

allow blood to pass from the left to the right side of the heart. The oxygen-rich blood then gets pumped back to the lungs instead of out to the body, causing the heart to work harder

ASD and VSD

How well did you know this?

Not at all

Perfectly

congenital heart defect diagnostic tests

Arterial blood gas analysis
Umbilical arterial catheter
Chest x ray
Echocardiogram

How well did you know this?

Not at all

Perfectly

Multiples pregnancies babies are at risk for

Mental retardation
Cerebral palsy
Vision/ hearing loss

How well did you know this?

Not at all

Perfectly

How often do women need to visit if they are pregnant with multiples at 12-14 weeks

twice per month

How well did you know this?

Not at all

Perfectly

when do weekly visits start for mothers pregnant with multiples

24 weeks

How well did you know this?

Not at all

Perfectly

when do biweekly non-stress tests start for a mother pregnant with multiples

32 weeks

How well did you know this?

Not at all

Perfectly

what week do mothers pregnant with multiples need to increase risk

30 weeks

How well did you know this?

Not at all

Perfectly

what is the recommended loading dose for caffeine citrate

20 mg/kg orally or IV followed by 5 mg/kg daily oral or IV over 30 min

what is the recommended loading dose for theophyline

5-6 mg/kg followed by 2-6 mg/kg divided by two or 3 doses

What is the recommended loading dose for aminophyline

5-7 mg/kg IV follwed by 1.5-2 mg every 6-8 hours

Acute inflammatory bowel disorder associated with ischemia and hypoxia Mucous-secreating cells are inactivated Leads to bowel necrosis and perforation

Necrotizing Entercolitis

Sequelae of necrotizing entercoclitis

``` Short bowel syndrome Colonic stricture with obstruction Fat malabsorption Failure to thrive Death ```

Benefits of kangaroo care

Weight gain Discharge home sooner Improved sleep Fewer apnea/bradycardia spells

includes rupture of vessels in the brain area during events such as hypoxia and associated increased venous pressure

Intra-ventricular hemmorrhage

grade that involves a smaller amount of bleeding | Most of the time there are no long term problems as a result of bleeding

Grade 1 and 2

grade 1 is also know as

germinal matrix hemmorrhage

Involves more severe bleeding The blood presses on or directly involves blood tissue Blood clots can form and block the flow of cerebrospinal fluid This can lead to increased fluid in the brain

Grade 3 and 4

grade 4 is also know as

intraparenchymal hemmorrage

how to confirm intra ventricular hemorrhage

head ultrasound

Treatment for intra ventricular hemorrhage

``` Vitamine E Pancuronium Phenobarbital Idomethacin Surfactant Analgesics ```

Sequelae of IVH

Hydrocephalus Sever neurodevelopment deficits Death

A condition of treatment related to pressure and volume barotrauma from ventilator Develops in preterm infants treated with O2 and PPV HArd time emptying lungs

Broncho-pulmonary dysplasia

Sequelae of BPD

Increased susceptibility of infection up to age 2 Poor growth Altered neurological development Death

Changes that involve breast tissue (non-disease) Dilation of ducts with variation of presentation Mass develops as result of inflammation in ducts Frequently occurs or increases one to two weeks before menstrual periods Is the MOST frequent benign disorder of the breast

Fibrocystic Breast change

ducts become surrounded by firm, hard, plaque-like tissue

Adenosis

Diagnosis of fibrocystic breast changes

Mammography Ultrasound Fine needle biopsy

Treatment of fibrocystic breast changes

OCP | Some evidence of vitamin E

Consists of dense epithelial and fibroblastic tissue Related to estrogen effect on susceptible tissue It is benign Most common in adolescent and young women and AA

Fibroadenoma

Treatment for fibroadenoma

removal or observation

Small benign tumor that grows within a milk duct of the breast near nipple Painful and non-palpable mass Most common cause of spontaneous nipple discharge

Intraductal papilloma

Mutations in genes_____ and ____ increase the risk of developing breast cancer

BRCA1 | BRCA2

most common of all malignancies of breast cancer

infiltrating ductal carcinoma

The cells in the breast resemble those of the medulla (grey matter) thus the name

Medullary carcinoma

Most often seen in upper outer quadrant | Most often estrogen and progesterone and respond well to hormonal therapies

infiltrating lobular carcinoma

Aggressive form of cancer that infiltrates the lymph system rapidly No lump almost always Poor prognosis Mutation of cells that proliferate and block lymph drainage Symptoms mimic mastitis

inflammatory breast cancer

Cancer cells in ducts collect in and around the nipple Underlying DCIS or invasive ductal carcinome Symptoms include redness, scaly and itchy skin, pain in nipple/areola

Pagets disease

Treatment for pagets diseas

Breast conserving or mastectomy | Tamoxifen therapy after surgery

Breast conserving surgery Removal of a cancerous lesion and some surrounding tissue with negative margins Usually followed by radiation therapy

lumpectomy

Removal of entire breast, but not lymph nodes or other tissue. This type of mastectomy is used for the treatment of non-invasive cancers

Total(or simple) mastectomy

Breast removed, plus the lining of the chest muscles and some of the lymph nodes in the armpit (called axillary dissection). In many cases, axillary dissection can be replaced by sentinel node biopsy. This type of mastectomy is used to treat invasive cancer.

Modified radical mastectomy

Surgical procedure used for treatment of AUB and symptomatic leiomyomas Is a second-line treatment used after trying oral medications Procedure is done with a hysterscope and electrical loop or laser which destroys the uterine lining

Endometrial ablation

Involves a rigid endoscope that has a fiber-optic light. Can also be used as a channel for use of probe, forceps, or laser instruments Uterus is distended using a medium - most commonly CO2. Used for evaluation and treatment of AUB, endometrial adhesions, leiomyoma, biopsy of endometrium and endocervix.

Hysteroscopy

Contraindications of hysteroscopy

Pelvic inflammatory diease Current STI Uterine perforation