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9 Cards in this Set
- Front
- Back
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Most common congenital heart defect.
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VSD
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hx: normal birth, late childhoold/early adulthood: fatiguability, frequent URI, FTT, right ventricular heave, fixed and split S2, systolic ejection murmur on upper left sternal border (pulmonary valve) and mid-dyastolic at left lower sternal border (tricupsid)
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dx: echo with color flow doppler (diagnostic), paradoxic ventricular wall motion, dilated right ventricle blood flow b/w atria
ECG shows right axis deviation (negative QRS in lead I, positive in lead aVF) with ostia secundum defects CXR shows increase pulmonary vascular markings and cardiomegaly tx: may close spontaneously, antiobiotc prophylaxis in ostium primum to prevent endocarditis, surigcal closure in infants with CHF, >2:1 pulmonary to systemic blood flow --> prevents arrythmias and Eisenmenger's |
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hx: premature infant, congential rubella in 1st trimester, some CHF, wide pulse pressure and machinery murmur at second left intercostal space at sternal border, loud S2 and bounding peripheral pulses
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dx: color Doppler demonstrates aorta to pulmonary artery flow (diagnostic), echo may show left atrial and left ventricular enlargement, ECG may show LVH
tx: indomethacin, if > 6mo surgical closure is preferred by ligation |
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hx: asymptomatic HTN, dyspnea on exertion, caludication, systolic BP higher in upper extremities, greater in the right arm than in the left, late systolic murmur heard in left axilla
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dx: obtain ECG shows LVH (negative QRS in lead I, upright in aVF), echo shows color flow doppler, cardiac catheterization (aortography)is diagnostic, CXR shows '3' sign: pre/post coarctation dilatation, aortic wall indentation, rib notching (circulation through intercostals
tx: surgical, balloon angioplasty is controversial, endocarditis prophylaxis even after treatment |
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hx: Apert, Down, Cri-du-chat, trisomy 13 or 18, critical illness, cyanotic at birth, progressive respiratory failure with signs of CHF
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dx: Echo, CXR may show "egg on a string" sign
tx: keep PDA open with PGE1, balloon atrial septostomy if immediate surgery not feasible, surgical switch procedure |
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hx: cyanosis, dyspnea, squat for relief, FTT, systolic ejection murmur at left sternal borderand reight ventricular life, single S2, some CHF
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dx: echo and catheterization, CXR shows boot shaped heart with decrease pulomary vascular markings, ECG shows right axis deviation
tx: PGE1, cyanotic spells with O2, propanalol, knee-chest position, fluids and morphine, definitive surgical correction |
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HBV Vaccine: Who, when?
Newborns of HBV positive mothers? |
Universally recommended esp. healthcare workers. Newborns at birth, 1-2mo, and and 6-18mo. Newborns born to HBV+ mothers also recieve HBVIgG with first dose of vaccine.
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HBV Vaccine: Who, when?
Newborns of HBV positive mothers? |
Universally recommended esp. healthcare workers. Newborns at birth, 1-2mo, and and 6-18mo. Newborns born to HBV+ mothers also recieve HBVIgG with first dose of vaccine.
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DTaP vaccine: Who, when, how?
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All newborns at 2, 4, 6, 15-18mo and 4-6yo. Common rxn: 24hr fever with redness at injection site. Less commomn rxn: incosolable crying >3hrs, fever >105, seizures.
Give DT instead to child and acetomenophen to relieve discomfort. |
