Cardiac

Question 1

cardiac abnormalities associated with tetralogy of fallot

Answer 1

Pulmonary stenosis (ULSB), VSD at LLSB, overriding aorta, right ventricular hypertrophy

Question 2

most common cause of congestive heart failure in the first year of life is?

Answer 2

VSD

Question 3

s/s of Congestive EARLY heart failure in a 2-month old are?

Answer 3

Tachycardia and tachypnea

hepatomegaly, edema is initially noted in the eyes (can be subtle) about 10% wt increase.

Question 4

what is the recommended sub acute bacterial endocarditis prophylaxis?

Answer 4

AHA recommends prophylaxis for children within 6 months of a surgical repair or catheterization procedure that left a closure device

OR (EASIER) children with repaired congenital heart disease with a residual effect.

Question 5

URSB heard best when sitting, decreases with a change in head position, generally when turning ipsilaterally?

Answer 5

Venus Hum

```
ipsilateral= same side
(contralateral= opp. side)
~~~

Question 6

heard best at ULSB, axilla, and back

Answer 6

Peripheral Pulmonary stenosis

Question 7

Recommendations for children (2-8) with increased BMI and family risk factors

Answer 7

perform 2 lipid profiles and avg results

limit saturate fats <7%

Question 8

t/f standard of care for high cholesterol for peds is statins

Answer 8

false, NO stating under 10 yrs

Question 9

Murmur heard at URSB where is the problem likely coming from?

Answer 9

Aortic valve or Vessel

Question 10

Murmur heard at ULSB where is the problem likely coming from?

Answer 10

pulmonic valve

Question 11

pathologic murmur heard at LLSB where is the problem likely coming from? what else might you consider?

Answer 11

VSD or Tricuspid valve (even though tricuspid is on the RIGHT side of the heart, murmur is heard at Lower Left Sternal border)

Question 12

grade 2 to 3/4 systolic ejection murmur heard at the ULSB concern for what kind of condition?

Answer 12

ASD

can be confused for pulmonary valve/artery problem but the question asked for systolic ejection NOT systolic ejection CLICK which is heard in stenosis

Question 13

holosystolic murmur, sometimes associated with a thrill heard at the LLSB concern for what condition?

Answer 13

VSD

Question 14

holosystolic murmur head at ULSB with a machinery sound concern for what condition

Answer 14

PDA

Question 15

loud systolic ejection click at mid/ULSB concern for what condition?

Answer 15

TOF

Question 16

hypercapnic hypercyanotic episodes are called? r/t what disorder?

Answer 16

TET spells

Question 17

Prolonged PR interval on ECG with evidence of group A beta hemolytic strep is suspicious for?

Answer 17

Rheumatic fever

Question 18

list some of the major Jones criteria for diagnosing rheumatic fever?(5) What are some of the minor? (4)

what is the diagnostic criteria?

Answer 18

major: subcataneous nodules, carditis, chorea, polyarthritis, erythema marginatum (erythema multiforme like rash, or lyme disease like rash)
minor: fever>102.2, elev CRP/sed rate, arthralgia, prolonger PR interval ECG with evidence of strep infection.

2 minor 1 major, or 2 minor 1 major

Question 19

Venous hum decreases or disappears what two ways?

Answer 19

when turning head ipsilateral (right side), and when supine

Question 20

what valve is most affected with rheumatic fever? which side is it?

Answer 20

Mitral- left side

Question 21

which syndrome has coarctation of the aorta, bicuspid aortic valve

Answer 21

Turner syndrome

Question 22

which syndrome has aortic regurgitation and mitral valve prolapse?

Answer 22

Marfan syndrome

Question 23

Which syndrome is at risk for aortic dissection?

Answer 23

Marfan syndrome

Question 24

acyanotic heart diseases?
cyanotic heart diseases?
obstructive heart diseases?

Answer 24

A- VSD, ASD, PDA
C- Tran of greater arteries, TOF
O- pulm stenosis, aortic stenosis, coarc

A=  (think holes in heart)
C= more extensive conditions TGA, TOF
O= obstruction of valves

Question 25

expected sounds and locations for TOF

Answer 25

LOUD systolic ejection CLICK @ mid and ULSB | pulm stenosis @ULSB

Question 26

which condition has an ejection click at the apex and URSB if bicuspid valve is involved?

