Cardiology Flashcards

(95 cards)

0
Q

medium to high pitched grade 1-2 mid-systolic murmur, soft ejection at birth to one week until 3-4 months

A

neonatal PPS from small pulmonary arteries - innocent

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1
Q

Murmur axillae and back, birth 2-3 months, grade 1-2

A

Pulmonary branch stenosis

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2
Q

low pitched 1-3 mid systolic vibratory musical buzzing murmur loudest when child is lying down but goes away if standing, from 1-10 yrs with vibration in LVOT

A

Still’s - innocent

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3
Q

Continuous grade 1-3/6 murmur, heard best at clavicle from 2-10 yrs, increased when upright, abolished by head turn or jugular compression

A

Venous hum - innocent

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4
Q

widely split S2

A

ASD

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5
Q

loud single S2

A

pulmonary htn

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6
Q

3 Pansystolic murmurs

A

VSD, TR, MR

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7
Q

Harsh murmurs (3)

A

VSD, valve stenosis, outflow tract obstruction

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8
Q

systolic clicks (3)

A

aortic or pulmonic stenosis, MVP

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9
Q

% w DS w/ CHD? and types?

A

40-50%, AV canal defect or primum ASD

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10
Q

Turner and CHD, % and types

A

30%, coarctation of Ao, bicuspic aortic, aortic stenosis, later w/ dissection/aneurysm

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11
Q

the high and common ASD?

A

Ostium secondum

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12
Q

Noonan % w/ CHD and type

A

80-90%, Pulm stenosis, ASD, HOCM! (Right heart)

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13
Q

William’s syndrome, %/CHD type

A

supravalvar aortic stenosis, Coarct (Left sided) 60%

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14
Q

22q11, %/type of CHD

A

Conotruncal 35%, interrupted aortic arch, truncus arteriosus, TOF

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15
Q

Alagille syndrome CHD %

A

95%, pulm art stenosis, TOF

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16
Q

CHD in Fetal alcohol

A

VSD, ASD, TOF

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17
Q

CHD and CHARGE?

A

ASD, VSD

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18
Q

De Lange and CHD?

A

TOF, VSD

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19
Q

Cri-du-chat and CHD?

A

Various CHD

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20
Q

CHD in fetal hydantoin?

A

ASD, VSD, Coarct

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21
Q

CHD and Infant of DM mother?

A

Hypertrophic cardiomyopathy, VSD, TGA

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22
Q

Laurence Moon Biedl and CHD?

A

TOF, VSD

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23
Q

Marfan and CHD?

