Exam #4: Pediatric Thorax & Lung Exam Flashcards Preview

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Flashcards in Exam #4: Pediatric Thorax & Lung Exam Deck (45)
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Is it normal to hear heart murmurs in the first dew days after birth?



Outline the fetal circulation and major differences from the adult circulation.

- Umbilical vein brings OXYGENATED blood to the fetus from the placenta
- Half of this blood bypasses the fetal liver via the "Ductus Venosus"
- IVC-->RA-->LA "Foramen Ovale"
- Blood that makes it into the RV goes through the pulmonary trunk to the "Ductus Arteriosus" to the descending aorta, bypassing the fetal lungs
- Blood goes back to the placenta via the "Umbilical Arteries"


What is a Patent Ductus Arteriosus?

- Birth defect in which the Ductus Arteriosus (pulmonary tunk-->descending aorta) does not closure
- With changes after birth in the circulatory pressures, high aortic pressure shunts blood into the pulmonary trunk


What are the diagnostic indicators of a PDA?

1) "Machinery Murmur"
2) Harsh, loud, continuous murmur heard at the 1st- 3rd intercostal spaces and the lower sternal border


What is the likely etiology of weak pulses in the infant?

Low CO
Increased peripheral vasoconstriction


What is a "bounding" pulse associated with?



What is the likely etiology of diminished femoral pulses in the infant?

Coarctation of the aorta


What is Coarctation of the Aorta?

Coarctation of the Aorta is characterized by constriction of the aorta (varying length)


What is the definition of a hypertensive newborn?

BP > 80/50 mmHg


What is an innocent murmur?

- Common in the 3-7 age group
- Usually at the mid left sternal border
- Midsystolic
- 2-3/6 intensity
- Heard better supine or when holding breath
- More commonly heard during periods of higher metabolic rate (i.e. fever)

*Heard least when standing


List the indications for referral of the newborn to a Cardiologist.

1) Abnormal cardiac size
2) Abnormal EKG
3) Diastolic murmur
4) Loud murmur accompanied by a thrill
5) Cyanosis
6) Abnormally strong or weak pulses


How should you check capillary refill?

Above the level of the heart


What is normal capillary refill?

Less than 2 seconds


What are the three cardinal signs of a severe (life-threatening) CHD in the newborn?

1) Cyanosis
2) Decreased systemic perfusion
3) Tachypnea


What is the initial step in management of a patient with signs of life-threatening CHD?

Prostaglandin E (PGE)