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46 Cards in this Set

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sx suggesting heart disease
1.trouble feeding
2.tachycardia
3.tachypnea
4.irritability
5.FTT
6.cyanosis
if you suspect pathologic murmur, you must get...
1.ecg
2.echo
cyanosis
bluish tinge of mm, skin, nail beds
cyanosis: evident sooner if...
1.high hb
2.decreased pH
3.increased pCO2
4.increased temperature
5.increased ratio of adult:fetal hb
determines presence of cyanosis
absolute concentration of deoxygenated hemoglobin
cyanosis: causes
1.cardiac
2.pulmonary
3.neurologic
4.hematologic
cyanotic infant: preliminary goal
etiology = cardiac / noncardiac?
how do you check for differential cyanosis?
check preductal v. postductal O2 sats
T/F: hyperoxia test may indicate if cyanosis is cardiac in origin
true

PaO2 > 250 = r/o cardiac dz
unstable CHD babies: start what medication?
PGE1

maintains patent PDA
truncus arteriosus: associated w/what disease?
diGeorge's
velocardiofacial syndrome
biventricular hypertrophy on ecg
pulse pressure widened
cardiomegaly
R aortic arch

dx?
truncus arteriosus
most common form of cyanotic CHD presenting in neonates
transposition
transposition:
aorta = anterior/posterior? pulmonary = anterior/posterior?
aorta = anterior
pulmonary = posterior
transposition: cyanosis at birth / later ?
severe cyanosis at birth
transposition: tx
surgery: arterial switch in 1st wk of life
transposition: medication that must be given immediately. why?
PGE1 (keep patent PDA)
most common CHD in childhood
TOF
episodes of cyanosis, rapid deep breathing, agitation

dx?
TOF

"tet" spells (resolves on own)
TOF: tx
surgery in first 3-6 mos
WPW: associated w/what valvular abnlity>?
ebstein anomaly
RAE
cyanosis, CHF (1st few days)
widely fixed split S2
gallop rhythm
ebstein anomaly
delta wave
short PR interval
ebstein anomaly
WPW: Tx
propranolol (prevent SVT)
ebstein anomaly: tx
all attempts to avoid surgery
heart transplant
staged palliation Fontan circulation
most common lesion in rheumatic heart disease
mitral regurg
most common finding in bacterial endocarditis
fever
myocarditis: most common cause in developed world
viral (coxsackie B, echovirus)
HPI: fever, dyspnea, fatigue, CP
PE: tachycardia, S3
ECG: ST-segment depression, T-wave inversion, low voltage
ECHO: dilated ventricles, pericardial effusion

dx?
myocarditis
myocarditis: dx confirmation
1.viral cx
2.pcr
3.endomyocardial bx
myocarditis: tx
1.supportive
2.IVIG
3.steroids
T/F: myocarditis can cause fulminant CHF + arrhythmia.
true
myocarditis: px
depends on extent of damage to myocardium
dilated cardiomyopathy: most common causes
1.idiopathic!
2.neuromuscular (Duchenne)
3.drug toxicity (anthracycline)
dilated cardiomyopathy: what is it?
myocardial dysfunction
ventricular dilation
HPI: dyspnea, orthopnea, PND
PE: S3, murmur (mitral regurg), edema
ECG: broad QRS, nonspecific ST-, T-wave ischemic changes
ECHO: poor ventricular fxn

dx?
dilated cardiomyopathy
pulsus alternans:

what is it?

dx?
beat-to-beat variability in pulse magnitude

dilated cardiomyopathy
dilated cardiomyopathy: tx
1.fluid restriction
2.diuretics
3.inotropic agents
4.vasodilators
5.anticoagulants
6.transplant
dilated cardiomyopathy: use antiarrhythmics?
only for fatal ventricular arrhythmias
hypertrophic obstructive cardiomyopathy: diastolic / systolic dysfxn?
diastolic dysfxn
hypertrophic obstructive cardiomyopathy: inheritance pattern
autosomal dominant

incomplete penetrance
hypertrophic obstructive cardiomyopathy: what is it?
ventricular septum thickened
hypertrophic obstructive cardiomyopathy: tx
1.Ca2+ channel blockers
2.beta-adrenergic blockers

(negative inotropic agents)
(no competitive sports)
peripheral pulmonary stenosis: age at presentation
neonate (birth-2 mos)
peripheral pulmonary stenosis: best heard...
L) upper sternal border, radiating to back
venous hum: cause
turbulent flow in jv/svc systems