cardio

Question 1

atrial septal defect murmur

Answer 1

asymptomatic when younger

ejection systolic upper left sternal edge

Question 2

atrial septal defect causes

Answer 2

fetal alcohol syndrome

trisomy 21

Question 3

Patent Ductus Arteriosus presentation

Answer 3

preterm babies
Poor feeding, failure to thrive, tachypnoea
continuous machinery murmur pulmonary area
bounding collapsing pulse

Question 4

ventricular septal defect presentation

Answer 4

harsh loud pan systolic murmur best heard in LLSE

Poor feeding, failure to thrive, tachypnoea

Question 5

Atrioventricular Septal defect (AVSD) presentation

Answer 5

common in trisomy 21
can lead to peripheral vascular disease
Poor feeding, failure to thrive, tachypnoea

Question 6

coarction of aorta presentation

Answer 6

narrowed aorta obstructs LV outflow
3 sign on CXR
radio-femoral delay
ejection systolic murmur upper left sternal edge

Question 7

aortic stenosis

Answer 7

Weak Pulses
Thrill palpable in suprasternal region and carotid area
Ejection systolic murmur in aortic area (URSE)
critical - collapsed and acidotic

Question 8

pulmonary stenosis

Answer 8

Ejection systolic Murmur in the Upper left sternal edge

asymptomatic

Question 9

tetrology of fallot

Answer 9

large VSD
overriding of the aorta
subpulmonary stenosis
right ventricular hypertrophy

Question 10

transposition of the great arteries presentation

Answer 10

incompatible with life
check 22q deletion
prostoglandin infusion to maintain ductus arteriosus
surgery

Question 11

rheumatic fever cause

Answer 11

cross sensitivity reaction to group A b haemolytic strep (strep pyogenes)
can occur after pharyngitis

Question 12

rheumatic fever - jones diagnostic criteria

major (5) minor (5)

Answer 12

2 major or 1 major 2 minor
major:
carditis (changed murmur, CCF, cardiomegaly)
polyarthritis
erythema marginatum (pink rings/redness of skin)
subcutaneous nodules
sydenhams chorea (uncoordinated jerks)

minor:
fever
raised ESR/CRP
arthralgia
previous
ECG PR<0.2

Question 13

rheumatic fever treatment

Answer 13

aspirin - careful of reyes (encephalopathy and liver failure)
phenoxymethylpenicilin, then benzylpenicilin for pharyngitis
prednsiolone for sydenhams chorea

Question 14

infective endocarditis presentation

Answer 14

fever + new murmur (until proven otherwise)
splinter haemorrhages
roth spots
janeway lesions
clubbing
osler nodes

Question 15

infective endocarditis diagnosis

major (2) minor (5)

Answer 15

2 major or 1 major 3 minor or 5 minor
major:
+ve blood culture on 2 separate cultures
endocardium involved (+ve echo)

minor: predispostion
fever >38
vascular phenomena (janeway lesions)
immunological phenomena (osler nodes, roth spots)
\+ve cultures not meeting major criteria

Question 16

infective endocarditis treatment

Answer 16

benzylpencilin and gentamicin

Question 17

cyanotic congenital heart disease
blood flow
examples

Answer 17

R to L shunt

Tetraology of Fallot if presents in first few months
Transposition of great arteries if presents in the first few days

Question 18

breathless congenital heart disease
blood flow
examples

Answer 18

L to R shunt

VSD
PDA
ASD

Question 19

what happens if tetrology of fallot is left untreated

Answer 19

Eisenmenger’s syndrome – long standing R to L shunt increases Pul pressure over time, leading to thickening of pulmonary arteries, which causes RVH and increases pressure in RV, reversing the shunt L to R (cyanotic).

Question 20

infective endocarditis cause

Answer 20

strep viridans

staph aureus