Chest problems Flashcards by Magda Kazmierczak

Kids with Respiratory distress, prenatal polyhydramnios, 70/40, 176bpm, 70RR, pulse ox,82%, absent breaths on left and fair aeration of right lung, right heart sounds, abd appears scaphoid;
DX?

Congenital diaphragmatic hernia (CDH)

How well did you know this?

Not at all

Perfectly

CDH causes

abdomincal viscera to herniate into chest:

pulmonary hypoplasia and pulmonary HTN

How well did you know this?

Not at all

Perfectly

Why is there polyhydramnios in CDH?

esophageal compression

How well did you know this?

Not at all

Perfectly

Stat protocol in CDH?

C/I maneuvers?

endotracheal intubation
bag-mask ventilation can pump air into GI and exacerbate problem
After airway secure: NG tube and suction

How well did you know this?

Not at all

Perfectly

1 day old Kid with respiratory problems, 80% sat, mask with 100% air doesnt help, Machine like murmur heard; administer what?

PGE1
Many congenital heart defects can be associated with a PDA and need to be ruled out first
PDA usually closes by day 3

How well did you know this?

Not at all

Perfectly

1 month old kid, harsh III/VI holosystolic murmur over LL sternal border, everything else normal, Dx?

VSD
Do echo
mcc of congenital heart disease

How well did you know this?

Not at all

Perfectly

Electrolyte derangements of QT prolongation?

Hypocalcemia
Hypokalemia
Hypomagnesemia

How well did you know this?

Not at all

Perfectly

Med induce long QT syndrome

Macrolide
Flouroquinolone
Antipsychotics
TCA
SSRI
Methadone
Oxycodone
Ondansetrone/gransetron
Class 1a: Quinidine, procainamide
Flecainide
Class 3: except amiodarone

How well did you know this?

Not at all

Perfectly

Inherited long qt syndrome

Jervel and lange nielsen sydnrome (AR)

Romano- Ward syndrome (AD)

How well did you know this?

Not at all

Perfectly

Rx long QT syndrome

Class II antiarrhythims
B-Blockers: Propranolol
possibly pacemaker placement

How well did you know this?

Not at all

Perfectly

Hypertrophic Cardiomyopathy EKG findings

LVH: Tall R wase in aVL + Deep S wave in V3

Repolarization change in anterolaterl leads (I, aVL, V4-V6)

How well did you know this?

Not at all

Perfectly

Trisomy 21 Cardiac problems

ECD: complete ACSD
VSD
PDA,ASD
MVP

How well did you know this?

Not at all

Perfectly

Trisomy 18 and 13 cardiac issues

VSD > ASD, PDA

cyanotic lesions

How well did you know this?

Not at all

Perfectly

Williams syndrome cardiac porblems

Supravalvular AS

How well did you know this?

Not at all

Perfectly

Turner syndrome cardiac issue

Bicuspid AV
Coarctaion of aorta
AS,MVP,
HTN common

How well did you know this?

Not at all

Perfectly

Neonatal lupus cardiac problem

congenital heart block

How well did you know this?

Not at all

Perfectly

Marfan syndrome cardiac problem

Ascending aortic dilation->dissecting aorts

2ndry AR or MVP

How well did you know this?

Not at all

Perfectly

Ehler Danlos syndrome cardiac problems

MVP, TVP
Aortic dilation-> dissecting aneurysm
ASD

How well did you know this?

Not at all

Perfectly

Fetal alcohol syndrome cardiac issue

VSD>ASD

TOF

How well did you know this?

Not at all

Perfectly

Rubella assoc cardiac problem

PDA

How well did you know this?

Not at all

Perfectly

Kawasaki disease cardiac issue

Coronary artery aneursyms

How well did you know this?

Not at all

Perfectly

Transient tachypnea of newborn xray findings

increased pulmonary vascular markings or fluid in the fissures
(bilateral perihilar linear streaking)

How well did you know this?

