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[OS 205] 3rd Exam > Trans - Adult and Pediatric Structural and Functional Correlates > Flashcards

Trans - Adult and Pediatric Structural and Functional Correlates Flashcards

1
Q

difference between adult and pediatric cardiac diseases

A

[1] adult - acquired cardiac diseases (eg. coronary heart disease
[2] pediatric - congenital cardiac diseases

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2
Q

coronary artery balloon angioplasty

A

procedure used to open blocked coronary arteries wherein a balloon is inserted into the artery via catheter and inflated

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3
Q

adult heart rate

A

60-100 bpm

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4
Q

newborn heart rate

A

110-150 bpm

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5
Q

heart rate in 2yr child

A

85-120 bpm

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6
Q

heart rate in 4yr child

A

75-115 bpm

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7
Q

heart rate in 6 yr child

A

60-100 bpm

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8
Q

CT ratio of pediatric

A

0.55

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9
Q

[T/F] newborns cannot increase stroke volume

A

T

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10
Q

newborn cardiac output is depended on?

A

heart rate

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11
Q

effect of thymus in chest xray

A

enlarged cardiac shadow

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12
Q

main difference of fetal and adult circulation

A

site of gas exchange

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13
Q

umbilical vein

A

entrance of oxygenated blood from placenta into the fetus

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14
Q

ductus venosus

A

shunts blood from umbilical vein away from liver into the IVC

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15
Q

foramen ovale

A

connects LA and RA to allow bypassing of pulmonary circuit

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16
Q

ductus arteriosus

A

connects pulmonary trunk and aorta to allow bypassing of pulmonary circuit

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17
Q

umbilical arteries

A

exit of deoxygenated blood from fetus into placenta

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18
Q

consequences of interruption of umbilical cords upon birth

A

[1] increase in systemic vascular resistance –> closure of ductus venosus

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19
Q

consequences of lung expansion upon birth [4]

A

[1] fall in pulmonary vascular resistance
[2] increased pulmonary blood flow
[3] increased LV pressure –> closure of foramen ovale
[4] increased blood O2 content –> closure of ductus arteriosus

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20
Q

what causes ductus venosus closure

A

increased systemic vascular resistance

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21
Q

what causes foramen ovale closure

A

increased LV pressure upon lung expansion

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22
Q

what causes ductus arteriosus closure

A

increased blood pO2 upon lung expansion, causing contraction of the smooth muscle

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23
Q

fate of ductus venosus

A

ligamentum venosum

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24
Q

fate of ductus arteriosus

A

ligamentum arteriosum

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25
Q

fate of formen ovale

A

fossa ovalis

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26
Q

fate of umbilical arteries

A

medial umbilical ligaments

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27
Q

fate of umbilical vein

A

ligamentum teres

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28
Q

incidence of congenital heart disease

A

4-8 per 1000 live births

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29
Q

Baltimore-Washington infant study - conclusions

A

frequency of certain cardiac defects varies according to gender:
[1] males - TGA, AV stenosis, tricuspid atresia
[2] females - AV canal defects, ASD, VSD

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30
Q

environmental factors causing congenital heart disease [2]

A

[1] maternal illness / infection

[2] drug exposure

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31
Q

[T/F] late cardiac defects are more critical

A

F, it is early cardiac defects which are more critical

32
Q

examples of early cardiac defects [5]

A 
[1] laterality and looping defects
[2] cardiac outflow tract defects
[3] AV septum defect
[4] VSD membranous type
[5] TAPVR
33
Q

examples of late cardiac defects [6]

A 
[1] VSD muscular type
[2] obstructive lesions
[3] ASD
[4] PDA
[5] Ebstein's malformation of tricuspid
[6] cardiomyopathies
34
Q

examples of acyanotic heart disease [2]

A

[1] left to right shunt

[2] obstructive lesions

35
Q

examples of cyanotic heart disease [3]

A

[1] right to left shunt

[2] transpositions of great vessels

36
Q

left to right shunt - effects

A

[1] increased pulmonary blood flow
[2] pulmonary hypertension –> congestive heart failure
[3] RV hypertrophy

37
Q

right to left shunt - effects

A

[1] reduction in pulmonary blood flow –> cyanosis

38
Q

Tetralogy of Fallot

A

[1] pulmonary stenosis
[2] overriding aorta
[3] RV hypertrophy
[4] VSD

39
Q

Ebstein’s anomaly

A

Downward displacement of an abnormal tricuspid valve into the right ventricular cavity. Part of the right ventricle is thus incorporated into the right atrium (atrialized right ventricle) and the remaining ventricular cavity is malformed and reduced.

