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Neo Review > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What increases Right to left shunt?

A

increase PVR , sedation, paralysis, hypoventilation, lower fio2
decrease SVT, milrinione, vasodilators

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2
Q

3 physical findings associated with cardiogenic shock

A

gallop murmur, pulmonary edema, hepatomegaly

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3
Q

In complex mixing lesions you are conerned not concerned about cyanosis, rather

A

Congestive Heart Failure

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4
Q

PGE might worsen symptoms in what CHD

A

Obstructed TAPVR, increases PBF

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5
Q

what are principles or repair of single ventricle?

A

separate pulmonary and systemic circulations
provide stable source of pulmonary and systemic circulation (not reliant on PDA)
balance pulmonic and systemic circulations

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6
Q

What CHD lesions do you see snowman appearance?

A

supracardiac form of TAPVC
patients have significant right atrial and right ventricular enlargement

usually have ASD (necessary to maintaining left ventricular output)

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7
Q

What does Alpha 1 do?

A

Increases SVR
Increases Contractility

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8
Q

What does alpha 2?

A

Decreases SVR

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9
Q

What does Beta 1 do?

A

Increases HR, increases Contractility, Increases Conduction

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10
Q

What does Beta 2 do?

A

Decreases SVR

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11
Q

what effect does epi have on HR

A

It increases HR at low dose (B1on SA and AV Node)
decreases HR at high dose

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12
Q

What is a Blalock-Taussig shunt?

A

Connects subclavaian artery to pulmonary artery to provide Pulmonary Blood Flow

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13
Q

What is Norwood procedure?

A

Creates a neoaorta from pulmonary artery and underdeveloped aortic arch to provide systemic circulation

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14
Q

what kind of heart defect has following:
Auscultation reveals that the infant has a systolic ejection murmur at the upper left sternal border and a low-pitched early diastolic rumble at the lower end of the sternal border. The second heart sound appears to be split.

A

Complete AV Canal

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15
Q

Where does obstruction occur in infradiaphragmatic TAPVR?

A
  1. obstruction of the common pulmonary or vertical vein can occur as it reaches the diaphragm
  2. at the junction with the portal veins
  3. or at the ductus venosus as it constricts in the early postnatal period.
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16
Q

which to left sided heart lesions require immediate intervention?

A

HLHS intact septum, obstructed TAPVR

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17
Q

Why is it important for cardioversion to deliver shock during QRS complex?

A

want to shock from being delivered during T wave while heart is being depolarized
R on T phenomenon can cause polymorphic tachycardia

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18
Q

why would you be judicious in use of oxygen in Right heart lesions and left heart lesions

A
  1. too much oxygen in Left sided lesions decreases flow in systemic circulation, which can lead to acidosis and shock
  2. too much oxygen in right sided lesion excessive pulmonary blood flow, acidosis and CHF
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19
Q

What is long QT for board purposes?D

A

450 ms

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20
Q

BPP what do you do if score is 6 and infant is >36 weeks and mother has favorable cervix?

A

Deliver

21
Q

highest PaO2 in placenta and umbilical cord

A

uterine artery (95)> uterine vein (40) > umbilical vein (29) > umbilical artery (18)

22
Q

Abnormal AFI

A

< 5 or > 24
normal 8-18

23
Q

Why is MCA doppler velocity increased with anemia?

A

fetus with anemia, needs to increase blood flow to brain/heart/adrenal glands.

24
Q

What do absent and reversed end diastolic flow signify?

A

increase in placental vascular resistance, and decrease placental blood flow

normally UA flow exists during diastole
in these conditions it does not

25
Q

Very first sign of placental insufficiency

A

ductus venous diameter increases, thus increasoing blood flow to heart.

26
Q

Most common other heart lesions seen in patients with Truncous Arterious?

A

the most common association is with aortic arch defects. Of these, the most frequent is a right aortic arch (seen in approximately 30% of patients with TA), followed by aortic arch hypoplasia or interrupted aortic arch (in approximately 10-12% of these patients).

27
Q

How does the diving reflex work?

A

increases parasympathetic output to the heart via the vagus nerve

28
Q

Why is neonatal Heart function more dependent on intracellular Calcium for contractility?

A

neonates have immature Sacroplasmic reticulum

29
Q

Why do you keep PDA open TGA

A

to promote atrial level mixing
augment more pulmonary blood flow back to the left atrium

30
Q
A
31
Q

Why does Prostaglandin decrease after birth

A

Prostaglandins metabolized in lungs do to increase PBF

32
Q

How does O2 uptake differ from fetus and infant?

A

in infant decrease in O2 uptake with hypoxemia, in fetus there could be 50% reduction fetal O2 delivery, and still no change in O2 uptake

33
Q

In utero if there is left obstructed heart lesion, is PDA wider or narrower

A

It will be wider( due to increased amount of flow)
would be narrower in (Right obstructed lesion due to decreased amount of flow)

34
Q

Which ventricle supplies most of blood in utero?

A

Right Ventricle

35
Q

Which ventricle is better oxygenated in utero, supplies better oxygenated blood

A

Left ventricle

36
Q

Why is PDA most important to stay open in HLHS

A

retrograde flow perfuses coronaries

37
Q

In what CHD do you see Left Superior QRS axis

A

Complete AV canal
(deep s wave in AVF), anatomic abnormality of HIS bundle, posterior and inferior rotation of AV node

38
Q

In what syndromes do you see hypertrophic cardiomyopathy?

A

Pompe, Hurler, Noonan

39
Q

What is pathophys of ALCAPA?

A

left coronary artery arises from pulmonary artery
clinical findings of ALCAPA depend on collaterals, PVR and myocardial effects

40
Q

How does Milrinone act?
What are some advantages over dopamine, epi and noriepi?

A
41
Q

How do Alpha 1, Alpha 2, Beta 1, and Beta 2 act?

A
42
Q

Differences between Dopamine and Dobutamine

A
43
Q

When would you use dobutamine over dopamine?

A
44
Q

Summary of Epi, high and low dose

A
Alpha more important than Beta
45
Q

Summary of noriepi

A
46
Q

How would Epi and CHF affect Frank Starling Curve?

A
47
Q

QP/QS Formula

A
48
Q

What do you see on imaging with vascular ring?

A

tracheal narrowing on CXR
barium swallow would show indentation of esophagus

Neo Review (18 decks)

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