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Flashcards in Treatment Deck (13):
1

You are the GP

A 2 week old baby is not feeding properly and is showing signs of increased work of breathing. The baby is pink.

You suspect ASD. What is the most common type?

What type of murmur would you expect to hear?

Surgical treatment of a hole between the walls of the atria. (ASD) Atrial Septal Defect Primum and secundum

Where in the hospital?

How old does the child need to be for the operation?

What do they do?

Secundum ASD (50% - 75%)

Soft systolic ejection

Catheter Lab

3-5 Yr old

Stitch the hole shut preferably using a catheter and mesh.

2

You are the GP

A 2 week old baby is not feeding properly and is showing signs of increased work of breathing. The baby is pink.

Name a cardiac cause of growth faltering in newborns

Is surgical treatment required for a SMALL hole between the walls of the ventricles - Asymptomatic VSD

VSD

No 3/4 of holes between the ventricles will close by themselves.

3

You are the GP

A 2 week old baby is not feeding properly and is showing signs of increased work of breathing. The baby is pink.

Is surgical treatment required for a MODERATE to LARGE hole between the walls of the ventricles.

What is the medical management for a hole between the ventricles (VSD).
(Hint think HF)

Yes If there is poor growth or weight gain

Diuretics for heart failure
ACEi (captopril) to reduce afterload

4

Treatment of hole in the ventricles VSD if there are severe symptoms of poor feeding, poor weight gain, increased work of breathing

(1/4 of all cases)

Surgery at 3-4 months to patch the hole

5

What might make you suspect a baby has a PDA in the History and Examination?

How long does the ductus arteriosus need to persist for before it is termed persistent in preterm infants

How long does the ductus arteriosus need to persist for before it is termed persistent in full term infants

What can be done to treat a small (less than 3mm) PDA

- Poor Feeding,
growth faltering,
poor weight gain,
increased respiratory effort

- 3 months

- 1 year

- Coil occlusion
Surgical closure with a device

6

1) What might make you suspect a baby has a ToGA on HxPC

2) What might make you suspect a baby has a ToGA on Examination?

3) Give a differential

4) Immediate Mgx for suspected cyanotic heart disease

5) Most helpful Igx

6) Name of procedure to Treat transposition of great arteries for babied with intact Ventricular septum

7) Name of corrective surgical procedure

1) History
T - first week of life
C - poor feeding, growth faltering, blue baby, increased WOB

2) Examination
I - sweating + tachypnoea
P - tachycardia

3) Fallot Tetralogy

4) PG

5) Echo

6) Balloon Atrial Septostomy

7) Arterial switch operation at 1 week

7

1) What primary symptom (PC) might make you suspect a baby has a Fallots

2) what normally accompanies this PC symptom in the HxPC

3) What examination findings accompany symptoms of Fallots on inspection

4) 3) What examination findings accompany symptoms of Fallots on auscultation

5) Surgical procedure to correct Tetralogy of Fallot with pulmonary atresia

1) blue baby or poor feeding

2) poor feeding, growth faltering, poor weight gain, increased work of breathing

3) cyanosis + abdominal breathing, recession, scoliosis, clubbing

4) Systolic ejection murmur and systolic thrill at the LLSternal border

5) MBTS

8

1) What primary symptom (PC) might make you suspect a baby has an Ebstein Anomaly (tricuspid valve abnormality)

Treatment of
Ebstein Anomaly
(Tricuspid regurgitation and cardiomegaly on CXR)

1) Blue Baby, Poor Feeding

Pulmonary vasodilation (O2, NO etc)

9

Treatment of Pulmonary Atresia with intact ventricular septum (PAIVS)

Radiofrequency perforation at cardiac catheter

10

1) What is AVSD

2) Which trisomy often occurs with atrio ventricular septal defect (AVSD).

3) What is the most useful first line investigation to help diagnose AVSD?

4) Corrective surgical procedure for AVSD

1) Tricuspid and mitral valves deformity + ASD + VSD

2) Downs

3) ECG

Operate at 3-4 months
Pulmonary Artery Banding or BT shunt

11

Treatment of Aortic stenosis presenting with carotid thrill

Balloon Dilate at cardiac catheter when
Doppler gradient on echocardiogram is > 64mmHg

12

Treatment of Pulmonary stenosis

Balloon Dilate at cardiac catheter when
Doppler gradient is > 64mmHg

13

Treatment of Coarctation in adults presenting with radio-femoral or radio-radial delay
Rare condition

Stent at cardiac catheter if >12 years