UW Peds Cards

Question 1

EKG showing left-axis deviation; tall, peaked P waves (d/t RAH) from ASD; small or absent R waves in precordial leads; plus CXR showing normal-sized heart

Answer 1

Tricuspid atresia

Question 2

CXR of tricuspid atresia

Answer 2

decreased pulmonary vascular markings and a normal sized heart

Question 3

Murmur of tricuspid atresia

Answer 3

Holosystolic murmur loudest at LLSB (VSD)

Question 4

increased pulmonary markings and cardiomegaly from excessive pulmonary blood flow and biventricular volume overload

Answer 4

CXR of CAVCD

Question 5

displacement of a malformed tricuspid valve into the RV –> severe TR and RAH

Answer 5

Ebstein’s anomaly

Question 6

Tall P waves and RAD on EKG plus extreme cardiomegaly from heart failure

Answer 6

Ebstein’s anomaly

Question 7

Increased or decreased pulmonary vascular markings on CXR with TOF?

Answer 7

Decreased

Question 8

Defect in which all 4 pulmonary veins fail to make their normal connection to the LA, so the RA receives blood from pulmonary and systemic circumlation

Answer 8

TAPVR

Question 9

EKG of TAPVR

Answer 9

RVH and RAD

Question 10

CXR of truncus arteriosus

Answer 10

cardiomegaly and increased pulmonary vascular markings

Question 11

truncus arteriosus is strongly a/w

Answer 11

DiGeorge

Question 12

benign murmur increases or decreases with standing

Answer 12

Decreases

Question 13

pathologic murmur increases with

Answer 13

standing or valsalva

Question 14

Pathologic murmurs may be a/w loud, fixed split or single S2 or decreases or absent

Answer 14

femoral pulses

Question 15

HOCM murmur increases with standing because

Answer 15

standing decreases venous return and preload, which increases the obstruction

Question 16

3 cardiac anomalies a/w Turner

Answer 16

bicuspid aortic valve, coarctation, aortic root dilation (w/ inc risk of aortic dissection)

Question 17

MVP is a/w

Answer 17

Marfan, Ehlers-Danlos, OI_

Question 18

PDA is a/w

Answer 18

congenital rubella, Char syndrome

Question 19

TOF is a/w

Answer 19

Down, DiGeorge

Question 20

VSD is occ a/w

Answer 20

trisomies 13, 18, 21

Question 21

carotid pulse has a dual upstroke, + strong apical impulse, + systolic ejection murmur along LSB

Answer 21

HOCM

Question 22

Maneuvers that increase either preload or after load, such as squatting, leg raise, or sustained hand grip, increase LV cavity size in HOCM and thereby

Answer 22

decrease outflow obstruction –> decreased intensity of murmur

Question 23

Maneuvers that decrease preload, such as Valsalva, abrupt standing, or amyl nitrate administration, decrease LV size in HOCM and thereby

Answer 23

increase intensity of murmur

Question 24

loud S2 due to pulmonary HTN, systolic ejection murmur from increase flow across P from L to R shunt across AD, holosystolic murmur of VSD

Answer 24

findings on auscultation in CAVSD

Question 25

pansystolic murmur that is loudest at LLSB plus diastolic rumble at apex due to increase flow across the mitral valve

Answer 25

VSD

Question 26

stridor at age 6 mos - 6 yrs with barky cough

Answer 26

croup

Question 27

strido most severe at age 4-8 months that worsens in supine position and improves in prone position

Answer 27

Laryngomalacia

Question 28

stridor that presents before age 1 year, improves with neck extension, and is a/w cardiac abnormalities; does NOT improve with steroids, rac epi, or albuterol

Answer 28

vascular ring

Question 29

w/u harsh holosystolic murmur best heard at LLSB

Answer 29

echo to determine location and size of VSD and r/o other defects

Question 30

accentuated peripheral pulses with continuous flow murmur last LSB

Answer 30

PDA

Question 31

mid systolic click with late systolic murmur

Answer 31

MVP

Question 32

Syndrome a/w several cardiac abnormalities including AS, PS, or septal defects

Answer 32

Williams syndrome

Question 33

tx PDA

Answer 33

indomethacin to close; prostaglandin E1 to keep open