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Flashcards in Cardiology Deck (54):
1

S1

closure of mitral and tricuspid valves heard at LLSB/apex

2

S2

closure of aortic and pulmonic valves split only on inspiration

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S3

early diastolic murmur d/t rapid ventricular filling heard at LLSB/apex

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S4

late diastolic sound usually found w/ reduced ventricular compliance

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cause of clicks

valvular abnormality or dilated aorta/pulmonary artery

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cause of mid systolic click

MVP

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Grade 1 murmur

soft, heard only under quiet conditions

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Grade 2 murmur

soft, heard under noisy conditions

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Grade 3 murmur

easily heard

10

Grade 4 murmur

loud murmur associated with thrill

11

Grade 5 murmur

loud murmur w/ stethoscope tilted and thrill

12

Grade 6 murmur

loud murmur heard 5-10 mm from chest w/ thrill

13

early systolic murmurs

AS, MS, ASD, coarctation

14

holo systolic murmurs

MR, TR, VSD

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late systolic murmurs

MVP

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early diastolic murmurs

AR, PR

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late diastolic murmurs

MS, TS

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continuous diastolic murmurs

PDA

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innocent murmurs

venous hum, pulmonary flow, pulmonic stenosis, Stills

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Stills murmur

low pitched musical sound at LLSB age 3 - adolescence

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P wave

atrial depolarization

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increased P wave amplitude

enlarged right atrium

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prolonged p wave

enlarged left atrium

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PR interval

beginning of P wave to beginning or QRS

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elongated PR interval

slowed conduction through AV node

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QRS complex

ventricular depolarization

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increased QRS amplitude

greater ventricular volume or mass

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QT interval

depolarization and repolarization of ventricles

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normal QT interval

< 0.45 sec

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prolonged QT interval

sudden death, hypocalcemia, hypokalemia, arrhythmia, Torsades de Pointes

31

syncope workup

reassurance, EKG, GTT, EEG

32

chest pain workup

MSK Hx, CXR, EKG, Holter, exercise stress test

33

Supraventricular Tachycardia (SVT)

rapid regular rate with narrow QRS, abrupt onset and termination, pounding HB, pallor, fatigue

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SVT treatment

vagal maneuver, IV Adenosine, synchronized cardioversion if Sx

35

Premature Ventricular Contractions (PVC)

premature HB /w no preceding P wave, QRS wider and abnormal

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PVC treatment

no intervention, remove caffeine, proper fluid intake

37

ventricular septal defect (VSD)

holosystolic murmur at LLSB; Tx: after load reduction and surgical closure

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atrial septal defect (ASD)

fixed split S2, soft systolic ejection murmur, increased RV impulse; Tx: surgery by age 3

39

patent ductus arteriosus (PDA)

continuous machine-like murmur infraclavicularly; Tx: IV indomethacin or ibuprofen, surgury

40

drug to maintain PDA

prostaglandins (PGE)

41

endocardial cushion defect

atrioventricular canal defect seen with Down's and causing HF

42

pulmonary stenosis (leaflet development failure)

systolic ejection murmur at 2nd ICS, some w/ click, dyspnea; Tx: valvuloplasty

43

aortic stenosis (leaflet development failure)

systolic ejection murmur w/ click, chest pain; Tx: often leads to valve insufficiency, observation

44

coarctation of aorta

narrowing of aorta, assoc. w/ Turner's (XO), UE HTN w/ LE low BP, S3; Tx: surgery

45

cyanotic CHD mnemonic

5 T's and an H screened during newborn

46

Tetralogy of Fallot

MC cyanotic, truncus arteriosus w/ mult. defects, severe cyanosis, "tet" spells (blue skin when crying or feeding), squatting; Tx: knee-chest position, VSD and pulm. stenosis repair, prophylaxis for endocarditis

47

transposition of great arteries

switched aortic and pulmonic arteries, death w/out blood mixing; Tx: prostaglandins, atrial septoplasty if severe, switch w/in 2 weeks

48

tricuspid atresia

no tricuspid and hypoplastic RV, severe cyanosis; Tx: prostaglandin, Staged surgery: 1)Blalock 2)bidirectional Glenn 3)Fontan

49

truncus arteriosus

failure of truncus septation, cyanosis and cough; Tx: supportive CHF care, surgical repair

50

total anomalous pulmonary venous return (TAPVR)

pulmonary veins connect to right atrium instead of left, hyperactive RV and widely split S2 w/ systolic ejection murmur; Tx: open pulmonary vein into L atrium

51

hypoplastic left heart

MCC death in 1st mo, failed dev. of aortic arch/mitral valve/aortic valve, gray mottled skin; Tx: prostaglandins, ventilation, surgical: Norwood, Glenn, Fontan

52

rheumatic fever

group A strep then autoimmune attack of valves, triad: erythema marginatum, subcutaneous nodules, Sydenham chorea; Tx: benzathine PCN, salicylate, bedrest

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Jones Criteria

evidence of strep + 2 major or 1 major and 2 minor criteria

54

pediatric autoimmune neuropsychiatric disorders associated with strep (PANDAS)

post strep autoimmune d/o with onset or worsening of OCD/tic disorders