Lec 14 Pathology of Congenital Heart Diseases

Question 1

What is the most common cyanotic congenital heart defect?

Answer 1

TOF

Question 2

What is the most common acyanotic congenital heart

Answer 2

VSD

Question 3

Initial L-R shunt with late reversal of flow.

Answer 3

Cyanose Tardive

Question 4

What chromosomal abnormality has a 100% chance of having CHD?

Answer 4

Trisomy 13 and 15

Question 5

What is the chance of having CHD in Down syndrome?

Answer 5

50%

Question 6

What drugs causes CHD?

Answer 6

Lithium for psychiatric disorders, anti-convulsants, etc

Question 7

T or F. The fossa ovalis is anatomically closed so no blood can pass through.

Answer 7

F. It is anatomically open BUT functionally closed so no blood can pass through it. A probe can be inserted in the fossa ovalis.

Question 8

Most common form of VSD.

Answer 8

Failure of the membranous portion.

Question 9

VSD type. Failure of the muscular portion of the interventricular septum to fuse with the free edge of the conus septum.

Answer 9

Membranous VSD

Question 10

VSD type. Excessive diverticulation of the muscular septum

Answer 10

Membranous VSD

Question 11

Septum starts developing in ___ days.

Answer 11

35

Question 12

Number of hours where there is functional closure in the normal full term infant.

Answer 12

10-15 hours

Question 13

Time when there is anatomic closure of the PDA.

Answer 13

2-3 weeks

Question 14

Cut-off period for persistent PDA

Answer 14

3 months

Question 15

Frequent in infants whose mothers were infected with rubella.

Answer 15

PDA

Question 16

Ductus can be kept open by administration of what drug?

Answer 16

PGE2

Question 17

Ductus can be caused to close by what drug?

Answer 17

Prostaglandin inhibitors (eg. Indomethacin)

Question 18

Rare defect between the base of the aorta and pulmonary artery. Functionally similar to PDA

Answer 18

Aortopulmonary window

Question 19

Common trunk for the origin of the aorta, pulmonary artery, coronary arteries

Answer 19

Truncus arteriosus

Question 20

Results from incomplete or complete lack of development of the spiral septum

Answer 20

Truncus arteriosus

Question 21

T or F. You can have a truncus without VSD

Answer 21

False. PTA always overrides a VSD

Question 22

The bulbus cordis and the truncus arteriosus become divided by an aorticopulmonary septum into the definitive pulmonary trunk and aorta at week ___.

Answer 22

5

Question 23

4 anatomic changes in TOF

Answer 23

1. Subpulmonary arterial stenosis – muscular wall around entrance of pulmonary artery is hypertrophied and therefore narrowed
2. Ventricular septal defect (VSD)
3. Overriding of the Aorta – biventricular origin of the aortic valve (consequence of VSD)
4. Right ventricular hypertrophy (RVH) – consequence of stenotic valve

1 results to 4. 2 results to 3

Question 24

P.E. Findings: boot shaped heart on CXR

Answer 24

TOF

Question 25

Aorta is anterior to pulmonary artery and to the right.

Answer 25

TGA. Normally the pulmonary artery is anterior to the aorta.

Question 26

The most common type of local constriction almost always immediately below the origin of L subclavian artery at the site of ductus arteriosus

Answer 26

Juxtaductal constriction

Question 27

T or F. The postductal type of coarctation is more dangerous than the preductal type.

Answer 27

F. The preductal type is more dangerous. Aortic isthmus remains hypoplastic into late fetal life and after birth.

Question 28

Intercostals cast a shadow on ribs giving them a notched appearance.

Answer 28

Coarctation of Aorta

Question 29

How many pulmonary veins are there?

Answer 29

4

Question 30

VSD that may close spontaneously and have little functional significance.

Answer 30

Roger's Defect :)

Question 31

Type of VSD is closer to the valve

Answer 31

Membranous VSD