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PEDS final

Jimmy B Englisch 247 Karten

PEDS final

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  1. 1What do ASD's result from?Failure of the IAS to close during fetal development
  2. 2When do most defects happen?In the first 7 weeks
  3. 3What is the most common ASD? %?Ostium Secundum, 70%
  4. 4What is the second most common ASD? %?Ostium Primum, 20%
  5. 5What are the 2 anomalies associated with Ostium Primum?Deformed MV, Endocardial Cushion Defect
  6. 6What is the 3rd most common ASD? %?Sinus Venosus, 10%
  7. 7What anomaly is associated with Sinus Venosus?All pulmonary veins do not enter LA
  8. 8What are the 2 rare ASD'sCoronary Sinus, Common Atrium
  9. 9This ASD is the result of the absence or near absence of the IAS.Common Atrium
  10. 10The hemodynamic effect of an ASD depends on all of the following except...Compliance of ventricles...Response of pulmonary vascular bed to increase blood flow...Size and direction of shunt...Compliance of the atria.Compliance of the atria
  11. 11What is the ideal view for visualizing an ASD? Why?Subcostal, parallel angle
  12. 12What is the formula to calculate the severity of an ASD/VSD?QP/QS
  13. 13What ratio is considered a large shunt?2:1 or higher
  14. 14In the QP/QS equation, what does the QP represent?Pulmonary flow
  15. 15In the QP/QS equation, what does the QS represent?Systemic flow
  16. 16What percent of the population have a foramen ovale that remains patent?25-34%
  17. 17VSD's range in size from_____ to _____?7mm-3cm
  18. 18This type of VSD lies immediately below the PV outflowSupracristal
  19. 19This type of VSD is located inferior/posterior to the crista supraventricularis.Infracristal
  20. 20What is the ONLY supracristal defect? %?Outlet Septum, 3-5% (Hint:easy to remember...First letter of Only and Supracristal (OS)= Outlet Septum :)
  21. 21The outlet septum has an increased incidence with what population?Asian
  22. 22What is the most common Infracristal VSD? %?Membranous/Perimembranous, 80%
  23. 23What is the 2nd most common Infracristal VSD? %?Trabecular, 5-20%
  24. 24What is the 3rd most common Infracristal VSD? %?Inlet Septum, 3-5%
  25. 25What is a common anomaloy with Inlet Septum?AV septal defect(endocardial cushion defect)
  26. 26I am a VSD that occurs when 2 portions of the IVS fail to align properly. What am I?I am Batman!!
    Or in medical terms, I am a Malalignment Septum
  27. 27What are 2 associated defects with a malalignment septum?Tetralogy of Fallot, Truncus Arteriosis
  28. 28Ideal view to visualize VSD's?Subcostal
  29. 29Endocardial Cushion Defect AKAAV Canal Defect
  30. 30What 3 things make up a complete Endocardial Cushion Defect?Ostium Primum ASD, Perimembranous VSD, Straddling AV Valves
  31. 31What 2 things are connected in the fetus by the Patent Ductus Arteriosis?Connects the pulmonary artery to the aorta
  32. 32Functionally, when should the ductus arteriosis close?At 15 hours
  33. 33Structurally, when should the ductus arteriosis close?At 2-3 weeks
  34. 34What is the ductus arteriosis called if it fails to close properly?Patent Ductus Arteriosis
  35. 35What does the ductus arteriosis become after birth.Ligamentum Arteriosum
  36. 36What is the formula to calculate the ratio pf a PDA?QP(SV LVOT)/QS(SV RVOT), the opposite of the formula for ASD/VSD's
  37. 37What is the term for when the truncoconal ridges fail to fuse?Persistent Truncus Arteriosis
  38. 38What are the 4 types of PTA's? This is an extremely difficult question.Type 1, Type 2, Type 3, Type 4 Omg, who was the genius that came up with these names
  39. 39Describe type 1 PTAShort main pulmonary artery arises and positioned to left of aorta