A

Aortic root aneurysm, mitral prolapse

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24
Rubella and CHD?
PDA, peripheral pulmonary stenosis
25
Rubinstein-Taybi and CHD?
PDA
26
Holt-Oram and CHD?
ASD, VSD
27
Treatment of hypercyanotic spell (5) (TET spell)
knee-chest, O2, sedation, fluids, phenylephrine
28
Prevention of hypercyanotic spells
no dehydration, treat iron def, B-blocker
29
most common cyanotic lesion in newborn?
TGA
30
BT shunt?
Aorto-pulmonary
31
EKG w/ q waves in 1, avl, V5, V6, ST elevation in V5, V6. Sweating, SOB w/ feeding? Also has holosystolic murmur
Coronary problem: ALCAPA. Murmur from MR (from ischemia of papillary muscles)
32
what is ALCAPA
coronaries from pulm artery instead of Ao
33
Anomalous left coronary artery from right aortic (not left) aortic sinus? Causes what in teens?
sudden death! exertional chest pain/syncope
34
Test if vascular ring is suspected?
barium swallow or CT
35
Two most common bugs in infective endocarditis
Strep viridans, >> Staph aureus
36
Dental prophylaxis for heart disease? which ones? What tx?
1. unrepaired cyanotic CHD (shunt/conduit) 2. complete repair w/ prosthetic material in 6 mos 3. repaired but residual defect at site of lesion or prosthetic 4. transplant w/ valve issue AMOX
37
Criteria for ARF?
JONES: joints (arthritis), carditis, nodules, erythema marginatum, Sydenham's chorea are major
38
Tx of ARF?
Benzathine PCN G (IM) no NSAIDS until dx established ASA 100mg/kg/day in 4-6 divided doses RArely steroids
39
murmur in carditis in ARF?
regurgitation: Mitral or aortic
40
dx req for Kawasaki?
Fever! | 4/5
41
% of coronary artery aneurysm in Kawasaki/
15-20%
42
Diagnostic test in suspected pericarditis? Finding?
ECG: diffuse ST elevation segment and PR segment depression:
43
% FH in HOCM?
30%
44
acute tx of SVT
cardioversion if unstable vagal maneuvers Adenosine: 0.1mg/kg IV bolus. Can repeat and double. Max 12mg
45
Drug never to use in baby <2y w/ arrhythmia?
Verapamil
46
short PR interval, wide QRS, delta wave Dx? Complications?
WPW | prob: SVT, life threatening afib w/ rapid ventricular rate/sudden death
47
acute tx of ventricular tachycardia
cardiovert, amiodarone
48
two causes of congenital heart block
mom w/ SLE aBs: anti-Ro/SSA, anti-La/SSB | L transposition of Great arteries
49
most common wide QRS tachycardia in kids?
SVT with a bundle branch block
50
long QTC?
>470-480 (99%) | borderline is 440-470
51
inheritance in long QT?
autosomal dominant usually if not assoc w/ deafness
52
syncope without prodrome or with emotional / physical stress | EKG with tachycardia w/ polymorphic VT
long QT!
53
hallmark arrhythmia in long QT syndrome?
torsades, polymorphic vtach
54
recommendation if you see WPW in teen? Any tests? Management issue?
Do echo, because could be assoc w. CHD Sports restriction Not typically genetic/hi risk to other family members
55
neonatal PACs cause what? Tx?
p buried in T, PAC causes bradycardia b/c it gets blocked. Benign. observe.
56
CHD with sat in hand LESS than foot?
HAS to be TGA, with postductal saturation high, open ductus.
57
valve prob assoc w/ coarctation and Ao
bicuspid aortic valve
58
consider this in younger child w/ cardiomyopathy and systemic weakness
Becker! Less severe than Duchenne but with out of proportion cardiomyopathy, and sometimes initial presentation
59
Most common CHD presenting in late teen with cyanosis?
Tetrology (pink tet) if mild pulm stenosis
60
infant with cyanosis, no CHD and no resp distress. Well water
methemoglobinemia
61
``` normal sized heart cyanosis pulm edema short systolic murmur, single S2 Full term baby ```
TAPVR
62
normal sats on rt side of heart vs left?
right: 70s Left: close to 100
63
cyanosis on day 1-2, tachypnea, lack of increased vascular markings?
likely PDA closing, w/ ductal dependent lesion
64
``` asx till 3-5 mos palpable right ventricular impulse Single S2 RVH boot heart Dx? ```
TOF
65
4 components of TOF?
Pulm stenosis overriding aorta VSD RVH
66
what often triggers hypercyanotic hypoxic episode? | Cause?
TET spell often anemia triggered incr R-->L shunting
67
5 treatments for TET spell
1. knee to chest 2. morphine 3. phenylephrine 4. propanolol 5. volume expansion
68
precordial hyperactivity loud S2 but NO murmur very enlarged heart
Hypoplastic Left Heart: looks huge b/c all RV
69
common presentation of hypoplastic left heart? | Tx?
10 d newborn with cardiogenic shock, tx: PGE1 to keep ductus open
70
egg shaped heart single S2 incr pulm vascularity on CXR tachypnea and cyanosis in newborn
tga
71
Single S2: Two disorders and how to distinguish?
TGA: increased pulm vascularity TOF: no incr pulm vascularity
72
generalized facial swelling, fatigue, wt loss, nt sweats, dusky color?
venous stasis from Superior Vena Cava syndrome
73
managing Digoxin?
about borderline 1st degree heart block with PR of about 200. Not blood levels.
74
diastolic murmur on right OR systolic ejection click at apex | Dx?
endocarditis
75
tender lesions on pads of fingers / toes
Osler nodes
76
nontender red nodules on palms, soles
janeway lesions
77
best study to confirm endocarditis
blood culture (not echo)
78
most common bug in acute bacterial endocarditis
S aureus
79
most common bug in subacute endocarditis
strep viridans
80
most common bug in viral myocarditis
coxsackie group B
81
pulsus paradoxus, EKG w/ low volt, abnormal T wave, ST depression, DX? Tx?
myocarditis | No steroids
82
pericardial friction rub but no change in sound w/ change in position, non-positional
purulent pericarditis
83
Very good murmurs?
Vs: Very good, venous hum, vibratory, and Vascular (carotid bruit)
84
pansystolic murmur left lower sternal border OR single loud S2 and hyperdynamic precordium
VSD
85
Fetal alcohol causes what two heart defects
ASD, VSD
86
bad systolic murmurs?
pan or late systolic
87
"normal" third heart sound?
disappears when child sits up from lying
88
Superior QRS axis (30-90 degrees) found in what?
AV canal (conduction goes around the large middle defect)
89
two disorders causing left axis dev?
tricuspid atresia and AV Canal Defect
90
two populations when PACs are not okay
<1y or children on digoxin
91
Digoxin contraindicated when?
WPW
92
SVT: beware of two drugs?
Verapamil in babies < 1yr: cardiac arrest | Digoxin: contraindicated in WPW
93
major prognostic indicator with AV block?
if its a wide QRS complex in which case: risk of seizure and syncope
94
left axis deviation : 2 causes and ddx them
Tricuspid atresia, endocardial cushion defect. | Tricuspid atresia is cyanotic. ECC is not.