Peds - Congenital Cardiovascular

Question 1

Which valves are AV?

Answer 1

Between ATRIA and VENTRICLES
mitral
tricuspid

Question 2

Which valves are semilunar?

Answer 2

aortic

pulmonic

Question 3

What causes S1?

Answer 3

Closure of the AV valves

mitral
tricuspid

A is the 1st letter, AV make the S1 sound

Question 4

What causes S2?

Answer 4

Closure of the semilunar valves

aortic pulmonic

Question 5

When does systole occur?

Answer 5

Between S1 and S2

Question 6

When does diastole occur?

Answer 6

Between S2 and S1

Question 7

Generally speaking, what causes S3?

Answer 7

Increased fluid states

Question 8

Generally speaking, what causes S4?

Answer 8

Stiff ventricular wall

Question 9

What does S3 sound like?

Answer 9

Kentucky

Question 10

What does S4 sound like?

Answer 10

Tennessee

Question 11

Which valve is between the R atrium and the R ventricle?

Answer 11

Tricuspid

Question 12

Which valve is between the L atrium and the L ventricle?

Answer 12

Mitral

Question 13

Which valve is between the R ventricle and the pulmonary artery?

Answer 13

Pulmonic

Question 14

Which valve is between the L ventricle and the aorta?

Answer 14

Aortic

Question 15

Pneumonic for order of valves

Answer 15

To
Pay
More
Attention

Question 16

Auscultation area - aortic  
#

Answer 16

R upper sternal border

Question 17

Auscultation area - pulmonic 
#

Answer 17

L upper sternal border

Question 18

Auscultation area - aortic or mitral

Answer 18

Apex (Erb’s point)

Question 19

Auscultation area - tricuspid or VSD

Answer 19

L lower sternal border

Question 20

What might a thrill indicate?

Answer 20

VSD

ex: Tetralogy of Fallot

Question 21

Congenital murmurs tend to be:

Answer 21

Systolic

Question 22

Obstructive defects tend to have:

Answer 22

Ejection clicks due to turbulence

Referred or radiating sound

Question 23

What is the most common congenital heart defect?

Answer 23

VSD

30%

Question 24

Acyanotic lesions shunt which way?

Answer 24

Left to Right

Question 25

Cyanotic lesions shunt which way?

Answer 25

Right to Left

Question 26

acyanotic defect systolic murmur @ Left UPPER sternal border R ventricular hypertrophy

Answer 26

Atrial Septal Defect (ASD)

Question 27

acyanotic defect systolic murmur @ Left LOWER sternal border may feel a holosystolic THRILL L ventricular hypertrophy

Answer 27

Ventricular Septal Defect (VSD)

Question 28

``` acyanotic defect systolic murmur @ Left UPPER sternal border HOLOSYSTOLIC "machinery" sound L ventricular hypertrophy ```

Answer 28

Patent Ductus Arteriosus (PDA)

Question 29

``` cyanotic defect (same murmur as VSD but with RVH) ``` systolic murmur @ Left LOWER sternal border may feel a holosystolic THRILL X-ray - "egg on a string"

Answer 29

Transposition of the Great Arteries attempt to maintain PDA

Question 30

cyanotic defect loud systolic ejection click @ mid and UPPER L sternal border THRILL # X-ray - "boot shaped heart"

Answer 30

Tetralogy of Fallot

Question 31

obstructive defect systolic thrill @ R upper sternal border ejection click which does NOT vary with respiration L ventricular hypertrophy

Answer 31

Aortic Stenosis

Question 32

obstructive defect systolic murmur @ L upper sternal border ejection click which DOES vary with respiration R ventricular hypertrophy

Answer 32

Pulmonic Stenosis

Question 33

obstructive defect

Answer 33

Coarctation of the Aorta

Question 34

What can be given to stall closure of a PDA (as in the case of cyanotic defects)?

Answer 34

Prostaglandins

Question 35

Four defects of Tetralogy of Fallot

Answer 35

- Large VSD - pulmonary stenosis - overriding aorta - RVH

Question 36

What is a "Tet spell" and with which disorder is it associated?

Answer 36

Hypercyanotic episode associated with Tetralogy of Fallot often will squat or sleep in knee chest position to slow return of blood to the heart periobital edema

Question 37

What are the ACYANOTIC heart defects? | 3

Answer 37

Atrial Septal Defect Ventricular Septal Defect Patent Ductus Arteriosus

Question 38

What are the CYANOTIC heart defects? | 2

Answer 38

Transposition of Great Arteries Tetralogy of Fallot

Question 39

What are the OBSTRUCTIVE heart defects? | 3

Answer 39

Aortic Stenosis Pulmonic Stenosis Coarctation of Aorta

Question 40

DiGeorge is associated with which cardiac defect?

Answer 40

aortic arch anomalies

Question 41

Down's syndrome is associated with which cardiac defect?

Answer 41

septal defects

Question 42

Edward's syndrome (Trisomy 18) is associated with which cardiac defect?

Answer 42

septal defects <

Question 43

Marfan syndrome is associated with which cardiac defect?

Answer 43

aortic regurgitation | mitral valve prolapse

Question 44

Turner's syndrome is associated with which cardiac defect?

Answer 44

coarctation of the aorta

Question 45

Presenting signs and symptoms of child with cardiac defect?

Answer 45

``` cyanosis exercise intolerance diaphoresis edema clubbing ``` feeding problems frequent respiratory infections tachypnea during sleep Beck's triad

Question 46

Beck's Triad - includes what? indication of what?

Answer 46

o Lowered BP; widening of pulse pressure o Distant heart sounds o Jugular venous distention Indicates cardiac defect

Question 47

Pulse pressure definition

Answer 47

the difference between the systolic and diastolic BP readings

Question 48

Characteristics of innocent murmur

Answer 48

No association with failure to thrive or cyanosis low intensity (grade I-III) may vary with position no radiation

Question 49

Why do innocent murmurs occur in up to 50% of children?

Answer 49

thin chest wall more angulated great vessels more dynamic circulation

Question 50

Most common innocent murmur? quality? location? cause?

Answer 50

Still's Murmur musical between L lower sternal border and APEX caused by turbulence in LV outflow tract (stiLL's murmur LL border)

Question 51

Are innocent murmurs systolic or diastolic or both?

Answer 51

Only systolic

Question 52

Venous Hum

Answer 52

``` INNOCENT continuous hum R upper sternal border heard best in sitting position disappears when supine or by turning head/compressing neck ipsilaterally ```