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FOO/TAS > cardiology > Flashcards

cardiology Flashcards

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1
Q

types of shunts in antenatal circulation

A

ductus venosus
ductus arteriosus
foramen ovale

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2
Q

what circulation changes happwn after birth?

A
  1. doctus venosus closes as placenta removed
  2. lt sided circulation pressure increase leading to closure of ductus arteriosus
  3. LA pressure > RA pressure causes foramen ovale to close
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3
Q

incidence of cardiac malformation in live births?

A

8 in 1000

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4
Q

incidence of cardiac abnormalities in stillbirths?

A

1 in 10

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5
Q

what % of CHD is VSD

A

30%

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6
Q

what % of CHD is PDA

A

12

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7
Q

what % of CHD is ASD

A

7

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8
Q

what % of CHD is TOF

A

5

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9
Q

what % of CHD is TGA

A

5

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10
Q

what % of CHD is AS and coarctation of the aorta

A

5

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11
Q

Lt to Rt shunt (breathless)

A

VSD
ASD
PDA

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12
Q

Rt to Lt shunt

A

TOF
TGA
Eisenmenger Sx

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13
Q

common mixing (blue and breathless)

A

complete AVSD
Tricuspid atresia
Complex CHD

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14
Q

outflow obstruction (well child)

A

aortic stenosis
pulmonary stenosis
adult type CoA

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15
Q

outflow obstruction (collapsed neonate)

A

critical AS
hypoplastic left heart syndrome (HLHS)
CoA
Total anomalous pulmonary venous connection

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16
Q

incidence of infective endocarditis

A

1 in 1000
increased: CHD, prosthetic material in the heart, immunosuppression

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17
Q

most common organisms in IE

A

Staph aureus
coagulase negative staph
strep viridans

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18
Q

Common organisms causing Infective Endocarditis in diabetic and immunocompromised children

A

HACEK
- haemophilus
- Actinobacillus
- Cardiobacterium
- Eikenella
- Kingella

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19
Q

What are Roth spots

A

Also known as Litten spots

Seen in IE;
- white centered retinal haemorrhages

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20
Q

3 stages of surgical correction for HLHS?

A

1) Norwood procedure within first week of life

2) Glenn procedure at 3-6 months

3) Fontan procedure at 2-3 years (one ventricle supports both the pulmonary and systemic circulation). IT IS A PALLIATIVE PROCEDURE.

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21
Q

Surgical management for TGA?

A

Typically have a balloon atrial septostomy for stabilisation

Followed by the arterial switch operation (this has replaced the mustard operation)