  40. 40Describe type 2 PTASeperate but close arteries arising from posterior portion of the truncus
  41. 41Describe type 3 PTAWidely seperated PA's arising laterally from the truncus
  42. 42Describe type 4 PTAPA's arise from the descending aorta
  43. 43What % of congenital anomalies are from PTA's?.4-2.8%
  44. 44What is the most common anomaly of the heart?Bicuspid AoV
  45. 45What other heart abnormality is commonly associated with a Bicuspid AoV?Coarctation of the aorta, Turner Syndrome
  46. 46What % of the population have a Bicuspid AoV? Male to female ratio?1-2%, 2:1 Male to female
  47. 47What age do the symptoms usually begin with a Bicuspid AoV?Between 20-50 years
  48. 48What causes "blue baby" at birth?Aortic hypoplasia
  49. 49What else is Aortic hypoplasia associated with?Hypoplastic Left Heart Syndrome
  50. 50What is an under-developed AoV calledAortic Atresia
  51. 51In this abnormality, the L heart size is reduced due to restriction of LV In/OutflowHypoplastic Left Heart Syndrome
  52. 52What size does the LV need to be to diagnose HLHS.< 10mm
  53. 53WHat is key for treatment of HLHS?Early detection!!
  54. 54OB US can see HLHS problems at what point in fetal development?16-20 weeks
  55. 55What is administered at birth to maintain opening of PDA/PFO?Prostaglandin
  56. 5698% of aortic coarctations are located where?Between L Subclavian and dustus arteriosis
  57. 57What are the 3 types of aortic coarctations?Preductal, Juxtaductal, Postductal
  58. 58Preductal = ?Above the level of the DA/Ligament
  59. 59Juxtaductal = ?At the level of the DA/Ligament
  60. 60Postductal =Below the level of the DA/Ligament
  61. 61What is the most common anomaly associated with an aortic coarctation?Bicuspid AoV
  62. 62What are the other 2 anomalies associated with aortic coarctation?Transposition of the great vessels, DORV
  63. 63What % diameter reduction is considered severe in an aortic coarc?40%
  64. 64When does MV stenosis mostly begin to occur?Childhood due to rheumatic fever
  65. 65MV Hypoplasia = ?Small, but normally develpoed
  66. 66Mitral Atresia = ?Leaflets fail to develop normally
  67. 67Parachute MV = ?Chordae attached to a single pap muscle
  68. 68Tricuspi Atresia = ?Absence of functional TV
  69. 69Pulmonary Atresia = ?Absence of PV
  70. 70Imperforated TV = ?Leaflets form but fail to seperate
  71. 71Cor Triatriatum = ?Subvalvular membrane in LA
  72. 72This anomaly is when short fused chordae attach to multiple small or normal pap muscles by a fibrous tissue band.Arcade MV
  73. 73This anomaly is when a fibrous tissue bridge divides the MV in two.Double orifice MV
  74. 74What is a Cleft MV associated with?Trisomy 21, Ostium Primum ASD, Endocardial Cushion Defects
  75. 75What are the 3 types of PS?Valvular, Subvalvular, Supravalvular
  76. 76This the the most common of PS.Valvular, stenosis of the PV cusps
  77. 77This type PS is from RVOT stenosis.Subvalvular
  78. 78This type of PS is stenosis of the main PA above the PV.Supravalvular
  79. 79This is a rare congenital anomaly of the RV where the RV myocardium is absent or hypoplastic.Uhl's Anomaly
  80. 80Uhl's Anomaly AKA'sRV Dysplasia, Parchment Heart
  81. 81Which leaflet is the most commonly affected leaflet in Ebstein's Anomaly?Septal
  82. 82What % of Ebstein's Anomaly are commonly associated with an ASD?75%
  83. 83What is responsible for delivering oxygen/nutrients, removing waste, and oxygen/CO2 exchange?Placenta
  84. 84What is the oxygen saturation of the returning blood?Approx. 58%
  85. 85At what age is the complete fusion of the foramen ovale usually complete?1 year
  86. 86At what age is total obliteration of the umbilical arteries usually complete?2-3 months
