Cardiovascular Issues and Disorders

Question 1

What heart sound is heard when the mitral/tricuspid (AV) valves close?

Answer 1

S1

Question 2

What heart sound is heard when the aortic/pulmonic (semilunar) valves close?

Answer 2

S2

Question 3

What is the period between S1 and S2?

Answer 3

systole

Question 4

What is the period between S2 and S1?

Answer 4

diastole

Question 5

What heart sound can be heard during periods of increased fluid state, such as with CHF and pregnancy?

Answer 5

S3

Question 6

What heart sound is described as sounding like “Ken-tuck-y?”

Answer 6

S3

Question 7

What heart sound can be heard when ventricle walls are stiff, such as with an MI, left ventricular hypertrophy, or chronic hypertension?

Answer 7

S4

Question 8

What heart sound is described as sounding like “Ten-ne-ssee?”

Answer 8

S4

Question 9

What are you listening to when auscultating in the right upper sternal border?

Answer 9

aortic

Question 10

What are you listening to when auscultating in the left upper sternal border?

Answer 10

pulmonic

Question 11

What are you listening to at Erb’s point (apex)?

Answer 11

aortic or mitral

Question 12

What kind of defect would you hear at the left lower sternal border?

Answer 12

VSD or tricuspid

Question 13

Blood flows from areas of _____ to _____ pressure.

Answer 13

higher to lower

Question 14

What does a VSD sound like?

Answer 14

thrill

Question 15

What defects represnt left to right shunting?

Answer 15

acyanotic lesions

Question 16

What defects represent right to left shunting?

Answer 16

cyanotic lesions

Question 17

ASD, VSD, and PDA are considered what kind of defects?

Answer 17

acyanotic defects

Question 18

Transposition of the great arteries and tetralogy of fallot are considered what kind of defects?

Answer 18

cyanotic defects

Question 19

Aortic stenosis, pulmonic stenosis, and coarctation of the aorta are considered what kind of defects?

Answer 19

obstructive defects

Question 20

What is the most common congenital heart defect?

Answer 20

VSD

Question 21

With what heart defect is a fixed split S2 a common finding?

Answer 21

ASD

Question 22

What kind of murmur would you hear at the LUSB when an ASD is present?

Answer 22

systolic ejection murmur

Question 23

With what defect would you hear/feel a holosystic thrill at the LLSB?

Answer 23

VSD

Question 24

When would you hear a holosystolic thrill with a VSD?

Answer 24

throughout systole

Question 25

What kind of defect produces a "machinery" sounding holosystolic murmur heard best at the LUSB?

Answer 25

PDA

Question 26

What cyanotic heart defect has the same murmur as with a VSD?

Answer 26

transposition of the great arteries

Question 27

What heart defect is described as "egg on a string" with x-ray?

Answer 27

transposition of the great arteries

Question 28

What are the 4 defects associated with a tet?

Answer 28

large VSD, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy

Question 29

With what heart defect is the murmur described as a loud systolic ejection click at the middle and upper left sternal border?

Answer 29

tetralogy of fallot

Question 30

How is a tet spell described?

Answer 30

hypercyanotic episode

Question 31

With what heart defect is the murmur described as a systolic thrill at the RUSB and systolic ejection click which does not vary with respirations?

Answer 31

aortic stenosis

Question 32

With what heart defect is the murmur described as a thrill at the LUSB radiating to the back and sides and does the intensity of the murmur decrease with inspiration and increase with expiration?

Answer 32

pulmonic stenosis

Question 33

What is the cardinal finding associated with coarctation of the aorta?

Answer 33

decreased or absent pulses in the lower extremities, as well as BP lower in the lower extremities than the upper

Question 34

What kind of murmur is heard with coarctation of the aorta?

Answer 34

aortic/ejection click with radiation to the left inter scapular area

Question 35

What kind of heart defect(s) is associated with DiGeorge syndrome?

Answer 35

aortic arch anomalies

Question 36

What kind of heart defect(s) is associated with down syndrome?

Answer 36

atrioventricular septal defects, VSD

Question 37

What kind of heart defect(s) is associated with marfan syndrome?

Answer 37

aortic regurgitation, mitral valve prolapse

Question 38

What kind of heart defect(s) is associated with turner syndrome?

Answer 38

coarctation of the aorta, bicuspid aortic valve

Question 39

What kind of murmur is described as a low intensity systolic murmur that can vary with position (sitting > standing)?

Answer 39

innocent murmur (i.e. functional, benign, or physiologic murmur)

Question 40

What can be best described as when the heart rate varies upon inspiration and expiration?

Answer 40

sinus arrhythmia

Question 41

What is the most common innocent murmur in children?

Answer 41

still's murmur

Question 42

How is a still's murmur described?

Answer 42

musical systolic murmur heard best between LLSB and apex

Question 43

Where can a venous hum be heard best?

Answer 43

RUSB

Question 44

What murmur is heard best in the sitting position and disappears in the supine position?

Answer 44

venous hum

Question 45

What murmur is obliterated by turning head and/or compressing neck ipsilaterally?

Answer 45

venous hum

Question 46

What is a persitent elevation of average systolic/diastolic blood pressure >95th percentile with measurements obtained on at least three separate occasions per published tables for age and sex?

Answer 46

hypertension

Question 47

What is a post-infectious inflammatory disease that can affect the heart, joints, and central nervous system?

Answer 47

rheumatic fever/heart disease

Question 48

What kind of infection does rheumatic fever follow?

Answer 48

group A strep infection

Question 49

How is rheumatic fever diagnosed?

Answer 49

two major or one major and two minor Jones' criteria

Question 50

What is an acute febrile syndrome causing vasculitis and most commonly noted in children under the age of 2?

Answer 50

Kawasaki disease

Question 51

What is the leading cause of coronary artery disease in children of an infectious etiology?

Answer 51

Kawasaki disease

Question 52

What ECG changes would be seen with Kawasaki disease?

Answer 52

prolonged PR or QT interval

Question 53

When diagnosing Kawasaki disease, the patient must have fever > 5 days and at least 4 other symptoms. When remembering the symptoms, what pneumonic can be used and what does it stand for?

Answer 53

"Fiery CRASH" (think 5 days of fever and 5 letters in fiery); C - conjunctival injection, R - polymorphous rash, A - cervical lymphadenopathy, S - strawberry tongue, H - erythema and edema of hands

Question 54

How would a pediatric cardiologist treat Kawasaki disease?

Answer 54

high-dose aspirin, 80-100mg/kg/day until afebrile for 48 hours, then lower dose to 3-5mg/kg/day