Cv1 Showalter Intro To Pediactric Cardiology

Front 1

What is pediatric Cardiology?

Back 1

subspecialty dedicated to the evaluation and treatement of congenital and aquired heart diseases in infants, children and adolescents.

Front 2

What are the steps of cardiac embryology?

Back 2

1. Tube formation
2. Looping
3. Atrial seperation
4. Outflow tract/ great vessel seperation
5. Ventricular seperation

Front 3

The CV system arises from the ______

Back 3

Mesoderm

Front 4

At what day in developement does the heart start to beat?

Back 4

Day 22

Front 5

What day in developement does fetal circulation begin?

Back 5

Day 27 to 29

Front 6

The primitive heart tube forms constrictions creating these four stuctures

Back 6

1) Truncus Arteriosus
2) Bulbous cordis
3) Primitive ventricle
4)Atrium and SInus Venosus

Front 7

What provides gas exchange for the fetus?

Back 7

The placenta

Front 8

These 3 structures maintain the parallel fetal circulation.

Back 8

1) Ductus venosus
2) Foramen ovale
2) Ductus arteriosus

Front 9

Explain Fetal circulation

Back 9

Oxygenated blood from the placenta flows from the umbilical vein by passes the liver and enter the IVC via the ductus venosus

Blood enter the RA and crosses to the LA via the foramen ovale and then enter the LV to be ejected into the body via the aorta

Front 10

WHat happens to fetal blood that enters the RV?

Back 10

Only 10% of the blood in the RV goes into the lungs because pulmonary arterial circulation is constricted.

The rest of the blood passes thru the PA and to the Aorta via the ductus arteriosus to be ejected to the body.

Front 11

What happens to fetal circulation at birth?

Back 11

1) increase PO2 causes rapid decrease in pulmonary vascular resistance to allow flow to the lung

2)Ductus arteriosus is closed and become ligamentum arteriosum

Front 12

Name 4 maternal infections that can cause cardiac defect or myocarditis

Back 12

Rubella
CMV
HSV
Coxsackie B

Front 13

Name 4 medications that can cause cardiac birth defects if taken during gestation

Back 13

Amphetamines
Anticonvulsants
Lithium
Retinoic acid

Front 14

Maternal SLE is linked to what congenital defect?

Back 14

Congenital heart block

Front 15

What are the cardiac defects associated with excessive alcohol intake?

Back 15

VSD
ASD
TOF
PDA

Front 16

What are the defects associated wtih Fetal Rubella?

Back 16

PDA

VSD

Front 17

What are some of the issues that sould be asked about when obtaining an infants past medical history (PMH)?

Back 17

Weight gain
developement
feeding patterns
Cyanosis
Signs of Respiratory distress

Front 18

Marfan's Disease is associated with what cardiac defect?

Back 18

Aortic aneurysms (and Mitral Valve prolapse)

Front 19

What is a significant finding when asking about pediatric family history of Atherosclerotic heart disease?

Back 19

Hx of coronary artery disease before 55 in father or GF and before 65 in mother or GM

Front 20

Normal percentile for pediatric BP is _______

Back 20

90th percentile and below

Front 21

Pediatric hypertension is considered at what percentile?

Back 21

95th percentile and above

Front 22

What is a sign that a child may have coarctation of the aorta?

Back 22

BP higher in the upper extremity than in the lower extremity

Front 23

Clubbing of the finger may indicate _________

Back 23

chronic low arterial saturation

Front 24

Blue/red fingers and toes in a new born is termed _______

Back 24

Acrocyanosis

Front 25

Where is an apical impulse located and what does it indicate?

Back 25

> 7 yr old located at the 5th intercostal space mid clavicular line

< 7 yr old located at 4th intercostal space just left of the mid clavicular line

Could indicate cardiac enlargement

Front 26

What does the S1 sound indicate?

Back 26

Closing of the mitral and tricuspid valve heard best over the lower left sternal border

Front 27

What does the S2 sound indicate?

Back 27

Closing of the Aorta and Pulmonic valve heard best over the upper left sternal boarder

Front 28

Wide and fixed split S2 could indicate_________

Back 28

ASD or other cardiac defect

Front 29

When is S3 heard and what does it indicate?

Back 29

could be heard in early diastole

Normal in heathy athletic kids unless it is loud

Front 30

When is S4 heard and what does it indicate

Back 30

Could be heard in late diastole

Represents CHF and decreased ventricular compliance in cardiomyopath

Front 31

When are clicks heard?

Back 31

During systole

Front 32

A mid systolic click is often associated with what cardiac defect?

Back 32

Mitral Valve Prolapse

Front 33

Grade I heart mumur

Back 33

Barely audible

Front 34

Grade 2 heart murmur

Back 34

soft but easily audible

Front 35

Grade 3 heart murmur

Back 35

moderately loud but no thrill

Front 36

Grade 4 Heart murmur

Back 36

louder than 3 with thrill

Front 37

Grade 5 murmur

Back 37

audible the stethescope barely off the chest

Front 38

Grade 6 murmur

Back 38

audible with the stethescope off of the chest

Front 39

Innocent heart murmurs are usually accentuated during _________ and ________

And are associated wtih ________ and _________

Back 39

1) high out put state

2) febrile illness

3) Normal EKG

4) Normal CXR

Front 40

Characteristic of Still's Murmur

Back 40

most common innocent murmur

Mid systolic low frequency and vibratory

"twaging string"

Grade 2-3/6

Front 41

List the characteristics of a pulmonary ejection murmur of childhood

Back 41

Happens at age 8-14

Early to midsystolic

Blowing quality

Graded 1-3/6

Front 42

Pulmonary flow murmur of newborns

Back 42

Happens in newborns and may disappear at 3-6 months

systolic

Grade 1-2/6

Maximal at the ULSB but can radiate under the axilla and to the back

Front 43

Venous hum murmur

Back 43

heard in 3-6 yr olds

heard in the upright position over the supra/infra clavicular areas

Continuous murmur from jugular venous system

Grade 1-3/6

Front 44

Carotid bruit (supraclavicular systolic murmur)

Back 44

heard in early systole

from turbulence in the carotids

Grade 2-3/6

Front 45

EKG is used to detect ___________

Back 45

arrythmias

ischemia

LVH

Front 46

Echocardiography is used to detect ________

Back 46

structural cardiac defects

info about ejection fraction, CO, wall thickness and prescence of clots

assessment of HF, endocarditis and heart murmur