קרדיולוגיה

Question 1

What is thights syndrome?
תסמונת טייטס

Answer 1

דלקת של הסחוס המחבר את הצלעות לסטרנום- לא מצריך בירור נוס,

Question 2

Which symptoms have high suspicion for congenital heart disease in the newborn

Answer 2

התעייפות באכילה
FTT
אוושות
הפטומגליה

Question 3

What are the cyanotic heart disease

Answer 3

1- truncus arteriosus
2- TGA
3- Tricuspid atresia
4- TOF
5- Total anomulus of pulmonary veins

Question 4

What are the non-cynanotic HD?

Answer 4

ASD
VSD
AV-canal
PDA
Coractation of aorta

Question 5

fixed split of S2 with systolic murmur in LBS

which heart disease

Answer 5

ASD

Question 6

ECG finding seen in ASD?

Answer 6

rsR’

Question 7

most common congenital heart anomaly?

Answer 7

VSD

Question 8

The goal of closing small or large PDA?

Answer 8

in small- prevent endocarditis
large- prevent CHF + PHN

Question 9

Split S2 with systolic murmur in ULSB and click after S1 is a/w

Answer 9

light and mild pulmoanry stenosis

Question 10

a newborn present with light systolic murmur on ULSB with radiation of back and axilla.
the pt with no split of S2 or other finding.

what is most likely the dgx?

Answer 10

Peipharial pulmonic stenosis

Tx- clinical followup

Question 11

Where is the most common part of Coroctatio of aorta?

and which other anomaly if commonly seen?

Answer 11

below the exit of the left sabclavan in the origon of the ductus
(98%)

above 70% will present also with bi-cuspid valve

Question 12

what is the most common inital Tx of Cyanotic heart disease

Answer 12

PDE1 to prevent PDA closue

Question 13

Tx for coractation of aorta?

Answer 13

Prostaglandins E1- to prevent closure of PDA (and prevent shock)
surgical repair - Tx of Choice

Question 14

what is a severe complication of Cyanotic HD?

Answer 14

Brain abcess

Question 15

most common cyanotic HD?

Answer 15

TOF
10% of all congenital HD

Question 16

what are the 4 features of TOF?

Answer 16

1. Pulmonary stenosis
2. RVH
3. overriding aorta
4. VSD

Question 17

which congenital HD is a/w thromboembolic brain events and brain abcess?

Answer 17

TOF

התייצגות עם סימני צד נוירולוגים.

אבחנה ע”י הדמיית ראש
טיפול- אנטיביוטיקה לאבצס ולעיתים ניקוז

Question 18

What is the most common Cyanotic HD that discover already at delivery?

Answer 18

TGA

Question 19

Tx for total anomylous pulmonary venous return?

Answer 19

Immidiate surgery, ECMOuse PDE1- not effective
in severe obstruction respiratory ventilation will not help

Question 20

Ebstain anomaly is?

Answer 20

TR
+
low locationof tricuspid valve = smaller RV

Question 21

Which type of murmur is cherx by :
short systolic murmur, low vol, LSB, no radiation and getting weaker at sitting?

Answer 21

Physiologic murmur

80% prevalence, mainly in that first half year, age 3-7 and on puberty

mainly seen when CO is eleveted- stress, fever

Question 22

Premature atrial contraction around delivery- workup?

Answer 22

Follow-up. mainly benigh

Question 23

Which clinical presenation of Premature ventirucle contraction is usally more benigh?

Answer 23

• Heart with normal morphological stracture
• single beats which disapper with elevation in HR

Question 24

מהי האינדיקציה החשובה ביותר לבירור ושקילת טיפול בפעימות חדריות מוקדמות?

Answer 24

**הכי חשוב- מחלת לב ברקע / ניתוח בעבר
**
בנוסף:
* יותר מ-2 פעימות רצופות
* PVC מולטיפורמי
* עליה בתדירות הפעימות במאמץ
* הפעימה מופיעה על גל T של הפעימה הקודמת
* PVC < 20% מכלל הפעימות

Question 25

Tx for PVC (premature ventricular contractions)

Answer 25

1st line- lidocaine 2nd line- amiodarone

Question 26

Dgx of long QT syndrome? | and Tx

Answer 26

ECG during stress + 24h holter | Tx- BB

Question 27

indication of ICD for long QT syndrome?

Answer 27

pt after Heart arrest refactory syncope mut. in LQT3

Question 28

Congenital AV block?

Answer 28

Congenital SLE- check for Ab anti RO mainly (also Anti-La) ## Footnote indiaiton for ICD- syncome, prolong pause in HB, HB< 50

Question 29

Stable VT Tx?

Answer 29

Amiodarone > lidocaine

Question 30

which type of infection can be seen in PT who get nutrients by TPN

Answer 30

high risk for fungal infections

Question 31

prognosis of myocarditis in babies?

Answer 31

75% mortality rate risk for dilated cardiomyopathy in future

Question 32

Which bcateria can cuse pericarditis?

Answer 32

pneumoccoc, GAS, SA, Hib, **mycoplasma**

Question 33

most common reason for primary HTN in kids?

Answer 33

Obesity

Question 34

most common cause for secondary HTN in kids?

Answer 34

90% secondary to kidney disease ex.- scarring due to reflux UTI neurofibromatosis- pheochromicytoma / RAS

Question 35

How to Dgx inborn errors in arota and its branches?

Answer 35

Echo + CT/MRI symp. pt + evidanve of trachea pressure = surgery

Question 36

ECG of brugada syndrome?

Answer 36

Diffuse ST V1-V3 (coved ST elevation) ## Footnote AD inheritance- SCN5A gene (30% of cases)

Question 37

Digeorge syndrome chromosomal abnormality Cardiac defects electrolyte problems? Dgx?

Answer 37

22.11q TOF + Truncus (most common) a-thymic hypocalcemia | Dgx- FISH

Question 38

Hypercalcemia + supra-vulvuar aortic stenosis is a/w?

Answer 38

**Williams syndrome** cocktail party personality elf face, chrom. 7

Question 39

Which syndrome is a/w MS AS coractation of aorta

Answer 39

Shon complex (rare malformation) left side obstructions

Question 40

Eisenmieger syndrome definition

Answer 40

When the shunt switch from L to R to R > > L Cyanosis