Pathoma Congenital VSD, ASD, PDA 12/04

Question 1

When congenital arise?

Answer 1

During embryoigenesis (usually weeks 3 to 8)

Question 2

What cause those defects?

Answer 2

Most are sporadic

Question 3

Often results in what circulation?

Answer 3

shunting between left (systemic) and right (pulmonary) circulations

Question 4

What are symptoms of left-to-right shunting?

Answer 4

Relatively asymptomatic at birth, shunt can eventually reverse.

Question 5

incr. flow through the pulmonary circulation leads to …..

Answer 5

hyperthrophy of pulmonary vessels and pulmonary hypertension

Question 6

Incr. pulmonary resistance eventually results in —>

Answer 6

in reversal shunt, leading to late cyanosis (Eisenmenger syndrome) with right ventricular hyperthrophy, plolycytemia and clubbing.

Question 7

VSD. What defect?

Answer 7

in septum that divides the right and left ventricles

Question 8

defect in septum that divides the right and left ventricles?

Answer 8

VSD

Question 9

VSD. 2 reasons?

Answer 9

Most common congenital defect.
Assoc. with fetal alcohol syndrome

Question 10

Assoc. with fetal alcohol syndrome?

Answer 10

VSD

Question 11

VSD. Results in what?

Answer 11

left-to-right shunt.

Question 12

VSD. Size of defect determines…..

Answer 12

extent of shunting and age at presentation

Question 13

VSD. Small defects? symtoms.

Answer 13

Asymptomatic

Question 14

VSD. Large defects? symtoms.

Answer 14

leads to Eisenmenger syndrome (late cyanosis).

Question 15

VSD. Treatment?

Answer 15

Surgical closure. Small defects may close spontaneously.

Question 16

ASD. Defect in what?

Answer 16

in septum that divides right and left atria.

Question 17

ASD. Most common type of defect?

Answer 17

Ostium secundum (90proc.)

Question 18

ASD. Ostium primum is assoc with?

Answer 18

Down syndrome.

Question 19

Down syndrome is assoc with what?

Answer 19

ASD. Ostium primum type.

Question 20

ASD. Results in what shunt?

Answer 20

left-to-right AND split S2 on auscultation

Question 21

ASD. Why S2 split?

Answer 21

increased blood in right heart delays closure of pulmonary valve.

Question 22

ASD. What is important complication?

Answer 22

Paradoxical emboli

Question 23

Paradoxical emboli. Complication of what?

Answer 23

ASD.

Question 24

left-to-right AND split S2 on auscultation?

Answer 24

ASD

Question 25

Patent ductus arteriosus (PDA). Mechanism?

Answer 25

Failure of ductus arteriosus to close.

Question 26

PDA assoc. with what?

Answer 26

congenital rubella

Question 27

congenital rubella --> what defect?

Answer 27

PDA

Question 28

PDA. What shunt?

Answer 28

left-to-right shunt between the AORTA and the PULMONARY artery

Question 29

left-to-right shunt between the AORTA and the PULMONARY artery?

Answer 29

PDA

Question 30

PDA. Normally what happens during development?

Answer 30

ductus arteriosus normally shunts blood from the pulmonary artery to the aorta, bypassing the lungs.

Question 31

ductus arteriosus normally shunts blood from the pulmonary artery to the aorta, bypassing the lungs.?

Answer 31

PDA

Question 32

PDA. symptoms at birth?

Answer 32

Asymptomatic with continuous ,,Machine-like" murmur.

Question 33

PDA. symptoms may lead to ....

Answer 33

Eisenmenger syndrome, resulting in lower extremity cyanosis.

Question 34

Eisenmenger syndrome, resulting in lower extremity cyanosis.?

Answer 34

PDA

Question 35

PDA. Treatment?

Answer 35

indomethacin: decrease PDE, resulting in PDA closure

Question 36

What maintains ductus in PDA?

Answer 36

PGE maintains patency of the ductus arteriosus.