Test 4 part 3 Flashcards
CCHD physiological consequences
Cyanosis
Hypoperfusion
Respiratory distress and failure to thrive
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
Hypoplastic left heart syndrome treatment
Prostaglandins
Norwood operation
Cardiac transplantation
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
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)
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)
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)
Treatment for TAPVR
Emergency surgery in patient with venous obstruction
Require eventual heart-lung transplant
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
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
Treatment for coarctation aorta
PGE for short term PDA
Surgery
Closure of PDA leads to
cariogenic shock
atresia is
no opening
Tricuspid valve is not open which leads to no flow of blood from R atrium to R ventricle
Tricuspid atresia
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
what is used to keep PDA open
prostaglandin E
Treatment for pink baby defects, PDA, ASD, VSD (without other defects)
NSAIDS and CCB
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
congenital heart defect diagnostic tests
Arterial blood gas analysis
Umbilical arterial catheter
Chest x ray
Echocardiogram
Multiples pregnancies babies are at risk for
Mental retardation
Cerebral palsy
Vision/ hearing loss
How often do women need to visit if they are pregnant with multiples at 12-14 weeks
twice per month
when do weekly visits start for mothers pregnant with multiples
24 weeks
when do biweekly non-stress tests start for a mother pregnant with multiples
32 weeks
what week do mothers pregnant with multiples need to increase risk
30 weeks
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