Not at all

Perfectly

Rheumatic fever rx:

Study These Flashcards

penicillin G IM every 4 wks

RF w/out carditis duration of antibiotic

Study These Flashcards

5 yrs or until 21

whichever longer

RF with carditis but no residual hear or valvular disease; AB rx duration

10 yrs or until 21 | whichever longer

RF w/ carditis and persistent heart or valvular disease; | AB Rx duration

10 yrs or until 40 years olf | whichever longer

MS symptomatic rx

preload reduction: diuretics or nitrates

Auscultation and xray of Transposition of great vessels

Cyanosis w/in 24 hrs of life Exam: Single S2; +/- VSD Xray: egg on string

Auscultation and xray of TOF

Exam: Harsh PS murmur or single S2, VSD Xray: Boot shaped heart

Auscultation and xray of Tricuspid atresis

Exam: Single S2, VSD murmur Xray: minimal pulm BF

Auscultation and xray of Truncus arteriosus

Exam: SIngle S2, systolic ejection murmur (increased flow through truncal valve) Xray: increase pulmonary BF, Edema

Auscultation and xray of TAPVR with obstruction

Exam: severe cyanosis, respiratory distress Xray: pulmonary edema, snowman sign (enlarged supracardiac veins & SVC)

Pediatric viral myocarditis etiology

Coxsackie B virus | Adenovirus

Myocarditis Clinical presentation

Viral prodrome | HF: dyspnea, syncope, tachycardia, N/V, hepatomegaly

Xray of myocarditis

Cardiomegaly | Pulmonary edema

ECG and ECHO of mycarditis

EKG: sinus tachy ECHO: decreased EF Diffuse hypokinesis

auscultaion of myocarditis

holosystolic murmur may be identified secondary to dilated cardiomyopathy and the resulting functional MR

Rx of myocarditis

diuretics and inotrope | Rx in ICU due to risk of shock and fatal arrhythmias

Fredrich ataxia cardiac problems

assoc w/ necrosis and degeneration of cardia muscle fibers leading to myocarditis, myocardial fibrosis and cardiomyopathy EKG: T Wave inversion due to myocarditis

VSD auscultation and if uncorrected

holosystolic murmur at left lower sternal border, | uncorrected apical diastolic rumble( increased BF across MV)

VSD is not corrected what happens

L-R shunt produces permanant pulmonary htn and RVH leading to Eisenmenger syndrome which causes R-L shunting

In a TOF what are the 4 defects

RV outflow tract obstruction (PS or atresia) RVH Overriding aorta VSD

Patient with a RVOT obstruction develope profound cyanosis and hypoxemia why?

they develop a infundibular spasm precipitated by agitation or exertion (feeding, crying, hyperventilation) results in complete occlusion shunts blood R->L via VSD

Respiratory distress syndrome x-ray

diffuse reticulogranular (ground glass) appearance, air bronchograms, low lung volumes

High pulmonary vascular resistance results in R->L shunting and hypoxia; causes what?

Persistent pulmonary HTN | Tachypnea and severe cyanosis

Chest xray in Pulmonary htn

clear lungs w/ decreased pulmonary vascularity

inadequate alveolar fluid clearance at birth results in mild pulm edema; Dx?

Transient tachypnea of newborn

Croup: laryngotracheobronchitis C/f..

MC 6-6 yrs old assoc w/ barky cough, fever, rhinorrhea and Congestion

Laryngomalacia c/f

Stridor most severe at 4-8 months | persistent stridor that worsens in supine positions + improve in prone position

Vascular Ring C/F

Present before age 1 Persistent stridor that improves w/ neck extension Assoc. w/ cardiac abnormalities

Dx/Rx laryngomalacia

Dx: Flexible laryngoscopy Rx: reassurance (fixes by 18 months) Supraglottopasty is severe symptoms

Tricuspid Valve atresia EKG/xray

Left axis deviation Tall peaked P waves LVH Xray: decreased pulmonary BF

Ebsteins anomaly EKG

TR + R atrial enlargement= Tall P waves Right axis deviation

Respiratory Distress Syndrome R/F

Maternal DM Male sex perinatal asphyxia C-section w/out labor

How Maternal DM cause RDS

Maternal hyperglycemia leads to fetal hyperglycemia which trigger fetal hyperinsulinism High insulin antagonize cortisol and block maturation of sphingomyelin

Decrease risk of RDS in newborn

Intrauterine stress stimulates early fetal lung maturity: IUGR Maternal HTN PROM

Postpericardiotomy syndrome

pleuropericardial disease that occurs days or months after cardiac surgery or injury

Chest problems Flashcards

(57 cards)