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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31

Is it normal to hear heart murmurs in the first dew days after birth?

Yes

32

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"

33

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

34

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

35

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

Low CO
Increased peripheral vasoconstriction

36

What is a "bounding" pulse associated with?

PDA

37

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

Coarctation of the aorta

38

What is Coarctation of the Aorta?

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

39

What is the definition of a hypertensive newborn?

BP > 80/50 mmHg

40

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

41

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

42

How should you check capillary refill?

Above the level of the heart

43

What is normal capillary refill?

Less than 2 seconds

44

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

1) Cyanosis
2) Decreased systemic perfusion
3) Tachypnea

45

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

Prostaglandin E (PGE)