Cardiovascular

Question 1

What are the causes of systolic murmurs in a child?

Answer 1

Tetrology of fallot

Patent Ductus Arteriosus

Pulmonary/Aortic Stenosis

Ventricular Septal Defects

Mitral/Tricuspid Regurgitation

Truncus Arteriosus

Double Outlet Right Ventricle (DORV)

Total Anomalous Pulmonary Venous Defect (TAPVD)

Question 2

What are the causes of diastolic murmurs in a child?

Answer 2

Truncus Arteriosus

Mitral Stenosis

Pulmonary/Aortic Regurgitation

Question 3

Which congential heart defect doesn’t cause a murmur?

Answer 3

Transposition of the Great Arteries (TGA)

Question 4

Name one virus that can cause viral myocarditis

Answer 4

Coxsackie B

Question 5

Name 4 symptoms of Kawasacki Disease

Answer 5

Lymphadenopathy, red tongue and eyes, rash and swinging fevers

Question 6

What are the most common types of congenital heart disease?

Answer 6

Ventricular Septal Defects (VSD)

Question 7

What type of murmur do Ventricular Septal Defects cause?

Answer 7

Pan-systolic murmurs

Question 8

What kind of murmur do Atrial Septal Defects cause?

Answer 8

Ejection Systolic with wide-splitting S2

Question 9

When can Acyanosis be seen in Congenital Heart Disease?

Answer 9

Left-to-right shunting

Question 10

When can Cyanosis be seen in Congenital Heart Disease?

Answer 10

right-to-left shunting

Question 11

What does the image show?

Answer 11

Tetrology of Fallot

Question 12

What does the image show?

Answer 12

Coarctation of the Aorta

Question 13

What percentage of CHD are made up by Atrial Septal Defects?

Answer 13

10%

Question 14

What is a Secundum Atrial Septal defect?

Answer 14

When the hole in the septum forms in the place of the foramen ovale. This is the most common type of ASD.

Question 15

What type of shunt is Atrial Septal Defect (ASD)?

and is that cyanotic or acyanotic?

Answer 15

left-to-right shunt

Acyanotic

Question 16

What would an ECG show for ASD?

Answer 16

Right Axis Deviation

Question 17

What would a chest XR show for ASD?

Answer 17

cardiomegaly with right heart enlargement

Question 18

What is the most common type of VSD?

Answer 18

Peri-membranous VSD (hole in the membranous part of the ventricular wall)

Question 19

What would a CXR show for VSD?

Answer 19

Cardiomegaly from pulmonary hypertension?

Question 20

How are VSDs treated?

Answer 20

Diuretcs, and Digoxin (maybe)

Question 21

Where is the ductus arteriosus found in the foetus

Answer 21

An embryological channel between the aorta and pulmonary artery

Question 22

What happens in Patent Ductus Arteriosus?

Answer 22

The ductus arteriosus remains open in the child’s body

Question 23

What percentage of CHDs do patent ductus arteriosus represent?

Answer 23

5-10%

Question 24

What heart sounds can be heard in patent ductus arteriosus?

Answer 24

Wide pulse pressure

Machine like, continous murmur

Question 25

How is Patent Ductus Arteriosus (PDA) managed?

Answer 25

Diuretics and a PDA closure device?

Question 26

What is hypoplastic left heart syndrome?

Answer 26

A CHD that presents at birth in which the left side of the heart is critically underdeveloped. This causes the left side to be inefficient in pumping blood around the body.

Question 27

What is the pathology of Hypoplastic Left Heart Syndrome (HLHS)?

Answer 27

The left ventricle is either not present or incredibly small.

Question 28

Is HLHS a cyanotic or acyanotic condition?

Answer 28

Cyanotic

Question 29

What are some symptoms of Hypoplastic Left Heart Syndrome?

Answer 29

Cyanosis Tachypnoea or Dyspnoea Poor feeding Cold extremities

Question 30

There are 5 surgical methods to treat Hypoplastic Left Heart Syndrome. What are they?

Answer 30

Atrial Septostomy Norwood procedure Bidrectional Glenn procedure Fontan procedure Heart transplant

Question 31

What is an Atrial Septostomy?

Answer 31

A surgical procedure in which a hole is made in the atrial wall (used to treat hypoplastic left heart syndrome)

Question 32

What is the Norwood procedure?

Answer 32

It is a procedure that allows blood to be pumped from the right ventricule to the lungs and to the rest of the body. Used to treat hypoplastic left heart syndrome

Question 33

When is the Norwood procedure usually done?

Answer 33

Within the first 2 weeks of life

Question 34

When is the bidirectional Glenn procedure usually done?

Answer 34

In the first 3-6 months of the child's life

Question 35

What is the bidirectional Glenn procedure?

Answer 35

Comes after the norwood procedure It is a procedure that allows the right ventricle to prioritise the aorta in terms of delivering blood to the body. The procedure also results in body from the body being directed to the lungs so that it can be oxygenated directly. (thus the end result for blood movement is: body -\> lungs -\> right side of heart -\> aorta -\> body)

Question 36

When is the Fontan procedure usually carried out?

Answer 36

In the first 18 months to 4 years of life

Question 37

What is the Fontan procedure?

Answer 37

The second part of the Glenn procedure in which the inferior vena cava is connected to the pulmonary arteries thus directing blood from the body to the lungs.

Question 38

What is Trisomy 13 called?

Answer 38

Patau's Syndrome

Question 39

What is the prognosis for Trisomy 13?

Answer 39

Usually fatal in the first year of life (only 8.6% cases make it past the first year of life).

Question 40

List some clinical features of Trisomy 13?

Answer 40

Microcephaly CHDs Midline facial defects (cyclopia etc) Malformed ears Small for gestational age

Question 41

What is Trisomy 18 called?

Answer 41

Edward's Syndrome

Question 42

What is Trisomy 21 called?

Answer 42

Down's Syndrome