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PEDS FINAL > Cardiology > Flashcards

Cardiology Flashcards

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1
Q

What are Congenital Heart Diseases (CHD) due to? What are the two types?

A

Abnormal fetal heart development

- Acyanotic vs. Cyanotic

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2
Q

What are Acquired Heart Diseases (AHD) due to?

A

Disease or genetic predisposition

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3
Q

What are the two signs/symptoms of cardiac issues in INFANTS?

A
  • FTT (failure to thrive)

- Tachypnea with feeding/activity

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4
Q

What are the five signs/symptoms of cardiac issues in CHILDREN?

A
  • Palpitations/chest pain
  • Dizziness
  • Syncope
  • Exercise intolerance/SOB
  • Unexplained HTN
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5
Q

What three findings on physical exam are indicative of cardiac disease?

A
  • Femoral pulses unequal and not simultaneous with brachial
  • Clubbing of fingers/toes
  • Hepatomegaly
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6
Q

What are the two primary tests used to diagnose cardiac issues in peds? what other three tests should be considered, if needed?

A

Echocardiogram (TTE) and pulse ox

- Consider EKG, CXR and catheterization

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7
Q

What are the three types of innocent murmurs?

A
  • Still murmur
  • Pulmonary flow murmur
  • Venous hum murmur
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8
Q

What five general characteristics are often seen with innocent murmurs?

A
  • Short/Systolic
  • Grade 1 or 2
  • Musical/vibratory quality
  • No FH
  • Normal pulses/exam, normal diagnostics (pulse ox, EKG, CXR)
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9
Q

What five general characteristics are often seen with pathologic murmurs?

A
  • Holosystolic/Diastolic
  • Grade 3-6
  • Harsh/blowing quality, loud
  • Possible FH
  • Abnormal pulses/exam, hepatomegaly, MSK abnorm.
    normal diagnostics (pulse ox, EKG, CXR)
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10
Q

What is considered the age of infants?

A

4-6 months

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11
Q

What is the most common innocent murmur of early childhood? What ages is it typically seen in?

A

Still murmur

- Infancy, 2-7 years

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12
Q

What is the most common innocent murmur of older children/adults? What ages is it typically seen in?

A

Pulmonary flow murmur

- 3+ years

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13
Q

Which murmur is high-pitched at LLSB, musical/vibratory quality; loudest supine, diminished with inspiration or sitting?

A

Still murmur

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14
Q

Which murmur is soft-pitched at ULSB; loudest supine?

A

Pulmonary Flow Murmur

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15
Q

Which murmur sounds like VSD?

A

Still murmur

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16
Q

Which murmur sounds like ASD?

A

Pulmonary Flow Murmur

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17
Q

Which murmur is continuous musical hum at R/LUSB, low anterior neck; louder with sitting or head extension?

A

Venous Hum Murmur

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18
Q

Which murmur sounds like PDA?

A

Venous Hum Murmur

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19
Q

Which of the three innocent murmurs is diastolic? At what age is it typically seen?

Which two are systolic?

A

Diastolic: Venous Hum Murmur
- 2+ years

Systolic: Still, Pulmonary flow

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20
Q

Which of the murmurs disappears when supine or with turning head? What kind of murmur is this?

A

Venous Hum Murmur

- Innocent and Diastolic

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21
Q

Which fetal adaptation brings O2-rich blood from placenta/mother to fetus?

A

Umbilical vein

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22
Q

Which fetal adaptation is an opening between atrium?

When does it typically close?

A

Foramen Ovale

- Closes 2-10 days post-birth

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23
Q

Which fetal adaptation involves the umbilical vein to IVC (bypasses liver)?

A

Ductus Venosus

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24
Q

Which fetal adaptation brings blood from pulmonary a. to aorta (away from lungs)?

When does it typically close?