Answer 26

Coarctation

Question 27

What do you expect to see for blood pressures in the 4 limbs of kids with a coarc?

Answer 27

higher pressure in upper | Lower pressure in bottom

Question 28

TGA often has the same sounding murmur as what other condition?

Answer 28

VSD

Question 29

which condition has a machine like quality? where do you hear this?

Answer 29

PDA at the ULSB

Question 30

Where and what would you hear to make you suspect pulmonary stenosis?

Answer 30

ULSB, systolic ejection CLICK also thrill at the ULSB radiating to back and side (PPS) (click = think stenosis or narrow)

Question 31

Where and what would you hear to make you suspect aortic stenosis?

Answer 31

systolic thrill at URSB, systolic ejection click. | click = think stenosis or narrow

Question 32

What is the most common innocent murmur? where is it heard what does it sound like?

Answer 32

Stills murmur, between LLSB and apex | sounds musical, VIBRATORY

Question 33

Venous hum is heard best at? sounds like?

Answer 33

URSB, continuous humming murmur

Question 34

What is the flow of blood through the heart?

Answer 34

Sup vena cava, RA, Tricuspid valve, RV, Pulmonic valve, pulmonary artery, lungs, Pulm vein, LA, bicuspid/ mitral valve, LV, aortic valve, aorta, body= DONE :) give yourself a hug that one is rough

Question 35

S1 is the closure of?

Answer 35

Mitral and tricuspid valves (AV valves think atrioventricular as they separate the atrium and ventricles)

Question 36

S2 is the closure of?

Answer 36

aortic/ pulmonic valves

Question 37

Systole is the period between?

Answer 37

S1 and S2

Question 38

diastole is the period between?

Answer 38

S2 and S1

Question 39

describe the S/S for Kawasakis? | tx?

Answer 39

``` Fiery CRASH Fiery= Fever for 5days or more C= conjunctiva injected No exudate R= rash, appears polymorphic/ morbiliform, A= cervical lymphadenopathy S= Strawberry tongue H= hands, fingers edematous/ swollen then desquamation Tx: high dose ASA, IGG ```

Question 40

Rib notching, cardiomegaly, grade 2-3 systolic ejection murmur, possible ejection click at URSB, what condition is this?

Answer 40

Coarctation of the Aorta

Question 41

What are some red flags that concern you a patient is having chest pain related to cardiac symptoms?

Answer 41

Abrupt onset with no prodromal symptoms frequent pain associated with activity or exertion radiating pain, associated nausea, dizziness, fatigue

Question 42

what are some signs and symptoms of chest pain that are likely not cardiac in origin?

Answer 42

sharp, stabbing pains along two or more costochondral joints, occurs at rest, short duration (seconds to few minutes)

Question 43

what cholesterol level is considered hyperlipidemia?Borderline?

Answer 43

``` 200= hyper 170-199 = borderline ```

Question 44

what is the most useful test for eval of suspected rheum fever? - ASO titer - CRP - EKG - UA

Answer 44

ASO titer because it is important to evaluate for current or recent infection

Question 45

Wolff-Parkinson white syndrome is associated with what cardiac disorder?

Answer 45

SVT

Question 46

loud systolic ejection murmur heard at ULSB, holosystolic ejection murmur heard at LLSB with thrill. What condition are you concerned for?

Answer 46

TOF

Question 47

Turner syndrome has what cardiac anomalies?

Answer 47

coarctation of the aorta and bicuspid aortic valve

Question 48

Marfan syndrome has what cardiac anomalies?

Answer 48

mitral valve prolapse, aortic regurgitation and risk for aortic dissection

Question 49

down syndrome often has what cardiac anomalie?

Answer 49

ASD/ VSD

Question 50

List the 5 major jones criteria for diagnosis of rheumatic fever (think P.E.C.C.S)

Answer 50

``` polyarthritis erythema marginatum carditis chorea subcutaneous nodules ```