Cardio

Question 1

Breathless shunts

Answer 1

Left to right
VSD *
PDA
ASD

Question 2

Cyanotic shunts

Answer 2

Right to left
Tetralofy of Fallot *
Transposition

Question 3

Shunts in utero

Answer 3

ductus venosus (placenta -> IVC)
-> ligamentum venosum
Foramen vale (RA-> LA) 
-> fossa ovale
Ductus arteriosus (RV -> aorta)
-> ligamentum arteriosum

Question 4

Rubella- cardiac abnormalities

Answer 4

pulmonary stenosis

PDA

Question 5

SLE-cardiac abnormalities

Answer 5

Complete heart block

Question 6

SLE antibodies

Answer 6

anti-RO

anti- La

Question 7

DM- cardiac abnormalities

Answer 7

increased incidence overall

Question 8

Warfarin cardiac abnormalities

Answer 8

pulmonary valve stenosis

PDA

Question 9

Fetal alcohol syndrome cardiac abnormalities

Answer 9

ASD, VSD

tetralogy of Fallot

Question 10

Down syndrome cardiac abnormalities

Answer 10

AVSD
VSD
PDA

Question 11

Edward syndrome- chromosomal abnormality

Answer 11

trisomy 18

Question 12

Patau syndrome- chromosomal abnormality

Answer 12

trisomy 13

Question 13

Turner syndrome cardiac abnormalities

Answer 13

aortic valve stenosis

CoA

Question 14

Turner syndrome chromosomal abnormality

Answer 14

45, XO

Question 15

Williams syndrome cardiac abnormalities

Answer 15

supravalvular aortic stenosis

peripheral artery stenosis

Question 16

Noonans syndrome

Answer 16

hypertrophic cardiomyopathy
ASD
pulmonary valve stenosis

Question 17

Innocent murmur characteristics

Answer 17

aSymptomatic
Soft blowing murmur
Systolic
left Sternal edge

Question 18

Hear failure in neonates features

Answer 18

breathless (tachypnoea)
tachycardia 
gallop rhythm
cardio- & hepatomegaly  
sweating 
poor feeding 
recurrent chest infections

Question 19

Heart failure neonates causes

Answer 19

obstructed circulation (duct dependant)

• CoA
• interruption of ascending aorta
• critical aortic stenosis
• hypoplastic LH syndrome

Question 20

Heart failure in infancy

Answer 20

high pulmonary blood flow

• VSD
• AVSD
• Large PDA

Question 21

Heart failure in older children

Answer 21

Eisenmenger syndrome
Rheumatic heart disease
Cardiomyopathy

Question 22

ASD types

Answer 22

secundum- persistent foramen ovale (higher)

primum ASD- partial ass with abnormal AV valves (AVSD)

Question 23

ASD signs

Answer 23

ESM
fixed widely split 2nd heart sound
ECG: RBBB common, RAD

Question 24

AVSD signs

Answer 24

AVSD -> apical pan systolic murmur (regurgitation)

ECG: superior axis (-ve in aVF)

Question 25

ASD Rx

Answer 25

significant if RV dilatation occlusion device 3-5 yers

Question 26

VSD signs

Answer 26

active pericardium soft pansystolic murmur (no murmur = large) apical mid-diastolic murmur ECG: biventricular hypertrophy

Question 27

VSD Rx

Answer 27

diuretics captopril inc. calories surgery 3-6 m

Question 28

PDA define

Answer 28

failure of Ductus Arteriosus closure by 1 month after the expected delivery due date

Question 29

PDA causes

Answer 29

congenital | prematurity

Question 30

PDA signs

Answer 30

``` continuous machinery murmur (Gibson's) increased pulse pressure collapsing or bounding pulse asymptomatic large: heart failure, pulmonary HTN ```

Question 31

PDA Rx

Answer 31

ibuprofen (NSAID) dexamethasone coil/occlusion device (cardiac catheter) at 1yr

Question 32

Tetralogy of Fallot: characteristics (4)

Answer 32

1. VSD 2. Overriding aorta 3. RH hypertrophy 4. Subpulmonary stenosis

Question 33

Tetralogy symptoms

Answer 33

Tet spells- hyper cyanosis | squatting (inc. vascular resistance)

Question 34

Tetralogy signs

Answer 34

clubbing harsh ESM CXR: boot shaped w/ pulmonary artery bay ECG: RV hypertrophy later

Question 35

Tetralogy CXR

Answer 35

boot shaped w/ pulmonary artery bay

Question 36

Tetralogy ECG

Answer 36

RV hypertrophy later

Question 37

Tetralogy Rx

Answer 37

medical initially surgery at 6m Tet spells if followed by sleep >15 mins - morphine - IV propanolol/ alpha agonist (vasoconstriction) - IV fluids -bicarbonate (for acidosis)

Question 38

Transposition of the great vessels signs

Answer 38

cyanosis day 2 of life loud, single S2 CXR: egg on side w/ narrow upper mediastinum & RV hypertrophy

Question 39

Transposition Rx

Answer 39

``` prostaglandin infusion (maintains PDA patency) balloon arterial septostomy definitive treatment- arterial switch procedure (neonatal period) ```

Question 40

AVSD Rx

Answer 40

medical management of heart failure | surgical repair 3-6 m