Shared Flashcard Set

Details

Peds: Cardiology
Peds: Cardiology Exam 1
89
Anatomy
Graduate
02/19/2012

Additional Anatomy Flashcards

 


 

Cards

Term
3 shunts in the fetus:
Definition
1. Ductus venosus (bypasses liver)
2. Foramen ovale (R>L atrial shunt)
3. Ductus arteriosus (R>L arterial shunt)
Term
Transitional circulation:
Definition
- Lungs expand within first few breaths
- Foramen ovale functionally closes
- Ductus arteriosus closes within 1 to 2 days
Term
The foramen ovale becomes the __ __.
Definition
fossa ovalis
Term
The umbilical vein beomces the __ __.
Definition
ligamentum teres
Term
The ductus venosus becomes the __ __.
Definition
ligamentum venosus
Term
The ductus arteriosum becomes the __ __.
Definition
ligamentum arteriosum
Term
Acyanotic shunts are __ to __ shunts.
Definition
left to right
Term
Cyanotic shunts are __ to __ shunts.
Definition
right to left
Term
3 types of acyanotic shunts:
Definition
- ASD
- PDA
- VSD
Term
VSD and PDA usually present in __ with __ __, __, and __ __.There is usually __ __ enlargement. __ and __are transmitted.
Definition
- infancy
- heart failure
- murmur
- poor growth
- left heart enlargement
- Flow and pressure
Term
ASD presents in __ with __ or __ __.There is __ __ __ usually __ __. Only __ is transmitted.
Definition
- childhood
- murmur
- exercise intoleranc
- right heart enlargement
- right atrial
- flow
Term
child presenting with murmur and exercise intolerance. acyanotic. murmur heard on exam:
Definition
ASD (Acyanotic L to R shunt)
Term
inant presenting with heart failure, poor growth, and murmur.
Definition
VSD or PDA
Term
VSD has a __ murmur.
Definition
holosystolic
Term
VSD and PDA transmit __ and __, whereas ASD only transmits __.
Definition
- flow and pressure
- flow
Term
Holosystolic murmur at lower left sternal border with heave:
Definition
VSD
Term
presentation and course of VSD depends on size of defect and the __ __ __.
Definition
pulmonary vascular resistance
Term
failure to thrive
tachypnea
diaphoresis with feeds
Definition
VSD(L-R acyanotic shunt)
Term
Most common of all congenital heart conditions:
Definition
VSD
Term
Boudning pulse,machinery like murmur:
Definition
PDA
Term
2nd most common congenital heart condition:
Definition
PDA
Term
___ can be used in preterm infants to help a PDA to close, but doesn't seem to work in term infants.
Definition
Indomethacin
Term
Indomethacin can be used to help cloe a __ in preterm infant.
Definition
PDA
Term
PDA clinical features:
Definition
- failure to thrive
- diaphoresis with feeds
Term
infant with failure to thrive, holosystolic murmur at LLSB:
Definition
VSD
Term
infant with failure to thrive,bounding pulses, machinery like murmur:
Definition
PDA
Term
Features of ASD:
Definition
- widely split fixed S2
- RV heave
- sytolic ejection murmur grade 1-3 at the pulmonary area
- large shunts cause a diastolic flow murmur at the LLSB (d/t increased flow across tricuspid valve)
- often asymptomatic
Term
systolic ejection murmur heard best at the pulmonic area
Definition
ASD
Term
If you hear murmur at LLSB how do you distguish b/w VSD and ASD?
Definition
- VSD would be holosytolic
- ASD would be diastolic
Term
VSD and PDA cause __ heart enlargement, while ___ causes __ heart enlargement.
Definition
- left
- right
Term
Both VSD and ASD have increased __ __ __, but VSD has left heart enlargement, while ASD has right heart enlargement.
Definition
increased pulmonary blood flow
Term
Cyanotic R>L shunts with increased PBF (pulmonary blood flow):
Definition
- Truncus arteriosus
- Transposition of the great arteries (TGA)
Term
Cyanotic R>L shunt with decreased PBF:
Definition
- Tetralogy of Fallot
- Tricuspid atresia
- Ebstein's anomaly
Term
Cyanotic R>L shunts like __ __ and __ of the __ __ are more likely to present with __ __.
Definition
- truncus arteriosus
- transpostion of the the great arteries
- heart failure
Term
With truncus arteriosus, there is extreme __ ___ and the pressures b/w the R and L ventricles are __. Thus o2 saturation can be as high a 93-94% due to the high ___ __ __.
Definition
- pulmonary overcirculation
- equal