  87. 87At what age does closure of the umbilical veins and ductus venosus usually ocurr?Shortly after the closure of the umbilical arteries
  88. 88The RV accounts for how much of the total ventricular output?2/3
  89. 89What is THE most important doppler evaluation of the fetus?Evaluating for pulmonary artery pressures
  90. 90To be able to evaluate pulmonary artery pressures, the patient must have one of the following circumstances. (3)PDA, VSD, Tricuspid regurg
  91. 91What equation is used to calculate pulmonary artery pressures?Modified Bernouli, 4(v)²
  92. 92What are 3 signs of increased pulmonary artery pressures?RV hypertrophy, RV increased size, Increased PA size
  93. 93Stage 1 begins around what day of gestation?22nd day
  94. 94What are the 5 sections the cardiac tube is divided into?Truncus Arteriosis, Bulbus Cordus, Primitive Ventricles, Atrium, Sinus Venosus
  95. 95Truncus Arteriosis becomes the_____ and the _____.Aorta/Pulmonary artery
  96. 96The Bulbus Cordis is comprised of what 2 things?Conus Cordis, Truncus Conus
  97. 97The Conus Cordis becomes the _____.RVOT/LVOT
  98. 98The Truncus Conus becomes the _____.RV
  99. 99The Primitive Ventricle becomes the_____.LV
  100. 100The Sinus Venosus becomes the______.Proximal Vena Cava...SVC/IVC
  101. 101The Sinus Venosus also creates the_____.Eustachian valve
  102. 102What is the Eustachian valve responsible for?Directing flow across the foramen ovale
  103. 103At what day in gestation does stage 2 begin?Around the 23rd day
  104. 104When does Dextro/D looping happen?Beginning of stage 2
  105. 105What is this process of Dextro/D Looping called?Atrioventriculobulba Loop
  106. 106How long does Dextro/D Looping take to finish?1 day
  107. 107At what day is stage 2 complete?28 days
  108. 108What also happens at the end of stage 2?Heart begins to beat
  109. 109What is stage 3 called?The Septation stage
  110. 110When does the Septation stage occur?Between the 27th and 37th days
  111. 111When does septation of the great vessels occur?Week 8
  112. 112When are the AV and Semilunar valves formed?Between the 5th and 7th week
  113. 113What is normal heart placement called? Location?Levocardia, Middle mediastinum/Apex left
  114. 114What are the 3 abnormal heart placements called? Locations?Dextrocardia, R chest/Apex right......Dextroposition, R chest/Apex left......Mesocardia, Midline/Apex midline
  115. 115Which abnormal heart location(name) is more commonly associated with congenital heart defects?Mesocardia
  116. 116This type of cardiac situs is considered "normal positioning" where the Descending Aorta, Stomach and LA are to the left, the IVC/Liver are on the right.Situs Solitus
  117. 117This type of cardiac situs is considered "inverted" where the heart/apex/stomach are on the right, the Liver is on the left.Situs Inversus
  118. 118What are the 2 syndromes associated with Situs Ambiguous?Asplenia/Polysplenia
  119. 119Polysplenia/Asplenia...which one typically has more severe cardiac anomalies?Asplenia
  120. 120Polysplenia/Asplenia...which one is more likely to be associated with a congenital heart defect(99-100%).Asplenia
  121. 121Polysplenia/Asplenia...which one is L atrial isomersion/Bi-atrial L sidedness/Both atria have L atrial morphological features.Polysplenia
  122. 122Polysplenia/Asplenia...which one is R atrial isomersion/Bi-atrial R sidedness/Both atria have R atrial morphological featuresAsplenia
  123. 123Polysplenia/Asplenia...which one has a 50% incidence of the cardiac apex rotated to the right?Polysplenia
  124. 124What are the 2 types of ventricular looping?Dextro/Levo
  125. 125Which ventricular looping has the RV on the left?Levo
  126. 126Which ventricular looping has the RV on the right?Dextro
  127. 127What is normal great vessel relationship called.Dextro, AoV to right of Pulmonary valve
