OB/ Paeds Cardio Qs

Question 1

Peripartum Cardiomyopathy

Answer 1

• last month of pregnancy or 5/12 postpartum
  *causes dilated cardiomyopathy –> heart failure, 2o MR
• ECHO test of choice

Question 2

next best investigation in pregnant pt with new HTN >20/40 no proteinuria, no end organ damage

Answer 2

24 hr urine protein collection to differentiate between gestational HTN and preeclampsia

Question 3

psychogenic pseudo syncope

Answer 3

type of conversion disorder
LOC with no impairment in cerebral function
* prolonged Loc duration
*absence of objective findings
*report symptoms occurring during the episode

Question 4

William’s syndrome

Answer 4

deletion of ch 7
*supravalvular aortic stenosis
*cognitive impairment
*low birth weight
*small upturned nose
*widely spaced teeth

Question 5

PDA

Answer 5

*continuous machinery murmur
* best heard Lt sternal border/Lt infraclavicular or post. intrascapular region
*symptoms depend on size
*small –> asymptomatic
*larger–> poor feeding, resp distress, reduced growth 1st year

Question 6

vascular ring

Answer 6

• great vessels encircle and compress trachea and/or oesophagus
• c/o biphasic stridor worse with crying or feeding, improves with neck extension
  *feeding difficulties from esophageal compression

Question 7

cardio defect seen in Trisomy 18

Answer 7

VSD

Question 8

Peripheral cyanosis in an otherwise healthy newborn

Answer 8

normal in the first few days of life

Question 9

Acyanotic congenital heart disease

Answer 9

3 D’s
*VSD
*ASD
*PDA

Question 10

Cyanotic congenital heart disease

Answer 10

12345 T’s
*Truncus arteriosus
*Transposition of the great vessels
* Tricupsid insufficiency
*Tetrology of Fallot
* Total anomalous pulmonary venous return

Question 11

Aortic coarctation initial mgx

Answer 11

*Prostaglandin E1 to keep ductus arteriosus patent
* surgery repair, balloon/ stent

Question 12

Aortic coarctation presentation

Answer 12

• a few days after birth ( when ductus arteriosus closes)
• symptoms of HF ( poor feeding, pulmonary oedema)
• higher BP and stronger pulse in upper Limbs compared to LL

Question 13

Transposition of the great vessels presentation

Answer 13

*central cyanosis within 24hrs of birth
*low SpO2 no improvement with O2
*single S2 sound ( absent pulmonary as aorta is more ant)
*CXR egg on a string appearance
* ECHO diagnostic

Question 14

Tetralogy of Fallot features

Answer 14

• cyanosis
• single S2
  *harsh crescendo decrescendo murmur 2o RVOT obstruction

Question 15

Complete atrioventricular septal defect (CAVSD) features

Answer 15

• commonly associated with Down syndrome
• present around 6/52 after birth
  *sweating, dyspnoea with feeds +, crackles on ausc
  *fixed split S2 (2o ASD)
  *systolic ejection murmur ( 2o LT to Rt flow)
  *holosystolic murmur ( 2o VSD)
  *holosystolic apical murmur ( 2o arterioventricular valve regurgitation

Question 16

PDA dependent congenital heart disease

Answer 16

*coarctation of the aorta
*transposition of the great arteries
*hypoplastic LT heart syndrome
*total anomalous pulmonary venous
*tricuspid atresia

Question 17

appropriate mgx of pt with hx of rheumatic fever and findings suggestive of rheumatic heart disease

Answer 17

prophylactic IM penicillin G benzathine every 3-4/52

Question 18

Digeorge syndrome presentation

Answer 18

*Cardiac outflow anomalies (fallot, transposition, truncus arteriosus)
*Anomalous face
*Thymic hypoplasia
*Cleft palate
*Hypoparathyroidism –> hypocalcemia

Question 19

persistent pulmonary hypertension of the newborn

Answer 19

is persistence of fetal circulation
* abnormal persistence of high pulmonary vascular resistance causing rt to lt shunt across PDA
* pts have low O2 saturation in lower limbs with normal distal pulse