- pulmonary blood flow
Term
Cyanotic R>L shunts with decreased pulmonary blood flow, like __ of __, are more likely to present with __.
Definition
- Tetralogy of Fallot
- cyanosis
Term
4 aspects of Tetralogy of Fallot:
Definition
- VSD
- Overriding aorta
- Pulmonary stenosis/atresia
- Left ventricular hypertrophy
Term
Differential pulses or weak pulses in the lower extremities make you think:
Definition
coarction of the aorta
Term
weak pulse may signify:
Definition
cardiogenic shock or coarction of the aorta
Term
pulsus paradoxus:
Definition
- exaggerated systolic bp drop with inspiration
- cardiac tamponade
- severe asthma
Term
Pulsus alternans:
Definition
- altering pulse strength due to left ventricle mechanical dysfunction
Term
mid-systolic click:
Definition
Mitral Valve Prolapse (MVP)
Term
loud S2:
Definition
pulmonary HTN
Term
fixed split S2:
Definition
- ASD
- Pulmonary stenosis
Term
gallop(S3):
Definition
cardiac dysfunction or volume overload
Term
muffled heart sounds and/or rub:
Definition
pericardial effusion +/- tamponade
Term
continuous murmur:
Definition
PDA
Term
Holosystolic murmurs:
Definition
- turbulence begins with systole
- VSD
- MR
Term
vibratory, twangy, systolic murmur heard besst at LSB and apex, loudest in supine position, decreases in upright position,grade 1-3 of 6:
Definition
Still's murmur
Term
where is Still's murmur heard best:
Definition
LSB and apex in supine position
Term
An innocent pulmonary flow murmur is a __ __ murmur heard best over the __area. It is usually in __ __ and __. It is loudest when __ and may be heard in the __.
Definition
- systolic ejection murmur
- pulmonic area
- older children and adolescents
- supine
- back
Term
low pitched continuous hum heard best in the infraclavicular area:
Definition
venous hum
Term
Venous hum is primary __. It disappears when the patient is __ or with compression of the __ __.
Definition
- systolic
- disappears when pt is supine
- compression of jugular veins
Term
RED FLAGS:
Definition
- Diastolic murmurs (only venous hum is okay
- Continuous murmurs (PDA) should be gone by 48 hours
- Loud murmurs, especially with thrills
- SYMPTOMS, esp. cyanosis
Term
Number 1 cause of acquired heart disease:
Definition
Kawasaki Disease
Term
systemic vasculitis of uknown etiology:
Definition
Kawasaki Disease
Term
Dx criteria for Kawasaki Disease:
Definition
Fever for at least 5 days and 4 of the following 5 criteria:
- Eyes:bilateral conjunctival injection without exudates
- Lips and mouth: erythema, cracked lips, strawberry tongue
- Hands and feet: erythema and/or edema
- Skin: polymorphus exanthem
- Cervical lymphadenopathy: usually unilateral
Term
Lab findings of Kawasaki Disease:
Definition
1. Moderate to high WBC with left shift
2. Anemia
3. Thrombocytosis
4. Increased CRP and ESR
5. Mild-moderate increase in transminases
6. Sterile pyuria
Term
cardiac imaging study done for suspected KD;
Definition
Echocardiogram
Term
Kawasaki Disease tmt:
Definition
- IVIG
- high dose ASA
Term
KD tmt acute phase:
Definition
- IVIG 2g/kg
- ASA 80-100 mg/kg/day in 4 doses
Term
Tmt of KD weeks 2-8:
Definition
ASA 3-5mg/kg/day
Term
Acute Rheumatic Fever tmt:
Definition
- Penicillin G Benzathine 1.2 million units/month for 10 years or well into adulthood (this is to prevent rheumatic heart disease)
Term
rheumatic fever follows __ __ by about __ days or __ weeks.
Definition
- Group A strep pharyngitis
- 18 days (2-6 weeks)
Term
Earliest and most common feature of Rheumatic Fever:
Definition
- painful migratory arthritis, affects 80%
- usually in larger joints: knees, ankles, shoulders, elbows
Term
Major Jones Criteria for Dx of Rheumatic Fever:
Definition
- Carditis
- Migratory polyarthritis
- Chorea
- Subcutaneous nodules
- Erythema marginatum
Term
for polyarthritis to be part of rheumatic fever,it must be __ and involve _ or more joints.
Definition
- migratory
- 2 or more joints
Term
ARF tmt:
Definition
anti-inflammatory agents
salicylates, corticosteroids
antibiotics - penicillin
600,000 U IM < 10 yo
1.2 million U IM, children > 10 yo, adults
erythromycin 250 mg PO qid x 10 days
chorea - sedatives