  128. 128What is abnormal great vessel relationship called? AoV position?Levo, AoV to left of pulmonary valve
  129. 129What are the normal atrioventricular/ventricular arterial connections called?Concordant
  130. 130What are the abnormal atrioventricular/ventricular arterial connections called?Discordant
  131. 131What MHz transducer do we use for scanning fetal/pediatric?3-7 MHz
  132. 132What 3 things detrermine which transducer we use?Gestational age, body habitus, amniotic fluid
  133. 133What is the most common indication for doing a fetal echo?Prior family history of a CHD
  134. 134What are 3 other indications to do a fetal echo?Known exposure to alcohol/drugs, Chromosomal abnormalities, maternal conditions
  135. 135A chromosomal abnormality such as ________ has a 40-50% increased risk of CHD?Trisomy 21/Downs
  136. 136A maternal condition such as a ________ has a 12-16% increased risk of CHD?Diabetic mother
  137. 137In a Apical 4 view of the fetal heart, what chamber is located closest to the spine? Nearest to anterior chest wall?LA/RV
  138. 138What is seen in the Long axis Aorta view.Prox. aorta, Anterior aortic wall w/IVS, posterior aortic wall w/anterior MV leaflets
  139. 139What is seen in the Long axis/Pulmonary artery view?Shortened RV/PV/PA
  140. 140What is seen in the Short axis/Ventricles view?R/L ventricles, IVS
  141. 141What is seen in the Short axis/Great Vessel view?R/L atrium, RV/TV, PA, Ductus arteriosis
  142. 142What is seen in the Aortic arch view?Ascending/Descending aorta, Aorta w/branches, R Pulmonary artery, Foreshortened LA
  143. 143What do we see in the Ductal arch view?Ductus arteriosis, Aorta, PA,PV, AoV, TV,LA, RVOT
  144. 144What do we see in the IVC/SVC view?RA/RV/TV...IVC/SVC
  145. 145What MHx transducer for Neo-natal? Pediatric?7-7.5MHz, 5MHz or higher
  146. 146What is used to determine normal velocity ranges for different ages of children?BMI(Body Mass Index)
  147. 147This is when both great arteries arise from the RV.DORV(Double Outlet Right Ventricle)
  148. 148What are the 4 types of VSD's that can ocurr from the DORV?Subaortic, Subpulmonary, Doubly committed, Remote
  149. 149The aorta is normally______ to the PA.Posterior
  150. 150Aorta transposed would have the aorta to the_____ and_____ to the PA.Right/Anterior
  151. 151A child with a DORV but no PS will have_____ pulmonary blood flow and suffer from_____.Increased/CHF
  152. 152A child with a DORV and has PS/RVOT obstruction will have_____ pulmonary blood flow and be _____.Diminished/Cyanotic
  153. 153What is the best view to determine placement/size of a VSD and great vessel relationship?PSAX
  154. 154What is the most common malformation in children born with cyanotic heart disease?Tetrology of Fallot
  155. 155What 4 items are associated with ToF?Misaligned VSD, PS, RVH, Over-riding Aorta
  156. 156Treatment for ToF is surgery, but when do we do that?When cyanosis begins
  157. 157What are the 2 types of transposition of the great vessels?Complete, Congenitally corrected
  158. 158What is the most common form of great vessel transposition? %?Complete, 80%
  159. 159What causes great vessel transposition to happen?Dextro-Looping
  160. 160If the great vessels are transposed, why is it such a big problem?The blood can not mix, therefore, no oxygen is being delivered to the body
  161. 161What may mask/hide the great vessel transposition abnormality during fetal development?The baby has the PFO and Ductus Arteriosis mixing the blood
  162. 162What must happen at birth to a baby with a known great vessel transposition abnormality?The PFO/DA must be kept open to mix the blood
  163. 163What drug is administered to do that?Prostaglandin
