Cardiology

Question 1

Systolic ejection murmur at 2nd LICS, widely split S2

PE: right sided enlargement

Answer 1

ASD

Question 2

systolic regurgitant murmur at LLSB, loud and single S2

PE: left sided enlargement; biventricular hypertrophy if with Eisenmenger syndrome

Answer 2

VSD

Question 3

Continuous “machinery-like” murmur at the 2nd left infraclavicular area
PE: bounding pulses, wide pulse pressure, left-sided enlargement, enlarged aorta

Answer 3

PDA

Question 4

MC cyanotic heart disease in newborns

Answer 4

TGA

Question 5

Main pathologic mechanism behind the hypercyanotic spells or Tet spells in TOF

Answer 5

due to decreased pulmonary blood flow

Question 6

cardiac defect associated with Down syndrome

Answer 6

presence of endocardial cushion defect

Question 7

cardiac defect associated with Marfan syndrome

Answer 7

MVP and progressive enlargement of the aorta

Question 8

cardiac defect associated with Hunter syndrome or MPS II

Answer 8

thickening of cardiac valves

Question 9

cardiac defect associated with Noonan syndrome

Answer 9

pulmonary stenosis

Question 10

cyanosis manifesting within few hours at birth or within few days of life

Answer 10

TGA

Question 11

cyanosis after 1st year of life usually in an infant or a toddler

Answer 11

TOF

Question 12

Weak or absent femoral pulses; BP arms > legs; rib notching in xray

Answer 12

Coarctation of aorta

Question 13

systolic ejection murmur at LUSB with radiation to upper back

Answer 13

Pulmonic stenosis

Question 14

systolic ejection murmur at RUSB

Answer 14

Aortic stenosis

Question 15

Procedure for coarctation of aorta

Answer 15

Primary reanastomosis or patch aortoplasty

Question 16

Procedure for pulmonic stenosis

Answer 16

Balloon valvuloplasty

Valvotomy (Brock procedure)

Question 17

Procedure for aortic stenosis

Answer 17

Balloon valvuloplasty 
Ross procedure (valve translocation)

Question 18

Boot-shaped/ Couer en sabot

Answer 18

TOF

Question 19

Egg on string

Answer 19

TGA

Question 20

Snowman

Answer 20

TAPVR

Question 21

Figure of 8

Answer 21

TAPVR

Question 22

Rib notching

Answer 22

coarctation of aorta

Question 23

inverted E

Answer 23

coarctation of aorta

Question 24

3 sign

Answer 24

coarctation of aorta

Question 25

late systolic murmur with an opening click

Answer 25

MVP

Question 26

disparity in pulsation and BP in arms anf legs, weak popliteal, posterior tibial and dorsalis pedis pulses

Answer 26

CoA

Question 27

S2 widely split and fixed in all phases of respiration

Answer 27

ASD

Question 28

loud, harsh, blowing holosystolic murmur

Answer 28

VSD

Question 29

Blalock-Taussig shunt with GoreTex conduit

Answer 29

TOF

Question 30

Aortopulmonary window shunt

Answer 30

TOF

Question 31

Waterson Cooley

Answer 31

TOF

Question 32

Pott shunt

Answer 32

TOF

Question 33

Rashkind Atrial Septostomy

Answer 33

TGA

Question 34

Jantene Arterial Switch

Answer 34

TGA

Question 35

Senning and Mustard

Answer 35

TGA

Question 36

Fontan procedure

Answer 36

Tricuspid atresia

Question 37

Norwood procedure

Answer 37

Hypoplastic left heart syndrome

Question 38

Glenn anastomosis

Answer 38

Hypoplastic left heart syndrome

Question 39

Rubella

Answer 39

PDA

Question 40

DM

Answer 40

TGA

Question 41

Lupus

Answer 41

Complete heart block

Question 42

Aspirin

Answer 42

Persistent pulmonary HTN

Question 43

Alcohol

Answer 43

VSD and PS

Question 44

Lithium

Answer 44

Ebstein anomaly

Question 45

Mnemonics: minor crtieria for RF

Answer 45

FRAPE -fever, risk factor (pre RH or RHD), arthralgia, prolonged PR interval on ECG, Elevated acute phase reactants: ESR/CRP/leukocytosis

Question 46

Most consistent feature of acute rheumatic fever

Answer 46

Valvulitis

Question 47

ASO titers usually become elevated __wks after strep infection, peaks at __ wks, and decreases after another __wks

Answer 47

2 wks 4-6 2 wks

Question 48

antibiotic therapy once diagnosis of RF has been mafde regardless of throat culture results

Answer 48

10 days of oral penicillin or erythromycin OR single IM injection of benzathine Pen G Afterwhich, long-term antibiotic prophylaxis

Question 49

RF without carditis prophylaxis

Answer 49

5 yo or until 21 yo whichever is longer

Question 50

RF with carditis but without residual HD (no VD)

Answer 50

10 yo or until 21 yo whichever is longer

Question 51

RF with carditis and residual HD (persistent VD)

Answer 51

10 yo or until 40 yo whichever is longer, sometimes lifelong prophylaxis

Question 52

top 2 common organisms causing IE

Answer 52

viridans Strep | S. aureus

Question 53

Mnemonics: Duke Criteria

Answer 53

BE FEVERIsh Major: Blood culture + Echo finding Minor: fever, echo finding, vascular phenomena, evidence (microbial), risk factor, immunologic

Question 54

tender, pea-sized intradermal nodules in the pads of fingers and toes

Answer 54

Osler nodes

Question 55

painless small, erythematous, hemorrhagic lesions on the palms and soles

Answer 55

Janeway lesions

Question 56

fish-mouth buttonhole deformity

Answer 56

mitral valve stenosis

Question 57

How to differentiate murmur of VSD vs MR

Answer 57

VSD- no transmission to to the LAAL | MR- with transmission to LAAL

Question 58

high-pitched diastolic murmur loudest at 3rd to 4th LICS, more audible when sitting and leaning forward

Answer 58

AR

Question 59

diastolic thrill at 3rd LICS, hyperdynamic precordium, bounding water hammer pulse/ Corrigan pulse, wide pulse pressure

Answer 59

AR