Prevention
penicillin, erythromycin
Term
normal QT interval:
Definition
- less than 460 msec in women
- less than 440 msec in men
Term
features of LQTS:
Definition
- disease of ion channels
- prolonged action potential
- early after depolarization
- increased sympathetic activity in heart (stellate ganglion)
Term
Metabolic causes of acquired LQTS:
Definition
- Hypokalemima
- Hypomagnesia
- Hypocalcemia
- Hypothyroidism
- Anorexia
Term
Medications that can cause acquired LQTS:
Definition
- Antiarrhythmics: Sotalol, Amiodarone
- Antibiotics: Macrolides, Fluourquinoles
- Psychotropics: Haloperidol, TCAs, Thioridiine)
- Others: SSRIs, Risperidone, Methadone, Droperidoal, protease inhibitors
Term
good history questions if suspect congenital LQTS?
Definition
- syncope
- deafness
- FHX of sudden cardiac death
Term
LQT1:
Definition
exercise releated
Term
LQT2:
Definition
auditory related
Term
LQTS 3:
Definition
at rest/sleep

no benefit from beta blocker
Term
beta blockers are good for what types of LQTS?
Definition
1 and 2
Term
primary prevention with LQTS:
Definition
- Beta blockers
- Avoidance of strenuous activities/sports
- Left cardiac sympathetic denervation?
Term
Secondary prevention of LQTS;
Definition
- beta blockers
- ICD
- avoidance of QT prolonging agents
Term
Hypertrophic obstsructive cardiomyopathy (HOCM) aka:
Definition
- Idiopathic hypertrophic subaortic stenosis (IHSS)
- Hypertrophic cardiomyopathy
Term
HOCM is austomal __.
Definition
dominant
Term
HOCM presents in __ __.
Definition
early childhood
Term
__ arrhythmias may occur with HOCM and cause sudden cardiac death, espcially in athletes.
Definition
Ventricular
Term
HOCM symptoms:
Definition
- sudden cardiac death- VF
- dyspnea (90%)
- syncope or near syncope- esp with exercise
- presyncope- graying out
- chest pain
- palpitations
- reduced activity tolerance
- orthopnea
- paroxysmal nocturnal dyspnea
Term
crescendo decrescendo systolic ejection murmur heart b/w the apex and and LSB afer S1:
Definition
HOCM
Term
HOCM murmur intensity is DECREASED by what?
Definition
Maneuvers that increase ventricular volme
- handgrip
- passive leg elevation
- squatting from standing position
Term
HOCM murmur is increased by what?
Definition
Maneuvers that decrease ventricular volume:
- standing from squatting
- amyl nitrite
- valsalva maneuver
Term
Dx of HOCM:
Definition
- ECHO FIRST: ventricular hypertertrophy
- Stress echo
- 24 holter monitor
Term
HOCM tmt:
Definition
- Beta blockers
- Calcium channel blockers
- Avoid dehydration
- Avoid strenuous exercise
Supporting users have an ad free experience!