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39 Cards in this Set
- Front
- Back
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Kawasaki’s
Assoc risks |
Aneurysmal expansion
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Kawasaki
Pathology, Dx criteria, Bloods, Mx |
Medium sized BVs become inflamed
Dx: Fever + ≥ 4 of: Conjunctivitis Polymorphous rash Cervical LNpathy Strawberry tongue, dry chapped lips Desquamation of fingertips Oedema of hands + feet Thrombocytosis ↑ESR Previously untreated coronary aneurysms Mx: High dose aspirin – prevent aneurysms Followed by low dose aspirin maintenance IVIG Echo + ECG |
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Innocent murmur
7 S’s |
Soft
Systolic Sternal edge Supine Symptom free Single site S1+2 normal |
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Innocent murmur
3 types |
Stills vibratory
Venous hum Pulmonary flow |
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Pulmonary vascular resistance
In utero, at birth, 10-12wks |
In utero: high
Birth: drops to ~peripheral vasc resist 10-12wks: ¼ peripheral |
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When may a VSD become apparent?
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>6wks ↓pulmonary vasc resistance
∴ ↑L→R shunt |
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VSD
O/E, Mx |
Hepatomegaly
Pale + sweaty Pulmonary oedema + tachypnoea Gallop rhythm, tachycardia, S3 Rx: ACEi (norm captopril) Prevents renal feedback loop Spironolactone, furosemide Sx to repair |
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Eisenmenger syndrome
What, sequelae |
VSD not lg enough to cause full cardiac failure
Lg enough to make RV hypertrophy Exertion = reversal of shunt to R→L Pulmonary vasc beds destroyed Often req full heart + lung transplant |
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Acyanotic heart diseases
Baby colour Direction of shunt Name them |
Pink babies
L→R shunt 3 D’s PDA VSD ASD Also obstructive: Aortic/pulmonary stenosis, aortic coarctation |
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VSD
Murmur |
Harsh pan systolic, loud S2
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ASD
Murmur |
Fixed wide split S2
Systolic ejection murmur |
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PDA
Murmur, pulse abnormalities, Rx |
N.B. normal finding in 1st 24hrs of life
Continuous machinery murmur, loud S2 Wide pulse pressure Bounding pulse Rx: Indomethacin |
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Harsh Pan systolic murmur, loud S2
What heart condition |
VSD
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Fixed wide split S2, ejection systolic murmur
What heart condition |
ASD
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Continuous machinery murmur, loud S2
What heart condition |
PDA
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Rib notching is a sign of which cardiac condition
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Aortic coarctation
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PDA
Rx to keep open + to close |
Keep open: PGE1
Close: Indomethacin |
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Cyanotic heart diseases
Baby colour Direction of shunt Name them |
Blue babies
R→L shunt 5 T’s Truncus arteriosus Ttransposition of great vessels Tetralogy of Fallot Tricuspid atresia Total anomalous venous return |
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Truncus arteriosus
What is it, Mx |
Truncus arteriosus never divides into aorta + pulmonary A
Fed by both ventricles over VSD Sx to fix VSD + split A Rare |
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Transposition of great vessels
What is it What must also be there Presentation Murmur Mx |
Abnormal arrangement of any of the great A or V
ASD/VSD must be present or incompatible w/ life Cyanosis w/in 24 hrs of birth Systolic murmur (VSD) + single loud S2 PGE1 – keep PDA open Sx correction Commonest cyanotic condition |
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Di George syndrome
Characteristics, genetics |
Catch 22
Cardiac anomalies (transposition) Abnormal facies Thymic aplasia Cleft palate Hypocalcaemia 22q11 del |
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Tricuspid atresia
What is it What must also be there |
Complete absence tricuspid valve
Must have ASD to fill L atrium w/ blood No septum between ventricles |
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Tetralogy of fallot
What 4 conditions Murmur Colour of child What occurs when stressed CXR Mx |
PROV
Pulmonary infundibular stenosis RVen hypertrophy Overriding aorta VSD Systolic ejection murmur - upper left sternal border RVen heave Single S2 Severity of cyanosis dependent on pulmonary stenosis Can be pink if maintaining homeostasis Tet Spell when stressed – hypoxic, can actually go purple Knees to chest for relief CXR: boot shaped heart Mx: PGE1 to keep PDA open Sx to cure |
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Pulmonary infundibular stenosis
What is it, what murmur |
Narrowing of RVen outflow tract
At valve – valvular stenosis Below valve Infundibular stenosis Ejection systolic murmur |
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Total anomalous venous return
What is it What must be present |
All 4 pulmonary V connect to R side of heart / systemic venous return
Patent foramen ovale / ASD must be present Otherwise blood just going round lungs and not body |
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Wheeze
Insp/exp Type of sound |
Expiratory
High pitched musical |
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Stridor
Insp/exp |
Inspiratory
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Palivizumab
What is it |
Monoclonal Ab against RSV
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Bronchiolitis
What is it, Rx |
Inflammation of small airways (U+LRT)
Rx Hypertonic saline Draws water into lumen – softens mucous Supportive DO NOT give corticosteroids or bronchodilators (↓reg of β receptors in v.young) |
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Croup
Pathology, cause, O/E, CXR, Rx |
Viral inflammation of larynx
(subglottic space primarily) Parainfluenza Barking cough Harsh inspiratory stridor CXR: Steeple sign Narrowing of caudal trachea Mx: Supportive, steroids, neb racemic adrenaline Montelukast if recurrent |
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Epiglottitis
Pathology, cause, presentation, CXR, Rx |
Inflammation of supraglottic structures
(epiglottis, aryepiglottic folds) Hib, S.pneumoniae Cyanosis Upright tripod position Sniffing dog position CXR: Thumbprint sign Mx: Secure airway Ceftriaxone/cefuroxime IV 7/7 Rifampicin for all close contacts |
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Epiglottitis vs croup from initial O/E
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Hypoxia imminent – epiglottitis
Hypoxia on presentation – croup |
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Tracheitis CXR
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Subglottic narrowing
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CXR: Shaggy heart
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Bordatella pertussis
Whooping cough |
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Whooping cough stages
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Catarrhal (snotty)
Paroxysmal (coughing) Convalescent (less coughing) |
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Asthma
Criteria for Dx What age can you Dx What age are bronchodilators useful + why |
Chronic reversible airway obstruction disease
Dx: 2 yrs (some say 6) 2 yrs - ↓reg of β receptors before that |
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Peak flow
What should it be in <14yrs |
<14yrs: PF = 5 x height (cm) - 400
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Silent chest
What is it, what does it mean |
Quiet breathing + Ø added noises
Life threatening Sign kid I v.v.ill |
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Asthma
Mx in acute setting |
Neb salbutamol
Burst therapy back to back Aminophylline IV Magnesium sulphate IV |
