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MTB 3 Flashcards

(60 cards)

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1
Q

Which cardiac malformation requires ASD, VSD, or PDA?

A

Transposition b/c otherwise no oxygenation of blood

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2
Q

Early and severe cyanosis, single S2?

A

Transposition

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3
Q

What heart defect ass’d with Grey cyanosis?

A

Hypoplastic left heart syndrome

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4
Q

What is seen with Hypoplastic left heart syndrome?

A

LV Hypoplasia
Mitral valve atresia
Aortic Valve lesions

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5
Q

What is seen on CXR with Hypoplastic left heart syndrome?

A

Globular shaped heart

Pulmonary edema

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6
Q

Most accurate test for Hypoplastic left heart syndrome?

A

Echo

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7
Q

Severe dyspnea, early & frequent resp infxn, Single S2, peripheral pulses are bounding during first few days of life?

A

Truncus arteriosus

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8
Q

Tx for Truncus arteriosus

A

Surgery

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9
Q

Most severe sequelae of Truncus arteriosus

A

Pulmonary HTN

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10
Q

Cardiac defect early in life w/respiratory distress and severe cyanosis?

A

TAPVR w/obstruction

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11
Q

Cardiac defect age 1-2 with right heart failure and tachypnea

A

TAPVR w/OUT obstruction

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12
Q

CXR shows snowman or figure 8 sign

A

TAPVR w/OUT obstruction

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13
Q

Most accurate dx test for TAPVR w/OUT obstruction?

A

Echo

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14
Q

Treatment for TAPVR?

A

Surgical intervention

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15
Q

MCC of cyanotic heart lesion in NB?

A

Transposition

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16
Q

MCC of cyanotic heart lesion in childhood?

A

Tet of Fallot

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17
Q

Healthy child presents with holosystolic murmur and sx’s of failure to thrive?

A

VSD

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18
Q

EKG findings of VSD?

A

RVH

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19
Q

High pitched holosystolic murmur over lower left sternal border

A

VSD

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20
Q

Loud pulmonic S2

A

VSD

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21
Q

Tx for VSD

A

Smaller lesions close in first 1-2 yrs
Diuretics
Digoxin

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22
Q

Untreated VSD progresses to

A

CHF
Endocarditis
Pulm HTN

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23
Q

Fixed wide splitting of S2

A

ASD

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24
Q

Most definitive test for ASD

A

Cardiac cath

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25
Increased vascular markings on CXR
VSD | ASD
26
Tx for ASD
Most close spontaneously | Dysrhythmias and paradoxical emboli from DVTs in adulthood
27
When does PDA close?
PO2 above 50 mmHg
28
When is PDA a normal finding?
First 12 hours of life
29
PDA
Wide pulse pressure | Bounding pulses
30
Most common complication in child w PDA
Resp Infxn | Infective endocarditis
31
Best initial test PDA
Echo
32
Most accurate test PDA
Cardiac cath
33
Where do Tricuspid and Pulmonary lesions radiate to?
The back
34
Short girl w/webbed neck, shield chest, streak gonads, horseshoe kidneys, shortened 4th metacarpal
Coarctation of the aorta
35
How does coarctation of aorta present?
Severe CHF Respiratory Distress - first few months of life Differential pulses LE and UE
36
Reduces pules in LE + HTN in UE
Coarctation of aorta
37
When is hyperbilirubinemia pathological?
``` Appears on 1st day of life BR Rises more than 5 mg/dL/day BR rises above 19.5 mg/dL in term child Direct BR over 2 mg/dL Persists after 2nd week of life ```
38
NB presents with hypotonia, seizures, choreoathetosis, hearing loss?
Kernicterus
39
TX for Pathologic jaundice
Phototherapy | If BR 20-25 -> Exchange transfusion
40
How does breastfeeding jaundice present?
1st week of life Jaundice Signs of dehydration
41
What is breastfeeding jaundice present?
Lactation failure - Decreased BR elimination - Increased enterohepatic circulation
42
Tx for breastfeeding jaundice present?
Alter breastfeeding to every 2-3 hours for > 10-20 mins per breast for 1st month
43
How does breast milk jaundice present?
Starts at 3-5 days peaks at 2 weeks Normal exam Adequate breast feeding
44
How does esophageal atresia present?
Vomiting or choking, coughing, cyanosis with first feed | Hx of polyhydramnios
45
Complications with esophageal atresia?
Aspiration pneumonia - recurrent
46
What is seen on CXR with esophageal atresia?
Gastric air bubble Esophageal air bubble Coiling of NG tube
47
What sign is seen with pyloric stenosis?
String sign on upper GI series | - Barium swallowed and passage observed under fluroscopy
48
What sign is seen with Intussusception?
Doughnut sign
49
Steeple sign?
Croup
50
When do we see pyloric stenosis
First month of life - 6 months
51
When is a succussion splash heard?
Pyloric stenosis | sound of stomach contents slapping into pylorus
52
Succussion splash in adults (GI)?
When there is retained gastric contents - Gastric outlet obstruction - Gastroparesis
53
Differential DX for nonbilious vomiting?
Pyloric stenosis - projective GERD Infx
54
Metabolic derangement with pyloric stenosis?
Hypochloremic Hypokalemic Metabolic alkalosis
55
Why do we see hypochloremia and hypokalemia in vomiting?
Hydrogen lost in vomitus | Potassium loss worsens b/c of aldosterone release b/c of hypovolemia
56
What sign is seen on physical exam in pyloric stenosis
Olive sign - palpable mass size of olive | Epigastric
57
Best initial test for pyloric stenosis
Abdominal US | - thickened pyloric sphincter
58
Most accurate test for pyloric stenosis
Upper GI series
59
What 4 signs are seen in upper GI series w pyloric stenosis
1. String sign - thin column of barium that leaks thru a tightened muscle 2. Shoulder sign 3. Mushroom sign - hypertrophic pylorus against duodenum 4. Railroad track sign- excess mucosa in pyloric lumen
60
Tx for pyloric stenosis
1. Replace IVF 2. Replace electrolytes - esp K+ to decrease risk of post op apnea 3. NGT to decompress bowel 4. Surgical myotomy/pyloromyotomy

Peds (6 decks)

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