Cardiology

Question 1

Differential Cyanosis

Answer 1

post-ductal; cyanosis of lower extremities (toes)

ex: aortic arch obstruction, R->L shunt

Question 2

Reverse Differential Cyanosis

Answer 2

Pre-ductal, cyanosis of fingers

TGA

Question 3

S4 in children, differential

Answer 3

AS, HOCM, MR

Question 4

TR associated with

Answer 4

Ebstein Anomaly

Question 5

Peripheral Pulmonary Stenosis

Answer 5

increase in blood flow to lungs via pulmonary artery

SEM, back and axilla

Question 6

Venous Hum

Answer 6

blood draining from collapsed jugular veins into dilated intrathoraic veins
low pitched murmur, absent when supine

Question 7

Innocent Murmur and position

Answer 7

increase when supine (increase in stroke volume)

softer w/ Valsalva

Question 8

Aschoff Bodies

Answer 8

giant cells seen in heart associated with RF

Question 9

ARF - 5 Jones Criteria

Answer 9

polyarthirtis
carditis
chorea
subq nodules
erythema marginatum

Question 10

Carditis associated with ARF

Answer 10

Mirtral regurg
Myocarditis
Pericarditis

Question 11

Erythema Marginatum appearance

Answer 11

serpiginous

Question 12

Chronic treatment of ART

Answer 12

PCN for minimum of 5 years or until age 21

Question 13

Most common cardiomyopathy in children

Answer 13

dilated

Question 14

ASD - Ostium Secondum

Answer 14

Most Common
Fixed Splitting + RVOT
RVOT across pulmonic valve = SEM, best heard at LUSB

Question 15

EKG associated w/ ASD

Answer 15

RAD, RVH

except, primum = LAD

Question 16

ASD - Ostium Primum

Answer 16

partial AV canal defect, MR and TR

Question 17

LVH on EKG =

Answer 17

tall R + negative T wave in V6

Question 18

Anomalous Origin of Left Coronary Artery from Aorta

Answer 18

chest pain w/ exercise or SCD

when aorta dilates during exercise, cuts off blood supply to coronaries

Question 19

Most common cause of cyanosis in first days of life =

Answer 19

TGA

Question 20

d-TGA anatomy

Answer 20

pulmary artery connected to LV
Aorta connected to RV
need some type of connectin (PFO, PDA, VSD)

Question 21

TGA CXR will show

Answer 21

egg or oval shaped heart

Question 22

dTGA treatment

Answer 22

PGE1
balloon atrial septostomy to create AsD for mixing
additionally needs arterial switch surgery

Question 23

Most Common Symptomatic Aortic Arch Abnormality

Answer 23

double aortic arch

Question 24

Double Aortic Arch

Answer 24

encircling of the trachea and esophagus
will cause tracheal compression and resp compromise
associated with DiGeorge Syndrome

Question 25

Diving Seal Reflex

Answer 25

place an ice bag on infant's face for 10-20 seconds

Question 26

Romano-Ward Syndrome

Answer 26

AD QT prolongation

Question 27

Jervell and Lange-Nielseln Syndrome

Answer 27

AR QT prolongation | + sensoneurial hearing loss

Question 28

Ebstein Anomaly

Answer 28

septal leaflets of tricupsid valve are displaced downward | huge heart/RA

Question 29

Ebstein Anomaly associations

Answer 29

maternal lithium use

Question 30

Severe Pulmonary Stenosis

Answer 30

will present as severe cyanosis requiring PGE1 | presents similar to pulmonary valve atresia, requiring PDA for flow

Question 31

Mild-Moderate Pulmonary Stenosis Murmur

Answer 31

systolic ejection click + systolic C-D murmur

Question 32

VSD murmur

Answer 32

harsh, holosytolic, loudest at LLSB (similar to MR)

Question 33

PDA murmur

Answer 33

systolic/continuous murmur over left precordium

Question 34

PDA is

Answer 34

fetal connection between aorta and pulmonary artery

Question 35

Tricuspid Atresia presents as

Answer 35

cyanosis hours to days after birth | L superior axis deviation and LVH are present

Question 36

Tetraology of Fallot components

Answer 36

VSD Overriding aorta RVOT RVH

Question 37

Treatment of Tet Spells

Answer 37

``` increase SVR or decrease PVR calm the child (decrease PVR) knees to chest (increase SVR) oxygen beta block morphine ```

Question 38

Surgery or TOF

Answer 38

VSD patch closture | relief of PS/RVOT with transannular patch

Question 39

TOF genetic syndrome associations

Answer 39

DiGeorge, Down Syndrome, trisomy 13, 18, Alagille, CHARGE

Question 40

MVP

Answer 40

mid-late systolic murmur, louder with standing

Question 41

Aberrant Right Subclavian Artery

Answer 41

most common aortic arch anomaly | rarely causes symptoms

Question 42

Snowman or Figure 8 on imaging

Answer 42

total anomalous pulmonary venous return | pulmonary veins drain into the SVC

Question 43

Cardiac association with Williams Syndrome

Answer 43

supravalvular aortic stenosis

Question 44

Hypoplastic Heart Syndrome, correction

Answer 44

Norwood, Gleen, Fontan

Question 45

Hypoplastic Left Heart Syndrome abnormalities

Answer 45

underdeveloped LV underdeveloped aorta PDA dependent ASD

Question 46

Side effect of procainamide

Answer 46

drug induced SLE

Question 47

Rs pattern

Answer 47

normal in infants due to right ventricular predominance

Question 48

Cardiac Rhabdomyomas associated with

Answer 48

Tuberous Sclerosis

Question 49

CHD associated with fetal alcohol syndrome

Answer 49

septal defects, i.e. .VSD

Question 50

Mechanism for SVT in neonates

Answer 50

AV re-entry