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Flashcards in Cardio Deck (83):
1

inadequate oxygen delivery by the myocardium to meet metabolic demands of the body

CHF

2

3 compensatory mechanisms that cause CHF

hypo perfusion of end organs, increased renin angiotensis system, catecholamine release

3

what may cause high output CHF

anemia

4

rapid infusion of IV fluids in premature infants may cause

CHF

5

these drugs increase the efficiency of myocardial contractions and relieve tachycardia

digoxin (cardiac glycosides)

6

drugs that reduce Intravascular volume by maximizing sodium loss

Loop diuretics

7

treatment of CHF secondary to CHD

surgical repair

8

murmurs caused by turbulent flow that are not caused by structural heart disease and have no hemodynamic significance

innocent heart murmurs

9

3 types of innocent heart murmurs

Stills murmur, pulmonic systolic murmur, venous hum

10

This is the type of innocent heart murmur heard at the mid left sternal board in ages 2-7, loudest supine and with excersize

Stil's murmur

11

this innocent heart murmur is heard at the upper left sternal board, peaks early in systole, blowing high pitched, loudest supine and with exersice

Pulmonic systolic murmur

12

innocent heart murmur heard neck and below clavicles at any age, continuous and heard only sitting or standing, not heard SUPINE or with neck flexion or extension

Venous hum

13

type of ASD in lower portion of atrial septum w/ possible mitral regurg and common in DOWN syndrome

ostium primum

14

ASD defect in middle portion of atrial septum and most common overall ASD

ostium secundum

15

type of high ASD where right plum vein drain into the right atrium or SVC

sinus venosus

16

what may children with an osmium primum defect w/ mitral regurg develop?

CHF

17

physical findings include Increased right ventricular impulse, fixed S2 split w/ diastolic rumble and lower left sternal border

ASD

18

VSD pathophysiology

Bc of decreased pulmonary resistance and increased systemic resistance blood flows from the left ventricle into the right ventricle

19

as the size of the VSD decreases the intensity of the murmur _______?

increases

20

holosystolic murmur heard at apex

VSD

21

Eisenmenger syndrome

when PVR is greater than systemic resistance resulting in a switch from left to right to RIGHT TO LEFT shunt

22

large VSDs w/ pulmonary hypertension are closed at what age?

3-6 months

23

small vsd's are closed at what age?

2-6 years

24

continuous machine like murmur at the upper left sternal border w/ widened pulse pressure

PDA

25

what is used to close a PDA?

indomethacin

26

narrowing of aortic arch below subclavian artery

coarctation of the aorta

27

patient w/ severe coarctation may depend on what anomaly for perfusion of lower thoracic and descending aorta?

right to left shunt through PDA

28

hypertension in right arm and reduced blood pressure in lower extremity

PDA

29

what else may someone w/ coarctation have?

bicuspid aortic valve

30

in coarctation of the aorta does the femoral pulse precede the radial pulse?

no, femoral pulse is DELAYED.

31

treatment of coarctation in neonate

IV prostaglandin E (to keep pda open) and inotropic medication (dopamine)

32

what is the therapy of choice in recurrent cocarctation?

balloon angioplasty

33

ross procedure

aortic stenotic valve is replaced w/ pulmonary valve

34

why does severe aortic stenosis cause left ventricular hypoplasia in the neonate?

impaired fetal left ventricular development w/ myocardial ischemia

35

aortic stenosis symptoms in older children

chest pain, syncope and sudden death

36

high aortic valve pressure gradient

>50-70

37

high pulmonary valve pressure gradient

>35-40

38

what can be seen on chest x ray with patent ductus arterioles

cardiomegaly w/ increased pulmonary vascular marking

39

ejection click w/ systolic ejection murmur at base that radiates to the upper right sternal border and carotids

aortic stenosis

40

vasomotor instability and vasoconstriction causes

peripheral cyanosis

41

5 cardiac causes of central cyanosis

tetralogy of fallout, transposition of great arteries, tricuspid atresia, truncus arterioles and total anomalous pulmonary venous connection

42

tetralogy of flow components

Pulmonary stenosis, right ventricular hypertrophy, overiding aorta, VSD,

43

boot shaped heart

tetrallogy of fallow

44

what may a child w/ tetralogy of fallot do?

squat ( tet spells) increases venous return to heart and SVR decreasing the right to left shunt

45

graft imposed between subclavian and ipsilateral plum artery to improve pulm growth w/ tetralogy of fallot

blalock taussig shunt

46

definitive management of tetralogy of fallot

complete surgical repair at 4-8 months.

