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A. Block C Paediatrics > Congenital Heart Abnormalities > Flashcards

Congenital Heart Abnormalities Flashcards

1
Q

Heart anomalies are the most common congenital anomaly in newborns. What % of newborns are born with congenital anomalies?

1 - 1%
2 -15%
3 - 40%
4 - 60%

A

1 - 1%

Leading cause of infant mortality in among birth defects

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2
Q

What % of liveborn infants have significant cardiac malformations?

1 - 8 per 1000
2 - 300 per 1000
3 - 50 per 1000
4 - 800 per 1000

A

1 - 8 per 1000

  • 30% of these patients will require intervention in the first year of life.
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3
Q

What % of still births are thought to be due to congenital anomalies?

1 - 1%
2 - 10%
3 - 30%
4 - 60%

A

2 - 10%

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4
Q

Congenital heart anomalies can be due to a variety of reasons, including maternal disorders, maternal drugs or Chromosomal abnormalities. Which of the following is NOT a maternal disorder that does NOT typically lead to congenital heart anomalies?

1 - Rubella
2 - SLE
3 - Diabetes Mellitus
4 - Bacterial vaginosis

A

4 - Bacterial vaginosis

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5
Q

Congenital heart anomalies can be due to a variety of reasons, including maternal disorders, maternal drugs or Chromosomal abnormalities. Which 2 of the following can lead to congenital heart anomalies?

1 - Warfarin
2 - Alcohol
3 - NSAIDs
4 - Apixiban

A

1 - Warfarin
2 - Alcohol

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6
Q

Congenital heart anomalies can be due to a variety of reasons, including maternal disorders, maternal drugs or chromosomal abnormalities. Which of the following is NOT a common chromosomal abnormality that leads to congenital heart anomalies?

1 - Down Syndrome
2 - Edward or Patua Syndrome
3 - Turners Syndrome
4 - Type 1 diabetes

A

4 - Type 1 diabetes

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7
Q

In the growing foetus there are 4 key adaptations to the foetal circulatory system:

  • umbilical veins and arteries in the umbilical cord
  • ductus venosus
  • foramen ovale
  • ductus arteriosus

Which if these 4 adaptations allows oxygenated blood to be carried from the foetus to maternal circulation and the liver?

A
  • umbilical veins and arteries in the umbilical cord

This blood enters all the lobes of the liver and becomes de-oxygenated

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8
Q

In the growing foetus there are 4 key adaptations to the foetal circulatory system:

  • foramen ovale
  • umbilical veins and arteries in the umbilical cord
  • ductus arteriosus
  • ductus venosus

In addition to carrying oxygenated blood to the liver, what forms off the left umbilical vein, bypassing the liver and drains into the inferior vena cava as a second adaptation?

A
  • ductus venosus

This oxygenated blood mixes with de-oxygenated blood from the lower limbs

By bypassing the liver this delivers oxygenated blood to the left heart for systemic circulation and to the res tof the body

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9
Q

Congenital heart disease can be classified as cyanotic and acyanotic. In cyanotic congenital heart disease is there typically a left to right or right to left shunt?

A
  • right to left shunt

Essentially, blood skips the pulmonary system causing reduced oxygen concentration in the blood, referred to as Hypoxemia

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9
Q

In the growing foetus there are 4 key adaptations to the foetal circulatory system:

  • foramen ovale
  • umbilical veins and arteries in the umbilical cord
  • ductus arteriosus
  • ductus venosus

Which of the following adaptations creates a small blood vessel connecting the pulmonary artery and the aorta?

A
  • ductus arteriosus

Moves blood from high pressure pulmonary artery to the lower pressured aorta, which then sends blood around the body.

This ensures oxygenated blood is delivered to the foetus

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9
Q

Congenital heart disease can be classified as cyanotic and acyanotic. In acyanotic congenital heart disease is there sufficient oxygen?

A
  • Yes oxygen level is ok

But blood is being pumped around the body in an abnormal manner

  • left to right shunt
  • obstruction
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10
Q

When chemical is important for maintaining a patent ductus arteriosus in foetal development?

1 - COX-1
2 - COX-2
3 - prostaglandins
4 - tryptase

A

3 - prostaglandins

Once baby takes the 1st breathe, pulmonary vascvular resistance is reduced and the foramen ovale and ductus arteriosus close

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10
Q

In the growing foetus, which blood vessel is important for draining de-oxygenated back into the placenta?

