Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pediatrics > Peds CHD > Flashcards

Peds CHD Flashcards

(71 cards)

Start Studying
1
Q

S1 sound is produced by?

A

closing of the AV valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

S2 is produced by?

A

closing of semilunar valves

-they close at different times depending on pt breathing so could be split sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

rank of important things to listen for in a murmur

A
  1. timing - systolic, diastolic, continuous
  2. Pitch
  3. intensity - graded 1-6
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which types of pitches indicate that the murmur is ALWAYS abnormal?

A

-high pitch
or
-diastolic murmurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

2 classifications that indicated SYSTOLIC murmur

A
  • ejection

- holosystolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ejection murmurs

A
  • PS
  • AS
  • functional
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

holosystolic murmurs

A
  • VSD
  • MR
  • TR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Diastolic murmurs

A
  • AI
  • PI
  • MS
  • TS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

continuous murmurs

A
  • PDA

- BT shunt or other aortopulmonary collateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

normal murmurs in kids

A
  • venous hums
  • pulmonary flow (RV to MPA)
  • MPA to branch PA
  • Still’s murmur
  • supraclavicular or carotid bruit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

venous hum

A
  • continuous murmur
  • hearing the flow in the veins when they sit up and goes away when laying down
  • can hear better when head turns to one direction and goes away in opposite direction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Still’s murmur

A
  • blood flow across the cordae
  • don’t hear it sitting up but hear it laying down at mid sternal border
  • can vary w/ HR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Who to refer

A
  • murmur not clearly normal
  • abnormal EKG
  • Down’s or Marfan’s
  • high pitched or diastolic murmur
  • cardiac sx w/ or w/o murmur
  • fam hx of cardiomyopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CHF

A
  • heart is unable to pump enough blood to the body to meet its needs
  • not a good term - it’s actually working overtime
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

S/sx of CHF

A

-sweating, poor feeding, edema, increased sleeping, poor activity, FTT
-possible hepatomegaly, tachypnea, chest retraction, gallop
(different signs than in adults w/ CHF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MC causes of CHF in infants

A

-volume overload from VSD, PDA, AV canal

big left to right shunts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tx of CHF

A
  • diuretics: lasix/furosemide 1mg/kg BID - monitor K
  • inotropic agents: Digoxin 8-10mg/kg/day
  • ACE inhibitors: captopril start low and increase dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

when is captopril contraindicated?

A

in LVOT obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

types of ASD

A
  • secundum: MC; where the foramen ovale was
  • primum: lower down, part of an AVSD. Always have a cleft in MV
  • venous defect: always associated w/ APVR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

ASD

A
  • isolated lesions that rarely cause problems

- many spontaneously close, if not closure is indicated at 3-5 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the MC cause of CHD?

A

VSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

VSD

A
  • most close spontaneously w/i the first year, sep. the muscular ones
  • severity depends on size
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

describe the VSD murmur

A
  • holosystolic
  • the pitch depends how big the hole is
  • isn’t always hear at birth b/c pressure on right side is still elevated so not flowing L->R as hard
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

