The Pediatric Exam Lecture #2

Question 1

among most common group of abnormalities found at birth, affecting 1 in 100 infants

Answer 1

congenital heart defects

Question 2

leading cause of death among infants

Answer 2

congenital heart defects
OFTEN NO FAMILY HISTORY OF CHD
NO PREGNANCY COMPLICATIONS EITHER

Question 3

Major forms of CHD (what percentage?) can be identified before birth by fetal during routing abdominal US performed between weeks ____ and _____

Answer 3

90%
Between weeks 17 and 22

Question 4

Some fetal mothers at risk include mothers with (4)

Answer 4

1. Diabetes
2. A family history of CHD
3. If a sibling was born with congenital heart defect
4. A chromosomal or genetic abnormality discovered in fetus

Question 5

Certain medications or other circumstances may cause congenital heart defects (from the mother) (5)

Answer 5

1. anti-seizure meds
2. prescription acne meds
3. alcohol/drug abuse
4. CT dz such as lupus
5. If contracted rubella during pregnancy

Question 6

In utero surgeries are getting. more advanced; this second trimester surgery can correct critical fetal aortic stenosis by this operation

Answer 6

aortic balloon valvoplasty* to prevent progression of the fetal heart to hypo plastic left heart syndrome

Question 7

name 2 fetal echo heart procedures

Answer 7

aortic balloon valvoplasty
atrial septoplasty

Question 8

(general) in a pediatric patient you must always start with _________?

Answer 8

HISTORY (syndromes, genetics etc)

Question 9

3 main “cardiac segments” of the developing heart are

Answer 9

1. atria and veins
2. ventricles
3. great arteries

Question 10

What are the 2 connecting segments between the main segments of the heart

Answer 10

1. AV canal
2. Conus or infundibulum

Question 11

abnormalities always (generally) have

Answer 11

relatives…

example, find a right heart defect, look for another (tricuspid atresia-pulmonary stenosis)

find a left heart defect, look for another (aortic stenosis-coarctation)

Question 12

identifying left side of heart (segmental approach).

Answer 12

lv-smooth septal surface
finely trabeculated apex
bi-leaflet MV
MV has 2 papillary muscles attaching to LV free wall
Cone-shaped (externally)

Left atrium - has elongated LAA that is narrow/posterior. Left atrial surface has septum premium (valve of foramen ovale)

Pulmonary veins (could be tricky tho)

Question 13

identifying right. side of heart. (segmental approach)

Answer 13

Includes crista terminalis, eustachian valve. The RAA is broad based, triangular. and it sits more anterior

coarse thick trabeculations
moderator bands

Question 14

segmental approach - cardiac anatomy - outflow chambers

double outlet is what?

Answer 14

both arteries emerge into the same ventricle

Question 15

segmental approach - cardiac anatomy - outflow chambers

single outlet is what?

Answer 15

one great artery emerges into the heart.