Cardiology Flashcards by Huda Abdulrhman

Adolescent routine physical exam, apical midsystolic non-ejection click, and late systolic murmur; the murmur is louder when goes from a supine to a standing position, and the murmur becomes softer when squatting

Mitral valve prolapse

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The most common cardiac lesion associated with Noonan syndrome

Pulmonary stenosis and HOCM

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A 2-week-old boy develops congestive heart failure, severe metabolic acidosis, and poor perfusion of the lower extremities

Coarctation of the aorta

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The most common cardiac lesion associated with trisomy 18

Ventricular septal defect (VSD)

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Newborn presents with shock; the echocardiogram shows coarctation of the aorta. What is the drug of choice?

Prostaglandin E1

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What are some common side effects of indomethacin?

Thrombocytopenia GI bleeding Necrotizing enterocolitis Renal failure

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A 1-day-old newborn presents with cyanosis, single first and second heart sounds, chest radiograph, shows decreased lung markings, and electrocardiogram shows left axis deviation

Tricuspid atresia with pulmonary atresia

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Newborn presents with intense cyanosis and respiratory distress, chest radiograph shows a “snowman” shaped heart

Supracardiac total anomalous pulmonary venous return

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A 5-year-old, heart rate is 230 beats/min, chest discomfort; the heart rate decreases to 80 beats/ min after ice is applied to the face

Supraventricular tachycardia (SVT)

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A 4-year-old boy with physical examination significant for widely split and fixed S2 and crescendo-decrescendo systolic ejection murmur heard in the second intercostal space at the upper left sternal border. EKG shows a RSR1 pattern in V1. What is the most likely diagnosis?

Atrial septal defect

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Newborn infant presents with a soft, harsh systolic ejection murmur, best heard at the axillae, and precordium and no symptoms

Peripheral pulmonary stenosis (PPS)

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While having her hair brushed, a 15-year-old girl develops cold sweats, pallor, and palpitations and loses consciousness for 10 s

Vasovagal syncope

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Child presents with chest pain, fever, friction rub; EKG shows diffuse ST-segment elevation, had upper respiratory infection 10 days before

Pericarditis

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A 1-day-old infant with a history of maternal diabetes, cyanosis, and tachypnea, poor response to supplemental oxygen, loud single second heart sound, no murmur, chest radiograph shows narrow mediastinum with small heart tipped on side, increased pulmonary vascularity

Transposition of great vessels

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A late complication of an untreated ASD or VSD that results in desaturation

Eisenmenger syndrome—shunt becomes a right to left shunt

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Late diastolic rumbling murmur with an opening snap heard at the apex

Mitral valve stenosis

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What is the reason that left to right shunt lesions may not present until 1 month of age?

The pulmonary vascular resistance drops to normal levels at that time

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Child presents with a history of intermittent tachycardia; EKG shows a short PR interval, slurred and slow rise of the initial upstroke of QRS (delta wave), widened QRS complex

Wolff–Parkinson–White syndrome (WPW)

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EKG in a 12-day-old shows negative T wave in V6

Left ventricular hypertrophy

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The most common valvular lesion associated with acute rheumatic fever

Mitral regurgitation

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A mildly desaturated child with tetralogy of Fallot going in for dental work; is SBE prophylaxis indicated?

Antibiotic prophylaxis

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The most common cardiac lesion associated with cri du chat syndrome

VSD

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An athlete presents with dyspnea while playing; systolic ejection crescendo- decrescendo murmur best heard at the apex and left sternal border, and radiates to the suprasternal notch; the murmur is louder while standing and with Valsalva maneuver

Hypertrophic cardiomyopathy

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The most common cardiac lesion associated with trisomy 21 (Down syndrome)

Endocardial cushion defect

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What is the most likely etiology of an early highpitched diastolic murmur associated with bounding pulses in a patient with Marfan syndrome?

Aortic regurgitation

A 6-year-old with a continuous murmur, lowpitched sound, best heard in the infraclavicular region, disappears when supine and with gentle pressure on the jugular vein

Venous hum

The most common cardiac lesion associated with DiGeorge syndrome

Tetralogy of Fallot

EKG shows sinus tachycardia, widened QRS complex with an interval greater than 100 ms, in a child who presents with altered mental status after accidentally ingesting grandmother’s medication

Tricyclic antidepressant (TCA) toxicity

The most common cardiac lesion associated with Williams syndrome

Supravalvar aortic stenosis

The most common cardiac lesion associated with Alagille syndrome

Branch pulmonary stenosis

Child with a previous history of endocarditis; is SBE prophylaxis indicated?

Antibiotic prophylaxis

The most common cardiac lesion associated with lithium teratogen

Ebstein anomaly

Newborn presents with cyanosis in the lower extremities, tachycardia, respiratory distress, and loud single S2 sound

Persistent pulmonary hypertension (R→L shunting across the PDA)

The most common cardiac lesion associated with tuberous sclerosis

Cardiac rhabdomyoma

Adolescent diagnosed with influenza presents with fever, tachycardia, edema, and gallop; chest radiograph shows pulmonary edema, cardiomegaly, low-voltage EKG

Myocarditis

EKG shows progressive prolongation of PR interval followed by a drop in QRS

Second degree AV block (Mobitz I or Wenckebach)

Child routine physical exam, systolic murmur with a vibratory character, best heard in the lower sternal border, varies with changes in respiration and position

Still’s murmur

A 2-year-old with a history of tetralogy of Fallot has progressive agitation, increasing cyanosis, and increased fussiness , no murmur

Hypercyanotic spell (Tet spell)—next step is the knee-chest position

Most common valve abnormality associated with aortic stenosis

Bicuspid aortic valve

Newborn fails hearing screen; EKG shows a very prolonged QT interval

Jervell and Lange- Nielsen syndrome

Newborn presents with severe cyanosis, systolic ejection murmur, and a single second heart sound, chest radiograph shows decreased pulmonary vascular markings

Severe pulmonary stenosis

A 6-month-old infant with failure to thrive, diaphoresis, and hepatomegaly. Echocardiogram shows a large VSD. Next best step?

