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Child Health 2020 > Year 4 Cardiology > Flashcards

Year 4 Cardiology Flashcards

1
Q

what is a heave?

A

force pushes flat hand off the chest

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2
Q

what is a thrill?

A

palpable murmur

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3
Q

what is acrocyanosis?

A

hands and feet are blue

perioral blueness indicates peripheral cyanosis

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4
Q

what is intermittent central cyanosis a sign of?

A

tetralogy of Fallot

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5
Q

characteristics of murmurs?

A 
timing
location
intensity
radiation
quality
positional change
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6
Q

how is intensity of a murmur graded?

A

1-6

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7
Q

acyanotic heart disease causes

A 
VSD
ASD
PDA
pulmonary stenosis
coarctation
aortic stenosis
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8
Q

cyanotic heart disease causes

A

tetralogy of fallot

transposition of great arteries

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9
Q

pansystolic murmur causes

A

mitral regurgitation
tricuspid regurgitation
VSD

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10
Q

ejection systolic murmur causes

A

aortic stenosis
pulmonary stenosis
HOCM

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11
Q

what is an ASD?

A

hole between the left and right atria

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12
Q

what does an ASD cause?

A

oxygenated blood shunts from the left atrium into the right which causes enlargement of the atria, pulmonary artery and RV

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13
Q

classification of ASD

A
  1. secundum= middle of the wall

2. primum= lower part of the septum

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14
Q

ASD murmur presentation

A

EJECTION SYSTOLIC with FIXED SPLIT of 2nd HS

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15
Q

ASD presentation

A 
recurrent resp infections
fatigue post feed
failure to thrive
SOB syncope
fatigue
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16
Q

diagnosis of ASD

A

ECG
CXR
ECHO is diagnostic

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17
Q

management of ASD

A

surgery

pulmonary vasodilators

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18
Q

complications of ASD

A 
AF
atrial flutter
pulmonary hypertension
right heart failure
Eisenmenger
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19
Q

what is Eisenmenger’s syndrome

A

pulmonary pressure increases beyond systemic pressure so blood flows from right > left

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20
Q

why should Eisenmenger’s be avoided in pregnancy?

A

develops faster

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21
Q

what is a VSD?

A

interruption between interventricular septum

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22
Q

presentation of VSD

A

4-6 weeks with increased sweating (during feeding), failure to thrive, fatigue after feed and recurrent resp

23
Q

murmur in VSD

A

pansystolic murmur in LLSE and diastolic murmur in mitral area

24
Q

what does VSD have increased risk of?

A

IE so give prophylactic antibiotics in surgery

25
Q

what is a complete AVSD?

A

hole between all 4 chambers of the heart (common valve due to failure to differentiate)

26
Q

what is partial AVSD

A

both valves are usually present but one does not work

27
Q

murmur AVSD

A

holosystolic murmur at LLSE and mid-diastolic rumble

28
Q

what conditions are associated with AVSD?

A

T21
heterotaxy syndrome
Kartagner’s

29
Q

what happens as a consequence of Eisenmenger’s sydnrome?

A

polycythaemia causing plethoric complexion and increased risk of thrombus formation

30
Q

management in Eisenmenger’s

A 
heart-lung transplant
sildenaful for pulmonary hypertension
venesection
anticoagulation
antibiotics
31
Q

management of coarctation of the aorta

A

surgical repair
prostaglandin E to keep duct open
balloon dilation +/- stenting

32
Q

four features in tetralogy of Fallot

A

overriding aorta (blood from right and left ventricles)
VSD
RV hypertrophy
pulmonary stenosis

33
Q

what conditions is tetralogy of Fallot associated with?

A

T21
T18
T13
22q11 (DiGeorge)

34
Q

presentation of tetralogy of Fallot

A

cyanosis
poor feeding
failure to thrive
tets spell

35
Q

what is a tets spell?

A

sudden cyanosis as more blood goes right than left

36
Q

what can precipitate a tets spell?

A

walking
physical exertion
crying

37
Q

murmur in tetralogy of Fallot

A

ejection systolic 2nd left sternal border due to pulmonary stenosis

38
Q

CXR of tetralogy of Fallot

A

boot heart

39
Q

management of tets spell

A 
squat/ bend babies legs to increase systemic vascular resistance
morphine
beta blockers
adrenaline
IV fluids
oxygen
40
Q

management of tetralogy of fallot

A

total surgical repair at 6 months

41
Q

CXR in transposition of the great arteries

A

egg on side appearance of the heart

42
Q

what is Ebstein’s anomaly?

A

congenital heart condition where the tricuspid valve is set lower in the right side of the heart causing a bigger RA and small RV leading to poor flow to the pulmonary vessels

43
Q

presentation of Ebstein’s anomaly

A

gallop rhythm
cyanosis
SOB

44
Q

PDA murmur

A

continuous crescendo-decrescendo machinery murmur
wide pulse pressure
bounding pulse
murmur between clavicles

45
Q

how long is PDA monitored?

A

first year of life

46
Q

management of PDA

A

fluid restriction
ibuprofen
indomethacin
surgery

47
Q

what is Kawasaki’s disease?

A

type 2 hypersensitivity reaction that can affect the coronary arteries causing aneurysms

48
Q

presentation of Kawasaki’s

A 
high temp
maculopapular rash (blanches)
conjunctivitis
strawberry tongue
cracked lips
lymphadenopathy
desquamation of hands and feet
49
Q

management of Kawasaki’s

A

immunoglobulin

high dose aspirin

50
Q

why is aspirin normally avoided in children?

A

risk of Reye syndrome

51
Q

diagnosis of Kawasaki’s

A

serial echos for coronary artery aneurysms

52
Q

major criteria for rheumatic fever

A 
carditis
fever
polyarthritis
erythema marginatum
sydenham's chorea
subcutaneous nodules
53
Q

management of rheumatic fever

A

penicillin

Child Health 2020 (22 decks)

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