Test # 2 ch6,78

Question 1

Tap

Answer 1

sharp, well-localozed

associated with pressure-overload

Question 1

Quality / pitch of murmurs

Answer 1

pitch is : high, medium or low

high: turbuemce from a high pressure to a low pressure

aortic or mitral insufficiency

low presure difference is mitral stenosis (low-pressure turbuence in the flow)

Question 2

Prevalence of CHD (truncus, VSD, ASD, Coarc,transposition, TOF, Ebstein’s, interupted aortic arch, pulmonary atresia, tricuspid atresia, TAPVR, DORV, AV Canal,& HLHS

Answer 2

82/10000

Question 2

Drugs affecting he heart

Answer 2

amphetamines, alcohol, anticonvulsants (hydantoins, trimethadione, valproic acid, carbamasepine), lithium, retonic acid, thalidomide, coumadin

Question 2

L&D history

Answer 2

perinatal hypoxia, maternal infection, drugs

Question 2

s1

Answer 2

closure of mitral and tricuspid at the onselt of ventricular systole

heard most loudly at the apex

Loud at birth

decreases in intensity

s1 usually single; not split

Question 3

Thorough Maternal History

Answer 3

SLE, maternal diabetes and maternal CHD

Question 3

Heaves

Answer 3

PMI is slow rising and difuse

heaves are associated with volume overload

Question 3

Mitral

Answer 3

4th intercostal space, left midclavicular line

Question 4

Grade IV murmur

Answer 4

Louder

may be associated with a thrill

Question 6

Genetic factors important for CHD

-gather details about siblings (3-5% chance for recurrence)

Answer 6

Several disorders might demonstrate dominatn of recesie patterns are associated with specific CH defects

Question 7

Systolic ejection murmur

Answer 7

most common innocent murmur

grade I-II

best heard mid and upper left sternal border

vibratory

Question 8

increases the risk for CHD 3-4 times that of he general population

Answer 8

Maternal Diabetes

Question 10

Grade VI

Answer 10

Extremely loud

can be heard with the stethoscope being slightly removed from the chest

maybe a thrill

Question 11

s3

Answer 11

present in the apex if heard

siglals a rapd or increased flow across th AV valves (rapid ventricular filling)

Heard in preemies with a PDA

Question 12

Tricuspid

Answer 12

4th itercostal space, left sternal angle

Question 13

Aortic area

Answer 13

2nd intercostal space, right sternal angle

Question 13

Pulmonic

Answer 13

2nd intercostal space, left sternal angle

Question 14

birthweight, sex and GA

Answer 14

increase of CHD in low birthweight, preemies increased risk for PDA, several CHD are more common in one se versus another

Question 16

Grade III murmur

Answer 16

Moderate intensity

NOT associated with a thrill

Question 17

Location of murmurs

Answer 17

terms of the interspace and the midsternal

midclavicular

axillary lines

Question 19

VSD’s and transpositionCardiomyopathy (hypertrophic cardiomyopathy)

Answer 19

Commonly seen with IDM

Question 20

Grade V murmur

Answer 20

VERY LOUD

can be heard with a stethoscope rim barly on the chest

Question 21

Determining of CHD a factor?

Answer 21

perinatal hypoxia, maernal infection, drugs during labor

BW

GA

Sex

Question 23

thrills

Answer 23

low-frequency palpable murmurs cat purring felt best itht he palm at least a grade IV murmur

Question 26

Viral infections cause myocarditis if contacted within the

Answer 26

last 2 weeks of pregnancy

Question 27

S2

Answer 27

closing of the Aortic and pulmonic valves Heard at the base of the heart Single at birth, but splitting should occur WIDE splitting is abnormal (ASD, PS, Ebstein's, Partial anomolous pulmonary venous return, mitral regurge and right bundle branch block)

Question 28

Maternal CHD presents a risk of up to 15%

Answer 28

for infants being born with CHD

Question 29

radiation of a murmur posioned pulm outflow tract

Answer 29

let upper back

Question 31

radiation from normal aortic outflow

Answer 31

carotid arteries

Question 32

Grade 2 murmur

Answer 32

Soft, but audible immediately

Question 33

ejection clicks

Answer 33

heard just after the 1st heart sound considered abnormal after the 1st 24 hours of life in st 24 hours, they are normal r/t pul htn) Aortic or pulmotic stenosis dilation of PA, truncus, TOF

Question 34

s4

Answer 34

Rare At apex always pathologic uaually in Cardipmyopathy or chf myocardium that is stiff effecting the colume of the blood that is ejected

Question 35

Grade 1 murmur

Answer 35

Barely audible; audible only after careful ausculttion

Question 36

SLE

Answer 36

increase the incidence 1- COngenital AV Block (low resting HR sometimes in Utero)

Question 37

Innocent murmurs

Answer 37

usually 1st 48hrs associated with decreasing pulmonary vascular resistance/closure of the PDA Flow murmurs Most often grande I or II