  164. 164What % of transpositions are Levo-Looping20%
  165. 165Levo-Looping = LV where? Connects to?Right/Pulmonary artery
  166. 166Levo-Looping = RV is where? Connects to?Left/Aorta
  167. 167What are the 3 kinds of coronary artery anomalies?Abnormal origins, Abnormal connections, Fistulas
  168. 168Do coronary artery fistulas occur often?Nope, negatory, nada, most definitely rare
  169. 169When they do occur what is the percentage occurence with the RCA? LCA? Both?50%,42%,5%
  170. 170What are the most common connections/drainage sites for coronary fistulas in ORDER of FREQUENCY?RV-RA-PA-CS-LV-SVC
  171. 171Where are most coronary fistulas discovered(test)?Angiography
  172. 172What are the 2 types of venous malformations?Anomalous Pulmonary Veins, Persistent Left SVC
  173. 173With anomalous pulmonary veins, what is happening?They partially or totally drain into the RA instead of the LA
  174. 1742 ways anomalous pulmonary veins can present?Partial, Complete
  175. 175During development of the Sinus Venosus the left horn is obliterated. What is this known as?Persistent L SVC
  176. 176This type of murmur is ASx in school age children and is NOT associated with any structural heart disease.Innocent/Functional
  177. 177What % of children have this type of murmur at some point?50%
  178. 178what are the 3 timings of murmurs?Systolic, Diastolic, Continuous
  179. 179Systolic murmur (Functional form), 3 kinds.Still's murmur, TR 80%, Subclavian bruit
  180. 180Systolic murmur (Pathological form), (5)VSD/ASD, AS/PS, Coarctation
  181. 181Diastolic murmur (Functional)NONE!
  182. 182Diastolic murmur (Pathological)(3)AR/PR/MS
  183. 183Continuous(Functional)Venous hum
  184. 184Continuous(Patological) (3)PDA, AV malformation, Ruptured Sinus of Valsava
  185. 185When are the most significant defects found?Infancy
  186. 186What are the 2 types of CHF?Forward Failure/Backward Failure
  187. 187Which one is more common in newborns?Forward Failure
  188. 188Cardiac output Forward vs. BackwardForward Failure = High, Backward Failure = Low
  189. 189CHF is characterized by what 3 things?Tachycardia, Tachypnea, Poor feeding
  190. 190What is the leading cause of heart disease in children and young adults?Rheumatic fever
  191. 191What valves are more commonly affected (in order of how they occur)?AV valves, usually MV first, Semilunar valves, usually AoV second
  192. 192This disease of the myocardium is not typically seen with any other form of heart disease.Cardiomyopathy
  193. 1932 types of cardiomyopathy in pediatrics.Hypertrophic, Dilated/Congestive
  194. 194What group of chemo drugs are the most damaging to the heart?Anthracyclines
  195. 195What are 2 common types of anthracyclines?Adriamyacin, Cerubidine
  196. 196Systemic HTN is not common in children, but if they do have it, what is an example of another disease is it may be associated with?Renal failure
  197. 197What is most common to happen with Systemic HTN?Ventricular hypertrophy
  198. 198What is a common PHTN finding in children/young adults?Cystic Fibrosis
  199. 199How much fluid must be surrounding the heart for a pericardial effusion to be diagnosed?At least 2mm of fluid
  200. 200Is this common in fetal/pediatric?No
  201. 201With this disease, the echo can appear "pretty" because of the increase in fluid volume.End stage renal disease
  202. 202This is a reversal of the congenital shunt from L-R to R-LEisenmenger's Syndrome
  203. 203This disease is acute vasculitis that occurs in children < 5 years old.Kawasaki's Disease
  204. 204Vasculitis occurs within the first_____ days of the disease affecting the coronary arteries.10
  205. 205What are the S&S that patients usually present with in Kawasaki's disease?Strawberry tongue, Swelling of hands/feet, Total body rash
