Peds Cardio

Question 1

When are diastolic murmurs pathologic

Answer 1

always in children

Question 2

What is the most common defect in those patietns with chromosomal abnormalities

Answer 2

Ventricular Septal Defects

Question 3

What are the 5 Ts of congenital heart disease

Answer 3

Truncus Arteriousus, Transposition of the Great Arteries, Tricuspid Atresia, Tertralogy of Fallot, Total anomolous pulmonary venous return (TAPVR)

Question 4

What are the symptoms of moderate VSD that occur in infancy

Answer 4

Dyspnea, sweating, failure to thrive, respiratory symptoms

Question 5

What are the symptoms of large VSD

Answer 5

present 2-6 mos, breathlessness and sweating with feeding, pulm edema, cardiomegaly, harsh systolic murmur, pulm systolic ejection murmur, mitral mid-diastolic flow

Question 6

Diagnosis of VSD/ASD

Answer 6

CXR, ECG, ECHO

Question 7

Which type of VSD is treated initally

Answer 7

Large (6-10mm)

Question 8

What are the levels of VSD

Answer 8

Small (

Question 9

What are the 4 types of septal defect

Answer 9

Ostium secundum, ostium primum, sinus venosis, coronary sinus

Question 10

What is the most common presenting symptom of ASD

Answer 10

heart murmur

Question 11

what are the signs of ASD

Answer 11

hyperdynamic precordium, right ventricular heave, SEM in pum area, wide, fixed split S2

Question 12

What is the 2nd most common cyanotic malformation

Answer 12

tetraolgy of Fallot

Question 13

what determines the degree of cyanosis

Answer 13

degree of obstruction

Question 14

what age are most children cyanotic by with tetralogy of fallot

Answer 14

4 mos

Question 15

What are the 4 aspects of tetralogy of fallot

Answer 15

RVOT obstruction, VSD, overriding aorta, right ventricular hypertrophy

Question 16

What are ssx of tetralogy of fallot

Answer 16

may be pink in newborn, cyanosis increases over time, low borth weight, slow growth rate, DOE

Question 17

ECG diagnostic findings of tetralogy of fallot

Answer 17

right axis deviation (>90degrees), right atrial enlargement, dominant right ventricular forces over precordial leads

Question 18

CXR shows what on tetralogy of fallot

Answer 18

boot shaped heart d/t pulmonary artery segment and upturned apex

Question 19

what is the treatment of tetralogy of fallot

Answer 19

repair and palliative surgery

Question 20

what is the term for blood bypassing the lungs and not becoming oxygenating

Answer 20

Hypercyanotic “Tet” spell

Question 21

what do you monitor for in surgical mgmt of tetralogy of fallot

Answer 21

erythrocytosis, iron deficiency, anemia, coag disorders

Question 22

what is considered a “tet” spell

Answer 22

sudden onset or deepening of cyanosis, sudden dyspnea, alterations in consciousness, decrease or disappearance of systolic murmur

Question 23

treatment of tet spells

Answer 23

oxygen, tripod position, correct acidosis, morphine, propranolol

Question 24

what is palliation treatment of tetralogy of fallot

Answer 24

betablockers, systemic arterial to pulmonary arterial anastamosis, balloon angioplasty

Question 25

what is the most common form of cyanotic congenital heart disease presenting in neonatal period

Answer 25

transposition of the great arteries

Question 26

what is the definition of the transposition of great arteries

Answer 26

aorta arises from the right ventricle and pulmonary artery arises from the left ventricle

Question 27

SSx of transposition of the great arteries

Answer 27

severely cyanotic in first hours of life, no resp distress, CHF sx, SOB, right ventricular heave, large infants, males

Question 28

what is the treatment of transposition of the great arteries

Answer 28

PGE1 to keep PDA open and increase aorta to pulmonary artery shunting, dig, diuretic therapy, rashkind balloon artial septostomy

Question 29

What are the sx of valvular aortic stenosis

Answer 29

absent often even when severe, fatigue, doe, chest pain or exertional syncope, CHF

Question 30

what are the signs of valvular aortic stenosis

Answer 30

loud, harsh systolic murmur, ejection click, aortic sound, low systolic bp, left ventricle prominent

Question 31

what is the treatment of valvular aortic stenosis

Answer 31

exercise restriction, catheter balloon valvuloplasty, surgical calcotomy

Question 32

What common disease is associated with coarctation of the aorta

Answer 32

Turner syndrome in females

Question 33

presentation of the coarctation of aorta

Answer 33

Diastolic murmurand HTN, no femoral pulses felt

Question 34

exam for coarctation of aorta

Answer 34

pink, appearing well, prominent left ventricle, systolic ejection murmur, upper extremity HTN, collateral arteries over scapulae

Question 35

treatment for infants with low coarctation of the aorta

Answer 35

prostaglandin infusion to reopen ductus arteriosis, inotropic support, corrective surgery

Question 36

treatment for infants with nonacute correction of coarctation of aorta

Answer 36

balloon angioplasty, surgical, aortic stent placement in adults, correct before age 5

Question 37

presentation of murmur in an infant

Answer 37

poor feeding, failure to thrive, tachypnea

Question 38

Presentation of left sided failure in an infant with a murmur

Answer 38

tachypnea, orthopnea, wheezing, pulmonary edema, right sided failure

Question 39

presentation of right sided failure in an infant with a a murmur

Answer 39

HSM and edema

Question 40

Presentation of shock an infant with a murmur

Answer 40

tachypnea, gallop rhythm, thready pulses

Question 41

When are prostaglandins utilized in an infant with murmur and dyspnea

Answer 41

newborns

Question 42

what is the longterm medical treatment in an infant with a murmur

Answer 42

diruetics, digoxin, surgery