Cardiology

Question 1

what days are prime for teratogenic insult?

Answer 1

18-60 days post conception

Question 2

environmental factors

Answer 2

drugs
infections (TORCH)
maternal (DM/SLE)

Question 3

what happens in trisomy 21? turner syndrome?

Answer 3

ASVD

coarctation of aorta

Question 4

what happens in noonan? williams?

Answer 4

pulmonary stenosis

supravalvular aortic stenosis

Question 5

history factors?

Answer 5

feeding, weight + development
cyanosis
tachypnoea, dyspnoea
exercise tolerance
chest pain
syncope
palpitations

Question 6

examination factors?

Answer 6

weight and height
pulses - femoral!
heart sounds
murmurs

Question 7

investigations?

Answer 7

blood pressure
ECG
CXR
echo
angiography
MRI
exercise tolerance test

Question 8

what do you want to note about murmurs?

Answer 8

timing in cardiac cycle
duration
pitch/quality

Question 9

innocent murmurs common features?

Answer 9

systolic murmurs
no other signs of cardiac disease
vibratory or musical
localised
varies with position, respiration, exercise

Question 10

Still’s murmur?

Answer 10

2-7y
soft systolic and musical twangy
apex left sternal border

Question 11

Pulmonary outflow murmur?

Answer 11

8-10y
soft and vibrating - not radiating to back
upper left sternal border

Question 12

Venous hum?

Answer 12

3-8y
soft and indistinct
continuous murmur that is supra-clavicular

Question 13

3 types of VSD?

Answer 13

sub-aortic
perimembranous
muscular

Question 14

VSD murmur presentation?

Answer 14

pan-systolic murmur lower left sternal edge

Question 15

what happens in large VSD?

Answer 15

signs of cardiac failure leading to biventricular hypertrophy and pulmonary HT

Question 16

what is the treatment to close VSD?

Answer 16

Amplatzer or other occlusion device trans catheter

Patch surgery - which is open surgery

Question 17

ASD in early childhood?

Answer 17

few clinical signs with good chance of closure

Question 18

how is ASD detected in adulthood?

Answer 18

AF, HF or PHT

Question 19

how does ASD sound when auscultating?

Answer 19

splitting of the 2nd heart sounds

Question 20

what is the most common valvular condition in childhood?

Answer 20

pulmonary stenosis

Question 21

pulmonary stenosis symptoms?

Answer 21

asymptomatic in mild

exertional dyspnoea and fatigue in mod/severe

Question 22

how does pulmonary stenosis sound when auscultating?

Answer 22

ejection systolic murmur upper left sternal border with RADIATION TO THE BACK

Question 23

3 key changes at birth?

Answer 23

ductus arteriosus closes
ductus venosis close
foramen ovale closes

Question 24

who is patent ductus arteriosus common in?

Answer 24

pre-term infant

Question 25

treatment for patent ductus arteriosus?

Answer 25

fluid restriction/diuretics
prostaglandin inhbitors
surgical ligation

good chance of spontaneous closure in babies

Question 26

Tetralogy of Fallot four?

Answer 26

VSD
pulmonary valve stenosis
misplaced aorta
thickened RV wall