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Peds 2 (Exam 2) > Cardiac Issues > Flashcards

Cardiac Issues Flashcards

1
Q

what is the number one birth defect?

A

congenital heart defects

  • 0.8% of all children (1 in 150)
  • most problems are minor and self limiting
  • technology helps (18% dec in mortality)
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2
Q

what are congenital heart defects associated with?

A
  • down syndrome
  • inborn errors of metabolism (homocystinuria)
  • connective tissue disorders
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3
Q

abnormal opening between the atria

A

atrial septal defect

  • blood flows from R atrium to L atrium
  • pulmonary blood flow inc (HTN)
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4
Q

is atrial septal defect symptomatic?

A

no, but can lead to:

  • pulmonary HTN
  • CHF
  • atrial arrythmias
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5
Q

type of atrial septal defect in which there is a failure of the atrial septum to close during development

A

secundum

*80% of all ASD cases

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6
Q

type of atrial septal defect in which there is drainage of right pulmonary vein into right atrium instead of left

A

sinus venous type

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7
Q

type of atrial septal defect in which there is clefting of mitral valve and is commonly associated with DOWN SYNDROME (65% of down syndrome ppl have this)

A

ostium premium

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8
Q

type of atrial septal defect in which there is a coronary sinus (more RARE type of ASD)

A

coronary sinus septal defect

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9
Q

abnormal opening between the ventricles

A

ventricular septal defect

  • MOST COMMON congenital cardiac lesion (15-30%)
  • similar to having one venticle (“fontan circulation”)
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10
Q

is ventricular septal defect more common in males or females?

A

females

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11
Q

clinical significance of ventricular septal defect is directly related to what?

A

size of the defect

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12
Q

most common type of ventricular septal defect

A

perimembranous

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13
Q

ventricular septal defect near aortic valve as associatied with aortic valve prolapse

A

suprocrestal

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14
Q

type of ventricular septal defect that has spontaneous closure?

A

muscular singular

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15
Q

type of ventricular septal defect that resembles “swiss-cheese” and requires very complex surgical management

A

muscular multiple

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16
Q

failure of the ductus arteriosus to close after birth and leads to blood traveling form the aorta to pulmonary artery

A

patent ductus arteriosus

17
Q

patent dectus arteriosus is initially what?

A

acyanotic (left to right)

- and then leads to cyanotic (right to left) if not treated

18
Q

which gender is more likely to have patent ductus arteriosus

A

2:1 female

19
Q

casued by abnormal location of the muscle that separates the aortic valve and the pulmonary valve and is the MOST COMMON cyanotic defect after 1 year old

A

tetralogy of fallot

20
Q

which gender is more likely to have tetralogy of fallot

A

3:2 males

21
Q

what are the 4 aspects of tetralogy of fallot?

A
  • VSD: less oxygenated blood to body
  • pulmonary stenosis: less blood to lungs
  • R ventricle hypertrophy (inc work)
  • transposition of the aorta: less oxygenated blood to body
22
Q

what are some complications of kids with tetraology of fallot?

A
  • pacemakers
  • post-surgical arrythmias (bradycardia)
  • residual post surgical defect
  • fatigue/cyanosis
23
Q

narrowing of the aorta that is often accompanied by aortic valve defects, typically where ductus arteriosus closes

A

coarctation of the aorta

24
Q

what is often seen in coarctation of the aorta?

A
  • upper body HTN

- lower body HYPOtension

25
Q

what are the indications of pediatric heart transplant?

A
  • life expectancy less than a year

- significant limitation on daily life

26
Q

what are causes of end-stage heart disease in children?

A
  • viral or idopathic cardiomyopathy

- severe congenital heart defects

27
Q

how many pediatric heart transplants are done every year?

A

500

28
Q

why is survival after a pediatric heart transplant greatly improved?

A
  • advancements in PICU
  • immunosuppression is more effective
  • statins to reduce coronary disease

*survival approx at 90% at 3 years

29
Q

is the epi in LA going to cause any issues to the cardiovascularly compromised?

A

no

30
Q

what are some dental preventative practices for cardiovascularly compromised?

A
  • OHI
  • diet
  • pt edu
  • caretaker edu
31
Q

what percentage of pts using cylosporins have gingival overgrowth? have cancer?

A
  • 30-50%

- 50%

32
Q

what is the normal prothrombin time?

A

12-13 seconds

33
Q

what is the therapeutic range for INR?

A

2-4

*still high but local measures can be used to control bleeding

34
Q

what are the ranges for INR?

A

high INR = 5 or greater (high chance of bleeding)
low INR = 0.5 (high chance of clotting)
normal INR = 0.9 - 1.3

35
Q

what should you worry about with infective endocarditis?

A
  • consult/ present findings to cardiologist

- NO SEDATION or GA without clearance

Peds 2 (Exam 2) (10 decks)

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