A

Ductus Arteriosus:

- Closes by 14 days post-birth

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25
Which fetal adaptation is paired vessel that returns O2-poor blood from fetus to placenta/mother?
Umbilical arteries
26
What are the four acyanotic CHD?
- Ventricular Septal Defect (VSD) - Atrial Septal Defect (ASD) - Patent Ductus Arteriosus (PDA) - Coarctation of Aorta (CoA)
27
What are the six cyanotic CHD?
- Tetralogy of Fallot (ToF) - Transposition of Great Arteries - Tricuspid Atresia - Truncus Arteriosus - Total Anomalous Pulmonary Venous Return (TAPVR) - Hypoplastic Left Heart Syndrome
28
What is the most common congenital heart defect? What type of defect is this?
Ventricular Septal Defect (VSD) | - Acyanotic CHD
29
What type of defect involves blowing/harsh holosystolic murmur at LLSB (also tachycardia, tachypnea, hepatomegaly)?
Ventricular Septal Defect (VSD)
30
What type of defect involves CXR shows cardiomegaly, increased pulm vasc markings?
Ventricular Septal Defect (VSD)
31
If a Ventricular Septal Defect (VSD) is asymptomatic, what is the recommended treatment? If it is symptomatic or treatment fails, what is recommended?
- Asymptomatic = observe (can spontaneously close) | - Symptomatic/failed tx: surgical closure via median sternotomy
32
What medication is often administered with treatment of Ventricular Septal Defect (VSD), and why?
Diuretics | - Manage CHF
33
What type of defect is an opening between ventricles so LV → RV shunt?
Ventricular Septal Defect (VSD)
34
What type of defect is an opening between atria so LA → RA shunt? What type of defect is this?
Atrial Septal Defect (ASD) | - Acyanotic CHD
35
What is the most common classification/location of an Atrial Septal Defect (ASD)?
Ostium Secundum most common (vary in size and usually solo)
36
What type of defect involves fixed, widely split S2 (also tachypnea, hepatomegaly, rales)?
Atrial Septal Defect (ASD)
37
What type of defect involves EKG shows rsr’ in V1?
Atrial Septal Defect (ASD)
38
What type of defect involves if <6 mm, spontaneous close; if larger, surgical patch as treatment?
Atrial Septal Defect (ASD)
39
What type of defect is more common in preemies, females, maternal rubella?
Patent Ductus Arteriosus (PDA)
40
What type of defect involves delay/failure of Ductus Arteriosus closure? What must be determined with this type of defect?
Patent Ductus Arteriosus (PDA) | - Direction of shunt (L→ R OR R → L)
41
What type of defect involves continuous “machinery” murmur; wide pulse pressure, bounding pulses?
Patent Ductus Arteriosus (PDA)
42
What medication is given at birth to keep a shunt OPEN? What defect is it often used to treat?
IV Prostaglandin E1 | - Patent Ductus Arteriosus (PDA)
43
What medication is given before surgery to CLOSE a shunt? What defect is it often used to treat?
IV Indomethacin/NSAIDs | - Patent Ductus Arteriosus (PDA)
44
What defect is more common in males, but if it is seen in a female, it is associated with Turner Syndrome?
Coarctation of Aorta (CoA)
45
What defect is often associated with Turner Syndrome?
Coarctation of Aorta (CoA)
46
What condition involves short stature/poor growth, congenital lymphedema, web neck, renal anomalies?
Turner Syndrome
47
What defect involves absent/decreased femoral pulses; UE SBP >20 mmHg higher than LE SBP?
Coarctation of Aorta (CoA)
48
What defect involves narrowing of aortic arch?
Coarctation of Aorta (CoA)
49
Which defect involves CXR shows “Figure 3” sign and inferior rib notching?
Coarctation of Aorta (CoA)
50
What two signs are seen on CXR with Coarctation of Aorta (CoA)?
- "Figure 3" | - Inferior rib notching
51
What is the most common cyanotic CHD?
Tetralogy of Fallot | note: still rare
52
Which defect involves right ventricular hypertrophy (RVH), ventricular septal defect (VSD), overriding aorta, RV outflow obstruction/pulmonary stenosis?