If a VSD is also present would undergo the Rastelli operation

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22
Q

What type of vasculitis is Kawasaki disease

A

medium vessel
prediliction for coronary arteries

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23
Q

management of PDA

A

Trial of paracetamol, ibuprofen and indomethacin
duct ligation

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24
Q

duct dependent lisions

A

TGA
HLHS
Pulmonary/tricuspid atresia
CoA
PS

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25
most common CHD
Bicuspid aortic valve
26
Management of Paediatric SVT
1) Ice water to the face 2) Adenosine 3) Synchronised DC cardioversion (1J/kg for first shock followed by 2J/kg)
27
At what age do cyanotic spells usually develop in those with TOF?
4-6 months of age
28
types of HCM
Obstructiove non-obstructive (more common)
29
pharmacological management of HCM
Beta blockers CCBs Diuretics ACEi
30
surgical management of HCM
Implantable cardioverter defibrillator LV myomectomy if significant obstruction
31
TOF
VSD Overriding aorta RV outflow obstruction (PA) anterior malalignment of aorticopulomary septum
32
murmur in TOF
Ejection systolic at Lt sternal edge
33
CXR in TOF
Boot shaped heart
34
management of TOF
Surgery at 6 months: close VSD nad open PS Blalock Taussig shunt at 1 year
35
CXR in TOA
Egg on string
36
which conditions are associated with TOF
Foetal alcohol syndrome Di George (Chromosome 22q11 del)
37
which conditions are associated with transposition of great arteries
DM Rubella alcohol
38
clinical features of transposition
presents in first few days of like HF symptoms (poor feeding, tachypnoea, tachycardia, sweating)
39
murmur in transposition
no murmur
40
management of transposition
prostaglanding infusion ballon artery septostomy
41
what is prostaglandin used for
keep ductus arter open
42
murmur in tricuspid atresia
pansystolic murmur
43
investigations
ECG - L axis deviation and LV hypertrophy CXR ECHO
44
What is truncus arteriosus
PA and aorta are connected leading to mixing seen in Di George
45
clinical features of truncus
loud s2 systolic ejection murmur bounding pulse
46
what is hypoplastic left heart syndrome
underdevelop of Lt side of heart hypoplastic ventricle and aortic atresia no systemic flow from aorta Ductus arteriosis and ASD necessary for life
47
what is avsd
defect in between atria and ventricles associated with trisomy 21 L to R shunt
48
management of AVSD
Repair at 3 months treat CHF with diuretics
49
what is VSD
Defect in the septum that divides the right and left ventricles Leads to L to R shunt - Small VSD: harsh pansystolic murmur - Large VSD: soft, pansystolic murmur Associated with trisomy 21, 18, 13 and FAS
50
murmus in VSD
Pansystolic murmur small - harsh large- soft
51
complication of untreated VSD
Eissenmengers syndrome
52
what is patent ductus arteriosus
PDA is failure of fetal ductus arerioles to close increased risk of Endocarditis
53
murmur in pda
machinery murmur in L clavicle area
54
risk factors for pda
materal rubella prematurity female gender
55
management of pda
infomethacin (NSAID) closere with coil, occlusion device or ligation at 1 year if associated with heart defect, give prostaglandin
56
murmur in ASD
Soft ejection systolic murmur at 2nd left ICS
57
conditions assocaited with ASD
FAS Noonans syndrome
58
clinical features of coarctation
ejection systolic murmur that radiates to left side of chest absent/delayed femoral pulses HTN in arms
59
What conditions are associated with coarctation of the aorta?
turner syndrome (also bicuspid aortic valve)
60
clinical features of kawasaki disease?
CRASH and Burn Conjunctivitis Rash Adenopathy Strawberry tongue Hands (eruthema or swelling) Burning (fever for 5 days or more)
61
management of kawasaki
high dose aspirin in 4 divided doses ivig echo
62
causes of IE
Staph aureus most common step viridans if poor dental hygiene staph epidermis with prosthetic valve surgery
63
what is rheumatic fever
systemic immune response occurring 2-3 wks after beta haemolytic strep pharyngitis (Strep pyogens)
64
clinical features of rheumatic fever
erythema marginatum sydenham chorea polyarthritis pancarditis
65
management of RF
penicillin aspirin/naproxen heart surgery
66
investigations for RF
Strep antibodies throat swab rapid antigen group A test
67
innocent murmur
asymptomatic soft blowing systolic murmur lt sternal edge no thirll no radiation
68
what is ebstein anomaly
large RA nad small RV tricuspid incompetence
69
heart condition associated with Fragile X
Mitral valve prolapse
70
when does foramen ovale close
at birth
71
when does ductus arteriosus close
d2-3
72
when does ductus venosus close
d3-7
73
what is neede for tricuspid atresia to be compatible with life
ASD VSD
74
What type of asd is most common
secundum asd
75
what is delta wave associated with
wpw
76
cardiac conditions in Nanoon syndrome
Pulmonary stenosis 62%
77
Hypertrophic cardiomyopathy in nanoon syndrome is associated with mutations in which genes
RAF1 RIT1
78
What is the most common cardiac abnormality in Down syndrome
AVSD
79
ASD causes which ECG abnormality
RBBB
80
what is the most common symptom of aortic vascular ring
stridor
81
asd is associated with which other cardiac abnormality and murmur
mitral valve prolapse systolic click monitor with echo
82
hepatomegaly indicates which sides of heart failure
right
83
marfan syndrome causes cardiac?
aortic root aneurysm with aortic regurgitation (soft early diastolic murmur)
84
in asd, what does cardiomegally indicate
lt to rt shunting
85
most vommon cardiac malformation in turner syndrome
bicuspid aortic valve primary risk - aortic dissection
86
at is Lutembacher syndrome
congenital atrial septal defect with acquired mitral stenosis
87
tetralogy of fallot
ventricular septal defect pulmonary stenosis rt ventricular hypertrophy overriding aorta

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