40
Q

why are complex lesions called complex lesions?

A

these lesions involve mixing of pulmonary blood flow and systemic blood flow as a result of complex interactions between systemic vascular resistance and pulmonary vascular resistance

41
Q

obstructive lesions - effects

A

[1] pressure overload on ventricle –> hypertrophy

[2] low cardiac output

42
Q

tachypnea

A

pulmonary overcirculation

43
Q

Eissenmenger’s syndrome

A

the process in which a left to right shunt causes increased flow through the pulmonary vasculature, causing pulmonary hypertension, which in turn causes increased pressures in the right side of the heart and reversal of the shunt into a right-to-left shunt.

44
Q

ostium secundum defects

A

interatrial communications within fossa ovalis

45
Q

ostium primum defects

A

partial AV septal defect

46
Q

ASD - general direction of flow? why?

A

left to right, LA pressure is higher

47
Q

[T/F] there is faster flow through a VSD if pulmonary stenosis is absent

A

F

48
Q

difference of partial and complete AVSD

A

partial AVSD still has 2 valve orifices, complete AVSD only has 1 valve orifice (abnormal valve arrangement)

49
Q

partial AVSD is physiologically similar to

A

ostium secundum ASD

50
Q

PDA - effects

A

[1] increased pulmonary blood flow –> decrease in lung compliance
[2] increased pulmonary return –> hypertrophied / dilated LV
[3] continuous murmur

51
Q

methods of closure for PDA

A

[1] coil closure

[2] device closure

52
Q

types of pulmonary stenosis

A

[1] valvar
[2] supravalvar
[3] subvalvar / infravalvar
[4] branch peripheral –> stenosis of left, right, or both pulmonary arteries

53
Q

pulmonary stenosis defect develops during first __ weeks of pregnancy

A

8

54
Q

aortic stenosis - effect

A

[1] decreased cardiac output

[2] left ventricle hypertrophy –> may lead to chest pain

55
Q

how does aortic stenosis often occur in adults?

A

deposition of calcium in the valve (calcific aortic stenosis)

56
Q

coarctation of aorta - effects

A

[1] hypertension (high BP before point of coarctation, low BP beyond point of coarctation)

57
Q

Blalock-Thomas-Taussing Shunt

A

treatment for Tetralogy of Fallot –> anastomosing pulmonary artery with subclavian artery, bypassing pulmonary stenosis

58
Q

pulmonic atresia

A

pulmonic valve is replaced by a solid sheet of tissue (valve stays closed) –> closed pulmonary circuit

59
Q

Ebstein’s anomaly - effects

A

[1] poor development of tricuspid valve –> tricuspid regurgitation
[2] backing up of blood –> RA dilation, fluid buildup in heart
[3] poor pumping of RV –> not enough oxygen –> cyanosis

60
Q

tricuspid atresia

A

tricuspid valve is missing –> blockage of blood flow from RA to RV

61
Q

tricuspid atresia - effects

A

[1] hypoplastic RV –> underwork

62
Q

tricuspid atresia usually comes with these other defects:

A

[1] ASD
[2] VSD
[3] pulmonic stenosis

63
Q

treatment of tricuspid atresia

A

Blalock-Thomas-Taussig Shunt

64
Q

most common cyanotic congenital heart defect

A

transposition of great arteries

65
Q

truncus arteriosus

A

[1] truncus arteriosus instead of pulmonary trunk and aorta
[2] overrides both ventricles
[3] large VSD

66
Q

TAPVR

A

total anomalous pulmonary venous return
[1] pulmonary veins connect / lead to right atrium
[2] ASD present

67
Q

OPQRST

A 
onset
precipitating/aggravating factors
quality
radiation
severity
timing
68
Q

precordial bulge indicates:

A

cardiomegaly

69
Q

vibratory / still’s murmur

A

innocent murmur in children caused by small ascending aortic diameter

70
Q

innocent pulmonic murmur

A

continuous venous hum, louder in diastole

71
Q

long term effect of cyanosis

A

hypoxemia –> tissue death

72
Q

causes of cyanosis

A

[1] right to left shunt
[2] decreased pulmonary blood flow
[3] ventriculoarterial discordance {TGA}
[4] low cardiac output

73
Q

congestive heart failure

A

clinical condition wherein the heart cannot meet the metabolic demands of the body

74
Q

Harrison’s groove indicates

A

congestive heart failure

75
Q

in fetal circulation, fraction of blood flowing through RV

A

2/3

76
Q

in fetal circulation, fraction of blood flowing through foramen ovale

A

1/3

[OS 205] 3rd Exam (6 decks)

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