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Flashcards in Cardio Deck (39):
1

high BP and bounding pulses in upper extremities, low BP and weak/absent pulses in lower extremities

Coarctation of the aorta

2

deep inspiration will increase the intensity of the murmur -- systolic ejection murmur heard over LUSB and base, radiates to neck or back, harsh quality, widening of S2

pulmonic stenosis

3

Egg on a string

Transposition of the great arteries

4

Ejection click at RUSB

COA

5

acute rheumatic fever (ARF) peak age? usually the result of what type of infection?

peak age: 5-15 years

GABHS

6

midsystolic ejection murmur heard over RUSB and base, radiates to right neck, harsh quality, S2 may be silent -- this is?

aortic stenosis

7

HTN diagnosis in kids

average systolic or diastolic BP > 95% for age and sex on at least 3 occasions over 1-2 weeks

8

criteria for diagnosis of ARF - major (JONES) and minor

2 major or 1 major and 2 minor

major (JONES):
- Migratory polyarthritis (joints)
- carditis (significant new murmur)
- subcutaneous nodules
- erythema marginatum
- synenham's chorea

minor:
- fever
- arthralgia
- previous rheumatic fever
- elevated ESR or c-reactive protein
- prolonged PR interval

9

down's syndrome is associated with what cardiac defects

- AV canal defects
- VSD
- TOF

10

what type of heart failure?
- periorbital/facial edema
- hepatomegaly
- sudden weight gain
- dependent edema and ascites
- distended neck veins (rare in children)

right sided HF - systemic congestion

11

Turner's syndrome is associated with what cardiac defect

coarctation of aorta

12

management of ARF (4 points)

- refer to peds cardio
- treatment of GABHS with penicillin)
- anti-inflamatoryies (ASA, prednisone)
- daily prophylaxis

13

tx for kawasaki

aspirin, IVIG

14

warning signs for organic heart murmurs (5)

- rough, coarse, harsh
- loudest at base of heart
- usually at least grade III
- does NOT change with positioning
- tachycardia, tachypnea

15

IE prophylaxis including dental cleaning for kids with CHD - what to do?

amoxicillin 1 hr prior to the procedure -- no longer for GU or GI tract procedures

16

strawberry tongue, pink eyes (conjunctivitis but without discharge), trunk rash, dry/cracked lips, redness, swelling, flaking of palms and soles of feet

kawasaki disease

17

an athlete with active infectious ___ of the eye should not swim

conjuncitivitis

18

is S3 or S4 ever normal in kids?

S3 yes, S4 NOT normal

19

with regards to secondary HTN, the younger the child and the higher the BP, the greater the probability of ____ pathology

renal

20

systolic murmur that's low pitch, vibratory, twangy, changes with positioning, heart loudest lying down and after exercise, think

innocent heart murmur

21

the rash associated with acute rheumatic fever is:
- pink papular wit pale center on face and trunk that is pruritic
- macular erythematous with pale center on the trunk and extremities
- nodular near the extensors
- non-pruritic vesicular on trunk

- macular erythematous with pale center on the trunk and extremities

22

diGeorge's is associated with what cardiac defects

- interrupted aortic arch
- TOF

23

blood pressure should be measured at well child visits beginning at age

3 years

24

most common congenital heart defect in children

VSD

25

systolic ejection heard best at LUSB, results from increased blood flow through the PA, fixed S2 split all signs of?

ASD

26

the NP is assessing a neonate for congestive heart failure. the NP would expect to find:
- poor feeding and tachypnea
- jaundice and liver at 1 cm below RCM on palpation
- pitting ankle edema and lethargy
- bradycardia and sweating

- poor feeding and tachypnea

27

an otherwise healthy child with an acyanotic heart defect may have:
- low oxygen sat
- right to left shunting
- left to right shunting
- clubbing of the digits

left to right shunting

28

continuous murmur with systolic and diastolic qualities, heard over left sternal edge, thrill, continuous and machinery like, all signs of?

PDA

29

fixed S2 split? think what 2 dxs

- ASD
- pulmonic stenosis

30

murmur heard over LLSB, systolic ejection murmur, radiates to the RLSB, holosystolic and harsh, 38% of pathologic murmurs all signs of?

VSD

31

cyanotic lesions with right to left shunting (4)

- TOF
- transposition of the great vessels/arteries
- trunks arteriosus
- pulmonary atresia

32

acyanotic heart disease typically present with s/s of ____

congestive heart failure

33

what type of heart failure?
- tachypnea
- increased respiratory effort
- grunting and nasal flaring
- retractions
- crackles

left sided HF - pulmonary congestion

34

if pt presents with headaches, fatigue, high BP and bounding pulses in UE, low BP in E, systolic ejection murmur, think

COA

35

more gradual clinical decompensation, may not present until after the first 2-3 weeks of age, classic symptoms of tachypnea, tachycardia, hepatomegaly?

acyanotic heart disease (ASD, VSD, PDA)

36

Holosystolic thrill at LLSB

VSD

37

a most concerning cardiac finding in a newborn or infant assessment is:
1. a blood pressure of 70/40
2. decreased femoral pulses
3. a regular heart rate of 100 while sleeping
4. a soft, grade III/VI systolic murmur

2. decreased femoral pulses

38

Grade II-III/VI systolic ejection murmur at LUSB

ASD

39

which of the following is a common cause of acquired coronary artery disease during childhood?
- rheumatic fever
- hypertension
- SLE
- kawaski disease

- kawaski disease