Paeds cardio

Question 1

what type of shunt causes acyanotic heart diseases?

Answer 1

left to right

Question 2

acyanotic heart diseases

Answer 2

VSD
ASD
PDA
Coarctation

Question 3

what happens in acyanotic?

Answer 3

increase pulmonary flow
= pulmonary HTN
get Eisenmenger syndrome (reversal)

Question 4

what type of shunt causes cyanotic heart disease?

Answer 4

right to left

Question 5

cyanotic heart diseases

Answer 5

tetralogy
transposition
truncus arteriosus
total anomalous pulmonary return
hypoplastic Left Heart Syndrome

Question 6

what happens in cyanotic?

Answer 6

defect causes lung bypass

Question 7

when does AVSD present?

Answer 7

first few hours of life

Question 8

when does aortic coarctation/stenosis present?

Answer 8

first few weeks of life

Question 9

what is a +ve result in nitrogen wash out test?

Answer 9

if oxygen <15kPa after 100% oxygen for 10 mins

Question 10

when does tricuspid atresia present?

Answer 10

cyanosis/SOB in first 10 mins

Question 11

what does tricuspid atresia need in patients?

Answer 11

ASD and VSD to remain patent

Question 12

murmur in tricuspid atresi

Answer 12

ESM at LSE due to VSD

Question 13

management of tricuspid atresia

Answer 13

Blacklock-Taussig shunt (artificial ductus)

Question 14

when does ToGA?

Answer 14

presents when ductus closes at 2-4 days

Question 15

murmur in ToGA

Answer 15

loud S2 but no murmur

Question 16

X-ray in ToGA

Answer 16

egg on side

Question 17

Mx of ToGA

Answer 17

1. prostaglandin

2. surgery (switch vessels)

Question 18

2 types of ASD

Answer 18

1. secundum: defect of atrial septum (failure of closure of foramen ovale)
2. partial (AVSD): defect of AV septum

Question 19

when does AVSD present?

Answer 19

cyanosis ay 2-3 weeks

Question 20

symptoms of ASD

Answer 20

asymptomatic

recurrent/chest infection/wheeze

Question 21

murmur of ASD

Answer 21

ESM at ULSE

fixed wide splitting of S2

Question 22

how are VSDs categorised?

Answer 22

small <3mm

large >3mm

Question 23

symptoms of a small VSD

Answer 23

asymptomatic
breathless
poor feeding
tired
= LOUD pan systolic murmur

Question 24

symptoms of a small VSD

Answer 24

HF
SOB
recurrent chest infection
hepatomegaly
= SOFT pan-systolic murmur

Question 25

what do both VSDs increase the risk of?

Answer 25

small = endocarditis
large = Eisenmengers

Question 26

Management of a large VSD

Answer 26

CDC: calories, diuretics, catalopril

surgery at 3-6 months

Question 27

what are the exam findings in PDA?

Answer 27

continuous machinery like murmur
Left subclavicular thrill
heaving apex beat
wide PP
bounding, collapsing pulse

Question 28

murmur in Ebstein’s

Answer 28

split 1st and 2nd HS

Question 29

management of Ebstein’s

Answer 29

1. prostaglandin

2. cone repair of tricuspid valve

Question 30

what is the murmur in tetralogy of Fallot?

Answer 30

pulmonary stenosis

Question 31

X-ray in ToF

Answer 31

boot shaped heart

Question 32

Mx of TOF

Answer 32

1. prostaglandin

2. surgery at 6 months

Question 33

cause of A/P stenosis

Answer 33

partial fusion of valve leaflets

Question 34

S/S of A/P stenosis

Answer 34

no cyanosis
AS: carotid thrill (ESM)
PS: no carotid thrill, harsh heart murmur at LSE (ESM)

Question 35

Mx of A/P stenosis

Answer 35

trans catheter balloon dilatation

Question 36

coarctation of aorta S/S

Answer 36

ESM

High BP in arms, low BP in legs

Question 37

Mx of hypoplastic L heart

Answer 37

1. ABC, PG
2. BK shunt
3. surgical fix