47

results in pulmonic and systemic circulations in parallel rather than in series

transposition of the great arteries

48

what do patients need to survive w/ transposition of the great arteries?

shunting blood through a patent foramen ovale, ASD, VSD or

49

acute management of a TET spell

1. squat position
2. IV fluid bolus
3. oxygen
4. morphine (stops agitation
5. propranolol
6. Sodium bicarb
7. transfusion for anemia
8. surgery

50

central cyanosis, SINGLE s2, no murmur

transposition

51

2 initial managements of transposition of great vessels

PGE and emergent balloon atrial septostomy (rashkind procedure)

52

what does the rash kind procedure do?

increases the size of the ASD or PFO

53

condition in which an ASD or PRO is always present and a plate of tissue is on the floor of the right atrium?

tricuspid atresia

54

the only cause of cyanosis in the newborn period that results in LAD and LVH

tricuspid atresia

55

fontan procedure

treatment of tricuspid atresia where flow from inferior vena cava is directed into pulmonary arteries

56

most common acquired heart disease in children in US , asian males

kawasaki disease

57

kawasaki disease symptoms

5 day fever, bilateral conjunctivitis, oropharyngeal changes, cervical adenopathy, rash, red, cracked swollen lips, erythematous palms and soles.

58

causes of infective endocarditis?

strep viridans and staph introduced during an invasive proedure

59

what can be seen on valves during infective endocarditits?

vegetations

60

roth spots, janeway lesions and osier nodes are seen in?

bacterial endocarditis

61

most sensitive way to detect vegetations in infetive endocarditis?

transesophageal echocardiography

62

most common bacterial causes of pericarditis?

staph aureus and strep pneumo

63

chest pain most intense while supine and relieved when sitting upright, pericardial friction rub, distant heart sounds and pulses paradoxes , hepatomegaly

pericarditis

64

management of pericarditis?

1. antibiotics, 2. antiinflam, 3. drainage

65

common cause of death in young athletes

myocarditis

66

elevated ESR, CK MB fraction and C reactive protein

lab results for myocarditis

67

identification of organism of myocarditis?

PCR or viral serology of endomyocardial biopsy specimens

68

type of cardiomyopathy that is autosomal dominant w/ asymmetric septal hypertrophy

hypertrophic cardiomyopathy

69

most common cause of death in young athletes?

hypertrophic cardiomyopathy

70

valsalva and standing will increase or decrease the ejection murmur of cardiomyopathy?

increase

71

type of cardiomyopathy seen w/ amyloidosis and inherited infiltrative disorders?

restrictive cardiomyopathy

72

type of cardiomyopathy seen w/ carnitine and nutrition deficiency or mitochondrial abnormalities?

dilated cardiomyopathy

73

neonatal heart rate greater than 250?

SVT

74

delta wave on EKG?

WPW (sudden cardiac death)

75

SVT management?

vagal maneuvars, ice pack, carotid massage, IV ADENOSINE, chronic digoxin and propanolol, radio frequency catheter ablation

76

babies born to SLE moms typically have what kind of AV block?

third degree

77

prolongation of PR interval?

1st degree AV block

78

second degree type 1 block

wenkebock, progressive prolongation of PR interval

79

second degree type 2 block

more than one PR interval but no prolongation

80

treatment of AV block?

pacemaker

81

autosomal recessive syndrome associated w/ deafness and long QT?

jervel, lange, neilsen

82

autosomal recessive syndrome w/ long QT and no deafness?

Romano ward syndrome

83

causes an enlarged heart in older children w/ supra cardiac drainage "snow man appearance" w/ RVH and RAE

TAPVC