AV canal consists of what abnormalities

A
  • primum ASD
  • single AV valve
  • VSD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
AV canal is often associated w/ what condition?
Downs
26
S/s of AV canal
-HF w/i the first few months (worse in non-Downs pts)
27
murmur in AV canal
- may be hard to hear | - if present: holosystolic and gallop may be present
28
What complication can occur if AV canal isn't treated early enough in Downs?
Eisenmenger's physiology
29
long term complications of AV canal
- mitral valve function - AV block - sub aortic stenosis
30
RVOT aka pulmonary stenosis MC location
at the valve
31
RVOT (PS) murmur
typically a systolic ejection located left upper sternal that radiates to back/axilla**
32
LVOT (AS) murmur
typically systolic ejection located RUSB and radiates to carotids
33
Shone's Complex
- serial left heart obstructive lesions | - familial
34
Coarctation of the aorta (COA)
- hard to pick up prenatally b/c of PDA - can present in cardiogenic shock if PDA closes - difference in upper and lower pulses/BP (ALWAYS ck)
35
COA murmur
systolic ejection murmur heard in the back as well
36
tx of COA
- typically surg repair in first few weeks of life by end to end anastomosis - if found at older age can be stented
37
PDA
- aortopulmonary collateral that connects the aorta and pulmonary artery - more common in premies - it's lifesaving in ductal dependent CHDs
38
uses of meds w/ PDA
- prostaglandins keep them open | - indomethocin closes (if young enough)
39
TGA
- RV origin of the aorta - LV origin of the pulmonary artery - if no PFO or it's too small, there's no mixing of blue and red circulation - there's plenty of pulmonary blood flow but still cyanotic b/c it's all coming from the left ventricle - parallel circuits
40
TGA is incompatible with life unless what types of communication are present?
- ASD - VSD - PDA
41
TGA intervention
- if they have a small ASD, can do the Rashkind procedure --> - a balloon atrial septostomy to tear open the ASD to allow for more mixing - then preform an aterial switch operation
42
what's important to remember in a pt that has had the arterial switch operation to repair TGA?
the coronary arteries are moved in this operation so at risk for ischemic heart disease at younger age
43
what is the MC cause of neonatal cyanosis?
tetralogy of fallot (TOF)
44
4 abnormalities of TOF
- aorta override - RVOT obstruction (PS) - VSD - RVH
45
Tet spells
- spasm of subpulmonary area - most likely to occur in am d/t dehydration - cyanosis that worsens and doesn't resolve - increased R-->L shunting at VSD causing less pulmonary blood flow - a "misbalance" of pulmonary and systemic blood flow
46
how to confirm a tet spell is happening
-listen - if murmur is quieter or not present, it's a spell
47
management of tet spell
- knees to chest, O2, morphine - propanolol - increase SVR: phenylephrine, ketamine - push PRBC
48
what's CI in tet spell treatment?
beta agonists (albuterol, terbutaline, etc)
49
surgery for TOF
``` 1st: palliative surg = BT shunt then -lillihei w/ cross circulation then -complete repair: close VSD and open RVOT ```
50
long term effects of TOF
- to and fro murmur from some PF and PI - RBBB - RV failure
51
truncus arteriosus
-single artery comes from heart giving origin to coronaries, pulmonary arteries, and aortic arch
52
complication of an untreated truncus arteriosus
- uncontrolled pulmonary blood flow that leads to CHF uncontrollable w/ meds - eventual fixed PVR
53
surgery for truncus arteriosus
VSD closure w/ RV-PA conduit done around 1-4 weeks of age
54
TAPVR (total anomalous pulmonary venous return)
when all pulmonary veins drain via a venous channel into the RA or directly into the RA
55
in TAPVR, all CO is via what?
a PFO or ASD
56
3 types of TAPVR
- supracardiac: rarely obstructive; present like ASD; MC - intracardiac: rare - infradiaphragmatic: important! obstructed at ductus venosus. EMERGENCY
57
clinical presentation of an obstructed TAPVR
- extremely ill from soon after birth and progressively worsen (blue and getting bluer) - severe pulmonary HTN secondary to pulmonary venous obstruction
58
TAPVR surgery
- "fillet" open confluence and attach to atrium then ligate descending vein - usually done w/i hours of diagnosis
59
single ventricle physiology includes all anatomic arrangements requiring staged surgical repair. These 5 things are:
- tricuspid atresia - pulmonary atresia - mitral atresia - aortic atresa - hypoplastic left heart syndrome (HLHS)
60
other lesions leading to a single, functional ventricle
- unbalanced AVSD - some forms of Ebstein anomaly (tricuspid valve anomaly) - some forms of DORV, DOLV - some heterotaxy syndromes
61
HLHS presentation
- often presents when PDA closes - no source of systemic blood flow so look terrible - need to give Prostin to keep PDA open
62
PE in HLHS
- sign of poor systemic perfusion if no PDA: poor femoral pulses, cyanotic - normal S1 - single S2 - non-specific murmur
63
EKG and CXR in HLHS
- EKG: little LV forces and RVH | - CXR: non-specific
64
physiology of HLHS
- pulm venous return MUST cross atrial septum and enter RA - pulm venous return and systemic venous return mix in the RA - from there it can take 2 routes: systemic outflow (Qs) or pulm outflow (Qp)
65
what is the outcome of a pt w/ HLSH systemic outflow ratio (Qp:Qs) is 0.5:1
-the pt will have great systemic perfusion but O2 sats will be low
66
outcome of a pt w/ HLSH systemic outflow ratio (Qp:Qs) is 2:1
- pt will have great O2 sats and possible pulmonary edema | - but poor perfusion and poor BP and metabolic acidosis
67
outcome of a pt w/ HLSH systemic outflow ratio (Qp:Qs) is 1:1
- good systemic perfusion and acceptable O2 sats (80% is magic number) - pt is balanced
68
HLHS surgery
1. Sano operation 2. Glenn 3. Fontan
69
Turner's syndrome is associated w/ what CHD?
COA
70
Downs is associated w/ what CHD?
-AV canal
71
DiGeorge is associated w/ what CHD?
TOF

Pediatrics (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions