Peds-Cardiology 2

Front 1

Acynotic congenital heart disease is characterized by what?

Back 1

increased volume load and left to right shunts

Front 2

What are the most common lesions in the acynotic congenital HD group?

Back 2

-VSD
-PDA
-AV septal defects

Front 3

In acynotic HD oxygenated blood is shunted back to where?

Back 3

the lungs

Front 4

In acynotic HD, increased volume to the lungs decreases what?

Back 4

compliance

Front 5

In acynotic HD, fluid leaks into lung space resluting in heart failure with what symptoms?

Back 5

-tachypnea
-retractions
-nasal flaring
-wheezing

Front 6

What is the hallmark of rapid collapse in acynotic HD?

Back 6

right to left sided heart failure

Front 7

Right sided heart failure can result in what things?

Back 7

-hepatomegaly
-peripheral edema

Front 8

Left sided HF can result in what things?

Back 8

-pulmonary edema
-poor perfusion

Front 9

In cynotic HD there is decreased what?

Back 9

pulmonary blood flow

Front 10

In cynaotic HD, the degree if cyanosis depends on the degree of what?

Back 10

pulmonary stenosis example if mild there may be no cyanosis at rest

Front 11

In cynanotic HD, severity may also be modulated by what?

Back 11

PDA

Front 12

Cyanosis that is from increased pulmonary blood flow is caused by total mixing of blood within where?

Back 12

the heart or abnormal ventricular-arterial connections

Front 13

What are some examples of cyanotic HD from increased pulmonary blood flow?

Back 13

-transposition of the great vessels
-total anamalous pulmonary venous return

Front 14

Moderate to severe HD need modified activity so pt can do what?

Back 14

participate without restriction

Front 15

In congenital HD, routine ________ is a must/

Back 15

-immunizations

Front 16

Cyanotic pts are at risk for the development of what other things?

Back 16

-polycythemia so should avoid high altitudes

Front 17

Cardiac arrhythmias can be transient or what?

Back 17

permanent

Front 18

In cardiac arrythmias there is a risk of sever tachycardia or bradycardia leading to what?

Back 18

decreased cardiac output

Front 19

Sinus brady is a rate less than _____ in neonates and less than _______ there after

Back 19

-90 in neonates

-60 there after

Front 20

What arrhythmia is common in low birth weight babies?

Back 20

sinus brady with escape beats

Front 21

A wondering pace maker can be associated with what?

Back 21

subarachnoid hemorrhage and more than one sinus node

Front 22

An extra systole discharges from any where other than the ______ node and can be what?

Back 22

-sinus node and can be junctional or ventricular

Front 23

Premature atrial compleses are mostly normal in who?

Back 23

children

Front 24

Premature Atrial complexes need to be differentiated from what?

Back 24

PVCs

Front 25

Premature atrial complexes almost always have what?

Back 25

a p wave

Front 26

PVCx can be unifocal or .....

Back 26

multifocal

Front 27

Give me 5 situations in which you would treat a PVC

Back 27

-two or more in a row
-miltifocal origin
-increased ectopy with exercise
-R on T phenomenon
-in presence of HD

Front 28

SVT is a conduction devect about where?

Back 28

the bundle of His

Front 29

In infants with SVT reentry using what is most common?

Back 29

using an accessory pathway

Front 30

In children with SVT, reentry is is most common using what?

Back 30

AV nodal reentry

Front 31

SVT is most often associated with what in peds?

Back 31

post op or cardiomyopathy

Front 32

SVT is manifested by an ______ onset and what rate?

Back 32

-abrupt onset and rate > 180 to 300

Front 33

In SVT, QRS is what?

Back 33

normal and uniform

Front 34

What is WPW?

Back 34

type of SVT caused by reentry through an accessory pathway

Front 35

WPW can be associated with sudden death due to what?

Back 35

atrial fib begetting V-Vib

Front 36

If pt is stable what can a person do to tx SVT?

Back 36

vagal stimulation

Front 37

What can be used for cardioversion in an unstable SVT pt?

Back 37

adenosine

Front 38

What drug is used for maintenance if an accessory path way is used?

Back 38

Propranolol

Front 39

What drug is used for maintenance if no accessory pathway is used in SVT?

Back 39

dig or propranolol

Front 40

What can also be used for tx of SVT that uses an accessory pathway?

Back 40

radiofrequency ablation

Front 41

V-tach is defined as what?

Back 41

3 PVCs at a rate of > 120

Front 42

What are some causes of v-tach?

Back 42

-myocaditis
-MVP
-anamlous origin of the coronary artery
-cardiac tumors
-drugs (cocaine)
-WPW
-iatrogenic

Front 43

What is DOC for v-tach?

Back 43

-amiodarone

Front 44

What are some other tx for v-tach?

Back 44

tx:
-underlying cause
-lyte imbalance
-hypoxia
-drugs

Front 45

V-fib is a chaotic dysrhythmia that results in death unless what?

Back 45

a regular beat is restored immediately

Front 46

In V-fib, you do conversion first then do what?

Back 46

look for a cause

Front 47

What drugs are used for prevention of v-fib?

Back 47

Lidocaine and Amiodarone

Front 48

What is the MCC of sudden death in athletes?

Back 48

hypertrophic cardiomyopathy

Front 49

The mechanism of sudden death in cardiac arrythmias tend to mostly be what?

Back 49

bradycardia leading to V-Fib or asystole

Front 50

What are the sudden death classifications?

Back 50

-structural
-conduction
-myocardial disease
-misc

Front 51

What congenital HD is associated with sudden death in neonates?

Back 51

valvar aortic stenosis

Front 52

What HD usually causes sudden death in older children?

Back 52

coronary artery anomalies

Front 53

Dilated cardiomyopathy most common cause is what?

Back 53

exercise induced arryhtmias

Front 54

_______ presents in up to 40% of sudden death pts

Back 54

myocarditis

Front 55

What is commotio cordis?

Back 55

sudden death following blunt trauma to the chest

Front 56

Infective endocarditis is usually a complication of what?

Back 56

rheumatologic HD

Front 57

Infective endocarditis is rare in infancy but when it occurs if usually follows what?

Back 57

surgery

Front 58

What is the presentation of infective endocarditis?

Back 58

-symptoms are much worse when agent is strep
-pts may present with a prolonged fever lasting months without other symptoms
-Olser nodes
-Janeway lesions
-Splinter hemorrhages

Front 59

What valve is most often affected in rheumatic HD?

Back 59

-mitral valve then aortic

Front 60

Rheumatic HD that is mild has less ______ _______ and has a holosystolic murmur that radiates where?

Back 60

-mitral insufficiency
-radiates to the arm pit

Front 61

Tx for rheumatic HD
-mild
-severe

Back 61

-mild: only prophylaxis against further infections
-severe may require surgery

Front 62

What is Kawaski's Disease?

Back 62

vasculitis with an unknown eitiology

Front 63

Progression of Kawasaki is from what?

Back 63

vasculitis to inflammatory changes to weakness of th emyocardium to aneurysm formation

Front 64

You must follow pts with Kawasaki for what?

Back 64

aneurysms of the ascending aorta

Front 65

Tx of Kawasaki is directed at what?

Back 65

stopping the vasculitis with IVIG and inflammation with high dose ASA