Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
37 Cards in this Set
- Front
- Back
|
In terms of a circuit, compare CO of the ventricles of a fetus to a neonate.
|
Fetus: parallel circuit
neonate: series circuit |
|
|
At what age does the pulmonary pressure of the baby reach "adult" pressures?
|
1 week
|
|
|
What causes the ductus arteriosis to close (3 things)?
|
change in pressure, prostoglandins, inc. in O2
|
|
|
What causes the foramen ovale to close?
|
inc. in pressure of LA
|
|
|
What etiological factor should be suspected in any newborn w/ congenital heart disease?
|
chromosomal aneuploidy
|
|
|
30-60% of congenital heart disease can be detected by what modality?
|
ultrasound at 20 wks gestation
|
|
|
At what O2 sat. level should you suspect something is seriously wrong w/ the newborn?
|
below 95%
|
|
|
What week of embryological development correlates w/ a 4-chambered heart and absorption of the pulmonary veins?
|
Week 7
|
|
|
During what week does looping of the heart tube occur?
|
Week 4
|
|
|
During what weeks of development do the atrial septum and AV valves form?
|
wks 5-7
|
|
|
During what week of development does septation of the bulbus and ventricle occur?
|
wk 7
|
|
|
What L-to-R shunt does NOT lead to cor pulmonale in children (normal pressure, high volume)?
|
ASD
|
|
|
Which L-to-R shunt can lead to cor pulmonale (inc. volume AND pressure)?
|
VSD (and large PDA's)
|
|
|
What type of VSD is common in Asians?
|
supracristal
|
|
|
Of the muscular VSD's, 80% close by 1 yr of age if less than what size?
|
4 mm (95% close by age 18)
|
|
|
What L-R shunt is common in premature infants?
|
PDA (give indomethacin)
|
|
|
What congenital defect is associated w/ a 'Tet spell'?
How do you treat it? |
tetraology of fallot (accute PS, cyanosis)
Tx: calming, O2, morphine, alpha-agonist |
|
|
What are 3 things done to repair TOF?
|
close VSD
resection of infundibulum (below pulmonary valve) widen pulmonary valve |
|
|
What do you give neonates w/ pulmonary atresia?
|
prostoglandins to keep PFO
|
|
|
What 3 things can be done for Tricuspid Atresia?
|
NOT repairable, but to palliate:
1. Blalock-Taussig shunt (around birth) 2. glenn shunt (6-12 months) 3. fontan completion (18-36 months) |
|
|
What must infants have to survive AS?
|
A PDA (prostoglanding-dependent)
|
|
|
What are the surgical options for children w/ AS?
|
balloon valvuloplasty
ross procedure |
|
|
What is the standard of care for PS?
|
balloon valvuloplasty
|
|
|
What conditions can cause a wide S2?
|
inc. RV ejection time (ASD, pulmonary insufficiency
early aortic closure (HTN, coarctation of aorta) |
|
|
What conditions can cause a narrow S2?
|
late aortic closure (AS)
early PV closure (pulm. HTN) |
|
|
Where is S1 best heard?
|
apex and LLSB
|
|
|
What systolic (diamond shaped) murmur originates at the aortic root and characteristically makes a "twanging" sound at LLSB?
|
still's murmur
common in ages 18 mos to 4 yrs |
|
|
What murmur is best heart at left mid and upper sternal border in systole and is common up to adolescence?
|
Basal ejection murmur (pulmonary flow murmur)
|
|
|
Describe the grading system for murmurs.
|
I: barely audible
II: easily audible III loud (no thrill) IV: loud and thrill V: loud: audible w/ incomplete contact to skin VI: audible w/ steth off chest |
|
|
What pitch is a mitral inflow murmur?
|
low pitch (rumble)
|
|
|
What pitch is a small muscular VSD or aortic insufficiency murmur?
|
high pitch
|
|
|
What defect produces a classically holosystolic murmur during systole?
|
VSD... also have diastolic mitral inflow rumble if large defect
|
|
|
What defect can produce a fixed split S2 sound?
|
ASD
|
|
|
What defect produces a click (in systole) present at the left mid and upper sternal borders?
|
Pulmonary stenosis
|
|
|
Compare murmurs of PS and TOF in terms of degree of stenosis.
|
PS: greater stenosis= louder murmur
TOF: great stenosis = softer murmur |
|
|
What condition causes an audible mid-systolic click best heart at the apex?
|
MVP
|
|
|
What condition can produce a systolic click best heart at LLSB and apex?
|
aortic stenosis (if severe, S2 approaching being single and the murmur is longer and louder)... can radiate to the neck as well
|