  206. 206Treatment for Kawasaki's disease?Early detection to diminish the inflammatory process before any damage can occur
  207. 207To ease or reduce effect or intensity of a defect or disease.Pallitation
  208. 208Surgically connecting 2 structuresAnastomosis
  209. 209An acqueduct/channel one constructs surgicallyConduit
  210. 210Process of bindingLigation
  211. 211Opening the orifice of a stenotic valveValvotomy/Valvuloplasty
  212. 212Most ASD repairs are done within the first_____ years of life.5
  213. 213What is used to close larger ASD's?Patch of pericardium or prosthetic material
  214. 214What procedure is used to correct D-transposition of great vessels and DORV with PS?Damus-Kaye-Stansal procedure
  215. 215Anastomizing the _____ to the _____ will reestablish flow in the D-K-S procedure.Pulmonary artery/Aorta
  216. 216What is used as a graft to reestablish pulmonary flow in the D-K-S procedure?A graft from the subclavian artery or the thoracic aorta
  217. 217This procedure is used to correct D-TranspositionGreat Artery Switch
  218. 218This procedure is used for tricuspid atresia and ToF.Glenn Anastomosis
  219. 219The "classic" procedure attaches the _____ to the _____.SVC/Right pulmonary artery
  220. 220This procedure is used for Tetrology of Fallot.Blalock-Taussig Anastomosis
  221. 221What are the two types of aortic coarctation repair?End to End, Subclavian Flap
  222. 222The two ends are sewn together in this aortic coarc repair for older children.End to End
  223. 223Subclavian artery is ligated and sewn over coarc creating a live tissue graft. Usually used in young children/InfantsSubclavian Flap Procedure
  224. 224This procedure is used for HLHS and D transposition.Blalock-Hanlon Atrial Septostomy
  225. 225This procedure is used for a PTA, DORV, and a D-transposition with VSD.Rastelli Procedure
  226. 226This procedure is used for hypoplasia of the aortic annulus or tunnel subaortic obstruction.Konno/Konno-Rastan Procedure
  227. 227This procedure is used for D-transposition and DORV.Mustard-Senning Operation
  228. 228This is a procedure for alleviating MV stenosis.Balloon Valvuloplasty
  229. 229This procedure is used for the complex repair of HLHS. There are _____ stages in this procedure.Norwood procedure/3
  230. 230OMG another procedure. This one is used for TV atresia, Single ventricle, and ToF.Fontan procedure
  231. 231The next few cards are all about what will turn into what.The next few cards are all about what will turn into what.
  232. 232Truncus Arteriosis becomes the...Pulmonary artery/Aorta
  233. 233Bulbis Cordis divides into the ...Conus Cordis/Truncus Conus
  234. 234Conus Cordis becomes the ...RVOT/LVOT
  235. 235Truncus Conus becomes the ...RV
  236. 236Primitive Ventricle becomes the ...LV
  237. 237Atrium become the ... she will never ask this questionReally, you actually had to look at the answer? Haha, ok, ok, R/L atrium
  238. 238Sinus Venosus becomes the ...Proximal Vena Cava (SVC/IVC)
  239. 239AV Canal becomes the ...R/L ventricular cavity
  240. 240Cardiac septa develop forming the ...4 chamber heart
  241. 241Septum Primum divides the ...Atrium
  242. 242Two large endocardial cushions fuse resulting in ...TV/MV orifices
  243. 243Cushions grow and twist around each other forming ...Aorticopulmonary Septum
  244. 244Septum divides Truncus Arteriosis into...Aortic and Pulmonary channels
  245. 2456 aortic arches develop from the ...Truncus Arteriosis
  246. 246Cushions of conus cordis unite with aorticopulmonary septum and create the...RVOT/LVOT
  247. 247—

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Karteikarten am PEDS final, erstellt von Jimmy B am 04/04/2014.
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