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37 Cards in this Set
- Front
- Back
In terms of a circuit, compare CO of the ventricles of a fetus to a neonate.
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Fetus: parallel circuit
neonate: series circuit |
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At what age does the pulmonary pressure of the baby reach "adult" pressures?
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1 week
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What causes the ductus arteriosis to close (3 things)?
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change in pressure, prostoglandins, inc. in O2
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What causes the foramen ovale to close?
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inc. in pressure of LA
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What etiological factor should be suspected in any newborn w/ congenital heart disease?
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chromosomal aneuploidy
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30-60% of congenital heart disease can be detected by what modality?
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ultrasound at 20 wks gestation
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At what O2 sat. level should you suspect something is seriously wrong w/ the newborn?
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below 95%
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What week of embryological development correlates w/ a 4-chambered heart and absorption of the pulmonary veins?
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Week 7
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During what week does looping of the heart tube occur?
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Week 4
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During what weeks of development do the atrial septum and AV valves form?
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wks 5-7
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During what week of development does septation of the bulbus and ventricle occur?
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wk 7
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What L-to-R shunt does NOT lead to cor pulmonale in children (normal pressure, high volume)?
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ASD
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Which L-to-R shunt can lead to cor pulmonale (inc. volume AND pressure)?
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VSD (and large PDA's)
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What type of VSD is common in Asians?
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supracristal
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Of the muscular VSD's, 80% close by 1 yr of age if less than what size?
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4 mm (95% close by age 18)
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What L-R shunt is common in premature infants?
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PDA (give indomethacin)
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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 |
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What are 3 things done to repair TOF?
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close VSD
resection of infundibulum (below pulmonary valve) widen pulmonary valve |
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What do you give neonates w/ pulmonary atresia?
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prostoglandins to keep PFO
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What 3 things can be done for Tricuspid Atresia?
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NOT repairable, but to palliate:
1. Blalock-Taussig shunt (around birth) 2. glenn shunt (6-12 months) 3. fontan completion (18-36 months) |
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What must infants have to survive AS?
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A PDA (prostoglanding-dependent)
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What are the surgical options for children w/ AS?
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balloon valvuloplasty
ross procedure |
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What is the standard of care for PS?
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balloon valvuloplasty
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What conditions can cause a wide S2?
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inc. RV ejection time (ASD, pulmonary insufficiency
early aortic closure (HTN, coarctation of aorta) |
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What conditions can cause a narrow S2?
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late aortic closure (AS)
early PV closure (pulm. HTN) |
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Where is S1 best heard?
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apex and LLSB
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What systolic (diamond shaped) murmur originates at the aortic root and characteristically makes a "twanging" sound at LLSB?
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still's murmur
common in ages 18 mos to 4 yrs |
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What murmur is best heart at left mid and upper sternal border in systole and is common up to adolescence?
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Basal ejection murmur (pulmonary flow murmur)
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Describe the grading system for murmurs.
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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 |
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What pitch is a mitral inflow murmur?
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low pitch (rumble)
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What pitch is a small muscular VSD or aortic insufficiency murmur?
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high pitch
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What defect produces a classically holosystolic murmur during systole?
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VSD... also have diastolic mitral inflow rumble if large defect
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What defect can produce a fixed split S2 sound?
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ASD
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What defect produces a click (in systole) present at the left mid and upper sternal borders?
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Pulmonary stenosis
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Compare murmurs of PS and TOF in terms of degree of stenosis.
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PS: greater stenosis= louder murmur
TOF: great stenosis = softer murmur |
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What condition causes an audible mid-systolic click best heart at the apex?
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MVP
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What condition can produce a systolic click best heart at LLSB and apex?
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aortic stenosis (if severe, S2 approaching being single and the murmur is longer and louder)... can radiate to the neck as well
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