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CVPR exam 2 > Congenital Heart Disease I > Flashcards

Congenital Heart Disease I Flashcards

1
Q

What are prostaglandins a product of?

A

arachidonic acid

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1
Q

What could happen if a large PDA is left untreated?

A

pulmonary venous occlusive disease (***Eisenmenger’s syndrome- irreversible pulmonary hypertension) increased risk of subacute bacterial endocarditis

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2
Q

How does the ductus arteriosus close?

A
  1. fewer elastic fibers and more SM in the ductus 2. increased PaO2 after birth causes contraction of SM 3. removal of placenta removes prostaglandins that kept it open en utero
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2
Q

DX? Respiratory effects (Difficulty weaning off the ventilator, Pulmonary edema/hemorrhage) CHF Feeding intolerance, bowel ischemia, necrotizing enterocolitis Renal insufficiency Intraventricular hemorrhage or stroke Death

A

PDA

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3
Q

What is a shunt?

A

a connection between two chambers/vessels

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4
Q

How will a small PDA present?

A

usually baby will be asymptomatic

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4
Q

What are the physical exam findings in a large PDA with L to R shunting?

A

wide pulse pressure bounding pulses (palpable palmar pulses) increased work of breathing hyperactive precordium murmur

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5
Q

In whom is the incidence of PDA increased?

A

premees (70% of all babies born at

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5
Q

What is the classic murmur in PDA?

A

Continuous or machinery-sounding murmur along the left upper sternal border possible diastolic rumble

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7
Q

How old is the baby when a patent ductus arteriosus is considered persistent?

A

1 year

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9
Q

Usually a PDA is a _____ (direction) shunt.

A

L to R

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9
Q

What does PDA stand for?

A

persistent ductus arteriosus

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10
Q

What is the incidence of PDA?

A

5-12% of all congenital heart defects

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11
Q

DX? wide pulse pressure bounding pulses (palpable palmar pulses) increased work of breathing hyperactive precordium murmur

A

signs of PDA

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13
Q

____ is the most potent agent for maintaining ductal patency.

A

PGE2

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14
Q

In whom is the incidence of PDA increased?

A

premees (70% of all babies born at

15
Q

How does a moderate/large PDA present?

A

Respiratory effects (Difficulty weaning off the ventilator, Pulmonary edema/hemorrhage) CHF Feeding intolerance, bowel ischemia, necrotizing enterocolitis Renal insufficiency Intraventricular hemorrhage or stroke Death

15
Q

How does a moderate/large PDA present?

A

Respiratory effects (Difficulty weaning off the ventilator, Pulmonary edema/hemorrhage) CHF Feeding intolerance, bowel ischemia, necrotizing enterocolitis Renal insufficiency Intraventricular hemorrhage or stroke Death

16
Q

DX? Continuous or machinery-sounding murmur along the left upper sternal border possible diastolic rumble

A

PDA

18
Q

When is a the PDA a R to L shunt?

A

in premees, babies with lung disease, or babies born at high altitude (all causes of elevated pulm vascular resistance)

19
Q

DX? Respiratory effects (Difficulty weaning off the ventilator, Pulmonary edema/hemorrhage) CHF Feeding intolerance, bowel ischemia, necrotizing enterocolitis Renal insufficiency Intraventricular hemorrhage or stroke Death

A

PDA

20
Q

What does PDA stand for?

A

patent ductus arteriosus

21
Q

What is a connection between two chambers/vessels?

A

a shunt

22
Q

How is the ductus arteriosus kept open when needed?

A

IV PGE2

23
Q

How is PDA treated?

A

COX inhibitors (IV indomethacin) surgical ligation or percutaneous occlusion

25
Q

What is a shunt?

A

a connection between two chambers/vessels

26
Q

Where does the ductus arteriosus derive from?

A

left 6th aortic arch

28
Q

How does a moderate/large PDA present?

A

respiratory effects (difficulty weaning off ventilator, pulmonary edema/hemorrhage) CHF feeding intolerance, bowel ischemia, necrotizing enterocolitis renal insuff intraventricular hemorrhage or stroke death

29
Q

Older infant or young child with a ______ may present with a hoarse cry, history of pneumonias, failure to thrive, increased work of breathing and diaphoresis with activity/feeding.

A

large PDA

30
Q

When does closure of the ductus arteriosus normally occur?

A

functional closure at 10-15 hrs after birth (delayed at altitude, tho) anatomic closure by 2-3 week of life

CVPR exam 2 (29 decks)

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