Surgical correction

What is the next best step in a newborn with suspected transposition of the great vessels?

Prostaglandin E1 to keep the patent ductus arteriosus (PDA) open, followed by +/− balloon atrial septostomy and surgery

An infant of diabetic mother presents a few hours after birth with jitteriness, hypoglycemia, cyanosis; EKG shows prolonged QT interval

Hypocalcemia

The most common cardiac lesion in fetal alcohol syndrome

VSD, ASD

A 12-year-old presents with hypertension, occasional headache, leg cramps, weak and delayed femoral pulse, and blood pressure in the upper limb is higher than the lower limb, chest radiograph shows rib notching and scalloping on the undersurface of posterior ribs

Coarctation of the aorta

The most common cardiac lesion associated with supraventricular tachycardia

Ebstein anomaly

The most common cause of cyanotic heart disease presenting a few days after birth

Transposition of the great vessels

An 8-week-old boy presents with feeding difficulties, poor weight gain, episodes of bluish discoloration of the skin while feeding and crying, a harsh systolic ejection murmur (SEM) is heard over the pulmonic area and left sternal border; chest radiograph shows diminished vascularity in the lungs and diminished prominence of the pulmonary arteries, a boot-shaped heart (cœur en sabot)

Tetralogy of Fallot

The most common cardiac lesion associated with Turner syndrome

Bicuspid aortic valve

The most common congenital cardiac lesion overall

VSD

While running, a 15-year-old girl lost consciousness

Thorough cardiac evaluation and referral to a cardiologist

Child with prosthetic mitral valve going for surgery; is SBE prophylaxis indicated?

Antibiotic prophylaxis

Newborn presents with cyanosis (mother was on a medicine for severe bipolar disorder), chest radiograph shows cardiomegaly and right atrial enlargement

Ebstein anomaly

Child with mitral regurgitation and VSD, going in for dental work. Is SBE prophylaxis indicated?

No antibiotic prophylaxis

What is the most feared complication of Kawasaki disease?

Coronary artery aneurysm

Newborn with cyanosis, pulse oximetry changed from 60% to 88% on 100% O2

Pulmonary (most likely)

An 8-year-old presents with sharp stabbing nonspecific chest pain at rest that resolves shortly. There are no other symptoms and no past medical history

Reassurance (precordial catch syndrome)

The most common cardiac lesion associated with the infant of a diabetic mother

Ventricular hypertrophy

What is the initial management for an obese adolescent with elevated cholesterol levels?

Diet and lifestyle modifications, and if cholesterol is still elevated after 6 months, then start statin

Newborn with cyanosis, pulse oximetry changed from 60% to 64% only on 100% oxygen

Cardiac (most likely)

A girl with Turner syndrome presents with hypertension, weak and delayed femoral pulse

Coarctation of the aorta

What is the definitive treatment for SVT?

Radiofrequency ablation

At what ages is lipid screening universally recommended in the pediatric population?

Once between 9 and 11 and again between 17 and 21

What is the next best step for the newborn with suspected hypoplastic left heart?

Prostaglandin E1

History of repaired VSD with a small residual VSD next to the VSD patch, going in for dental work. Is subacute bacterial endocarditis (SBE) prophylaxis indicated?

Antibiotic prophylaxis

High-pitched holosystolic blowing murmur heard loudest at the apex and radiates to the axilla

Mitral valve regurgitation

During the first 48 h of life, a newborn rapidly develops cyanosis, tachypnea, respiratory distress, pallor, lethargy, metabolic acidosis, oliguria, weak pulses in all extremities, hepatosplenomegaly, and no murmur

Hypoplastic left heart (as PDA closes)

The most common cause of sudden cardiac death in an athlete

Hypertrophic cardiomyopathy

What is the most common organism responsible for infective endocarditis in pediatric patients with or without congenital heart disease?

Staphylococcus aureus

Systolic murmur most commonly heard at the right upper sternal border radiates to the neck and is associated with an ejection click

Aortic stenosis

Late crescendo systolic murmur associated with a mid-systolic click, may be seen in adolescents

Mitral valve prolapse

A 15-year-old boy with a history of recurrent chest pain during exercise faints and dies while playing basketball; hypertrophic cardiomyopathy ruled out as a cause of death. What is the next likely cause?

Anomalous left coronary artery is most likely

A football player presents with chest pain with exertion and several near syncope episodes during his football game. Next best step?

Restrict from sports then EKG and echocardiogram

An asymptomatic adolescent with blood pressure 137/87, all labs normal, renal US and chest radiograph normal. What is the next best step?

Salt restriction in diet

Tall, peaked T waves in precordial leads indicates

Hyperkalemia

The syndrome that is associated with true interrupted aortic arch

DiGeorge syndrome

A 15-year-old girl faints while running and has a positive family history of deafness and sudden death

Long QT syndrome

A premature infant with a continuous machine-like murmur and bounding pulses

PDA

The most common cardiac lesion associated with Holt–Oram syndrome

Atrial septal defect (ASD)

The most common cardiac lesion associated with Marfan syndrome

Aortic root dilation (risk for dissection)

Which medication is used to close a PDA in a premature infant?

Indomethacin

EKG shows normal PR intervals and periodic drop in QRS

second degree AV block (Mobitz II)

A 10-year-old male presents with sharp chest pain; the pain is reproducible on physical exam

Costochondritis

Prophylaxis of IE

Cardiology Flashcards

(85 cards)