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Neonatal Board Questions > Cardiology > Flashcards

Cardiology Flashcards

(65 cards)

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1
Q

MC neonatal cardiac tumor

A

Rhabdomyoma

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2
Q

Rhabdomyoma associated with

A

Tuberous sclerosis

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3
Q

MC type of TAPVR

A

Supracardiac (pulmonary veins entering into the vertical vein, azygous vein or SVC)

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4
Q

Obstructive cause of TAPVR

A

Infracardiac or sub diaphragmatic

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5
Q

MCC complete vascular ring

A

Double aortic arch

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6
Q

What vessels does iNO work on?

A

Selectively dilates pulmonary blood vessels that are VENTILATED, resulting in improvement of V/Q matching

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7
Q

PACs result from

A

Depolarization originating within the atrium, before the SA node

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8
Q

Functional closure of PDA in full term infants

A

48 hours

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9
Q

Anatomic closure of PDA in full term infants

A

2-4 weeks

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10
Q

Differential cyanosis defined as

A

oxygen saturation >/= 5% or PaO2 >/=20mmHg

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11
Q

Reverse differential cyanosis defined as

A

Lower extremity oxygen saturation or PaO2 higher than upper extremity
(picture explanation here) https://www.utmb.edu/pedi_ed/CoreV2/CardiologyPart1/CardiologyPart18.html

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12
Q

Differential cyanosis associated with

A

PPHN or cyanotic heart disease

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13
Q

Reverse differential cyanosis seen in

A

D-TGA + PDA + Coarct, Interrupted aortic arch or PPHN

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14
Q

MC type of VSD

A

Perimembranous

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15
Q

Highest oxygen saturation in fetus

A

Umbilical vein (70%)

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16
Q

Lowest oxygen saturation in fetus

A

SVC (40%) because brain has highest oxygen extraction

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17
Q

PR interval prolonged

A

First degree AV block

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18
Q

Increasing PR interval until atrial impulse not conducted

A

Second degree AV block, Mobitz type 1, Wenckebach phenomenon

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19
Q

Abrupt atrial beat not conducted

A

Second degree AV block, Mobitz type 2

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20
Q

Which medication can lead to cyanide toxicity?

A

Nitroprusside

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21
Q

Inotrope forces Frank Starling curve in which direction?

A

Upward and leftward

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22
Q

Cardiac output =

A

Systemic BP / Total peripheral vascular resistance
OR
HR x Stroke volume

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23
Q

MC cyanotic heart lesion in first week of life

A

TGA

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24
Q

MC cardiac lesion in Trisomy 21

A

Endocardial cushion defect

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25
EKG in Endocardial cushion defect
Superior axis deviation d/t superior displacement of the AV node
26
MC congenital herat lesion in VACTERL
VSD
27
High or low lying catheter associated with increased risk of ischemic complications?
Low
28
High or low lying catheter associated with increased risk of HTN?
Equal risk
29
MCC hypertension in neonate
Renovascular disease | MCC renal artery thrombosis from umbilical catheter placement
30
MCC hypertrophic cardiomyopathy in neonates under 4
Noonan syndrome
31
Infants with congenital heart block, are moms symptomatic?
No, less than 1/3 of mothers have a diagnosis of SLE and most are asymptomatic
32
MC cardiovascular cause of hypertension in neonate
Coarctation of the aorta
33
What are dilators of the PDA?
Acidosis, hypoxia, prostacyclin and PGE1
34
What are constrictors of the PDA?
PGF2-alpha, acetylcholine, bradykinin, oxygen
35
Initial treatment for stable infant with flutter?
Digoxin (to block the ventricular rate)
36
Initial treatment for unstable infant with flutter?
Synchronized cardioversion or esophageal pacing followed by digoxin
37
What week does cardiogenesis begin?
5th week
38
What week does the heart begin to beat?
6th week
39
What week does septation of the heart begin?
Between weeks 7 and 8
40
Conotruncal defect is defined by
Normal development of the cardiac outflow tract is disrupted
41
Examples of conotruncal defects
``` Truncus arteriosus TGA TOF DORV DOLV Interrupted aortic arch ```
42
Ductus arteriosus arises from which arch?
Left 6th aortic arch
43
Carotid artery arises from which arch?
3rd arch “Make Some Impoetant Shtuff” ICA from 3rd
44
R subclavian artery arises from which arch?
R 4th arch | “Make Some Important Schtuff”
45
Aortic arch arises from which arch?
L 4th arch
46
Complications of untreated PDA
CHF, pulmonary hypertension, Endarteritis, ductal aneurysm
47
MC form of intracranial injury after bypass
White matter injury
48
Congenital heart defects most prevalent in which twin in TTTS?
Recipient twin
49
Most frequent congenital heart defects in TTTS
VSD, ASD, pulmonary stenosis
50
Epinephrine side effects and what mediated by
Hyperglycemia, lactic acidosis due to B2 receptor stimulation in liver Tachycardia due to B2 receptor stimulation in heart
51
Why does epinephrine preferentially increase SVR over PVR?
alpha 2 receptor mediated production of nitric oxide
52
Why does prolonged use of Dopamine result in less effective inotropy?
Norepenephrine stores of the myocardium can become depleted after only 12 hours
53
Does evidence support onefluid bolus for hypotension?
No- RCTs comparing placebo with fluid bolus found no difference in BP or short term outcomes such as mortality
54
Dopamine effects on left ventricular output and superior vena caval flow
Reduces both | Alpha 1 stimulation --> inc vasc resistance
55
Dobutamine effects on left ventricular output and superior vena caval flow
Increases both
56
Epinephrine effects on left ventricular output
Increase
57
Are PDAs clinically silent in first few days of life?
most are
58
When MC time frame for pulmonary hemorrhage from PDA?
First 72 hours (as blood floods the lungs from decreased PVR)
59
How does epinephrine work during a code?
Alpha 1 receptors increase PVR and decrease preferential blood flow to the dilated aorta and instead to coronary arteries
60
What is MC cardiac defect in DiGeorge?
Conotruncal ie. TOF, Truncus arteriosus
61
Bruit over anterior fontanelle seen in
anemia, meningitis, AVM
62
Normal EKG findings in first few days of life
Rightward QRS axis, upright T waves in V1, small QRS voltage in limb leads, low voltage T waves
63
What does Digoxin do to inotropy and chronotropy?
Positive inotrope | Negative chronotrope
64
How does Digoxin work on inotropy?
Inhibition of sarcolemmal Na/K ATP --> increases intracellular Na and Ca
65
How does Digoxin work on chronotropy?
Decreased due to prolonged SA conduction rate and increased refractory period through the AV node

Neonatal Board Questions (12 decks)

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