Tetralogy of Fallot
53
Which cyanotic CHD is OFTEN associated with a Ventricular Septal Defect (VSD)?
Tetralogy of Fallot
54
Which defect involves “tet spells”?
Tetralogy of Fallot
55
Which defect involves sudden onset cyanosis, dyspnea; consciousness issues, often with crying/feeding?
Tetralogy of Fallot
56
Which defect involves CXR shows “boot-shaped” heart with upturned apex?
Tetralogy of Fallot
57
What sign is seen on CXR with Tetralogy of Fallot?
“Boot-shaped” heart with upturned apex
58
Which defect requires surgery by age 1 for survival?
Tetralogy of Fallot
59
What is the recommended treatment for Tetralogy of Fallot?
Surgery by age 1
60
Which defect involves aorta comes off RV, PA comes off LV?
Transposition of Great Arteries (TGA)
61
Which defect involves "blue baby"?
Transposition of Great Arteries (TGA)
62
Which defect involves cyanotic neonate without respiratory distress or significant murmur?
Transposition of Great Arteries (TGA) | - AKA "blue baby"
63
Which defect involves CXR shows “egg-on-a-string”?
Transposition of Great Arteries (TGA)
64
What sign is seen on CXR with Transposition of Great Arteries (TGA)?
"Egg-on-a-string”
65
Which defect involves Prostaglandin E1 administration; SURGERY (4-7 days) as treatment?
Transposition of Great Arteries (TGA)
66
What is the recommended treatment for Transposition of Great Arteries (TGA) (2)?
- Prostaglandin E1 | - SURGERY (4-7 days)
67
Which defect is ALWAYS associated with a Ventricular Septal Defect (VSD)?
Truncus Arteriosus
68
Which defect involves aorta and pulmonary a. do not separate so only ONE artery arises from heart?
Truncus Arteriosus
69
Which defect involves narrow S2 split (also poor feeding, lethargy, respiratory distress)?
Truncus Arteriosus
70
Which defect involves absence of tricuspid valve so NO communication between RA and RV?
Tricuspid Atresia
71
Which defect involves single heart sound of S2 (also FTT, tachypnea)?
Tricuspid Atresia
72
What is the recommended treatment for Tricuspid Atresia?
Prostaglandin E1 to maintain PDA then surgery
73
Which defect is often concurrent defects like ASD, VSD, PDA?
Tricuspid Atresia
74
Which defect must have ASD with R → L shunt for oxygenation?
Total Anomalous Pulmonary Venous Return (TAPVR)
75
Which defect involves pulmonary veins drain into venous system (SVC) so blood mixes in RA?
Total Anomalous Pulmonary Venous Return (TAPVR)
76
Which defect ALWAYS involves PDA?
Hypoplastic Left Heart Syndrome
77
Which defect involves Prostaglandin E1 MUST BE GIVEN to maintain PDA, then staged surgery as treatment?
Hypoplastic Left Heart Syndrome
78
Which defect involves stable at birth while ductus is still patent (“honeymoon period”) then rapid deterioration (shock)?
Hypoplastic Left Heart Syndrome
79
Which four defects are associated with Trisomy 21?
- VSD - ASD - ToF - PDA
80
Which two defects are associated with Fetal Alcohol Syndrome?
- VSD | - ASD
81
Which defect is associated with maternal rubella?
- PDA
82
What condition often involves carditis (valvulitis, especially of mitral valve)?
Acute Rheumatic Fever (ARF)
83
When does Acute Rheumatic Fever (ARF) often occur?
2-4 weeks post-GAS pharyngitis | Loving the HEENT Peds overlap here...
84
What condition is associated with coronary artery aneurysms (CAAs), and involves small/medium vessel vasculitis?
Kawasaki Disease
85
What condition is the leading cause of sudden cardiac death in young people?
Hypertrophic Cardiomyopathy
86
What is a common PE finding associated with Hypertrophic Cardiomyopathy?
Audible S4 heart sound
87
What risk factor is often associated with Hypertrophic Cardiomyopathy?
Family history of Hypertrophic Cardiomyopathy

PEDS FINAL (3 decks)

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