1 - foramen ovale
2 - umbilical artery
3 - ductus arteriosus
4 - ductus venosus

A

2 - umbilical artery

These are formed off each of the internal iliac arteries

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10
Q

In the growing foetus there are 4 key adaptations to the foetal circulatory system:

  • foramen ovale
  • umbilical veins and arteries in the umbilical cord
  • ductus arteriosus
  • ductus venosus

Which of the following adaptations creates an opening between the left and right atrium?

A
  • foramen ovale

This is a one way valve moving blood from right atrium to left atrium

Pressure is higher in lungs and right side of heart so the foramen ovale allows blood to avoid the lungs as they are not functioning

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10
Q

Which of the following is NOT a cause of cyanotic congenital heart disease?

1 - Tetralogy of Fallot
2 - Transposition of the great arteries
3 - Tricuspid / pulmonary atresia
4 - Ventricular septal defect
5 - Persistent truncus arterious
6 - Total anomalous pulmonary venous return

A

4 - Ventricular septal defect

Tetralogy of Fallot:
- a heart composed of four different heart problems: ventricular septal defect, overriding aorta, pulmonary stenosis and right ventricular hypertrophy.

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11
Q

All of the following are causes of acyanotic congenital heart disease caused by a left to right shunt, EXCEPT which one?

1 - Pulmonary stenosis
2 - Ventricular septal defect
3 - Patent ductus arteriosus
4 - Atrial septal defect
5 - Atrioventricular septal defect(2%)

A

1 - Pulmonary stenosis

11
Q

All of the following are causes of acyanotic congenital heart disease caused by aobstruction, EXCEPT which one?

1 - Pulmonary Stenosis(7%)
2 - Aortic Stenosis (5%)
3 - Co-arctation of the aorta(5%)
4 - Hypoplastic left heart syndrome
5 -Tetralogy of Fallot

A

5 -Tetralogy of Fallot

12
Q

Of all the causes of congenital heart disease below, which is by far the most common, accounting for 30% of all cases?

1 - Tetralogy of Fallot
2 - Transposition of the great arteries
3 - Ventricular septal defect
4 - Patent ductus arteriosus
5 - Atrial septal defect

A

3 - Ventricular septal defect

This is a acyanotic congenital heart disease causing a left to right shunt

13
Q

There are some ductal-dependent congenital heart diseaseconditions that are dependent on the ductus arteriosus remaining open to maintain systemic blood flow, including:

  • Hypoplastic left heart syndrome
  • Critical aortic stenosis
  • Coarctation of the aorta
  • Pulmonary atresia or severe tetralogy of Fallot

What are patients given to keep the ductus arteriosus open until they can receive surgery?

1 - prostaglandins
2 - surfactant
3 - corticosteroids
4 - aspirin

A

1 - prostaglandins

This is what keeps it open during foetal development

14
Q

Which of the following is NOT a typical presentation in a baby with suspected congenital heart defect at birth?

1 - Heart murmur
2 - Heart failure
3 - Liver failure
4 - Shock
5 - Cyanosis

A

3 - Liver failure

Babies may also present with a soft murmur, which may not be congenital heart disease and this would have the following features:

  • Systolic murmur only
  • Left Sternal edge.
    normal heart sounds, no added sounds
  • No parasternal thrill
  • No radiation.
15
Q

Babies with congenital heart defects can also suffer from heart failure. Which of the following is NOT a common symptom in a baby with suspected heart failure?

1 - Breathlessness (particularly on feeding or exertion)
2 - Sweating
3 - Haemoptysis
4 - Poor feeding
5 - Recurrent chest infections

A

3 - Haemoptysis

16
Q

Babies with congenital heart defects can also suffer from heart failure. Which of the following is NOT a common clinical sign in a baby with suspected heart failure?

1 - Chronic kidney disease
2 - Poor weight gain or faltering growth
3 - Tachypnoea
4 - Tachycardia
5 - Heart murmur, gallop rhythm
6 - Cardiomegaly
7 - Hepatomegaly

A

1 - Chronic kidney disease

17
Q

If you suspect a baby has a congenital heart defect, a paediatric cardiologist should be involved in the babies management. All of the following should be performed, EXCEPT which one?

1 - Chest X-ray
2 - ECG
3 - MRI
4 - Echocardiography
5 - IV prostaglandins
6 - Anti-failure medication
7 - Dietician for optimal growth
8 - Definitive surgery

A

3 - MRI

A. Block C Paediatrics (50 decks)

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