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Step 2: Cardio 9
Cardio 9
Question | Answer |
---|---|
What are the 3 points of mixing in fetal circulation? | Ductus arteriosus, Foramen ovale, Ductus venosus |
What point in the fetal circulation has the most O2? | Umbilical vein |
What is the 5 step process of changes in fetal to neonatal circulation? | 1. Lung expansion->raised pulm art pressure 2. low PGE2 levels->ductus art. closure 3. clamped umbilicus-> raised vascular resistance 4. raised resistance->ductus venous closure 5. increased LA pressure (lowered RA pressure)->foramen ovale closure |
What is the most common type of congenital heart defects? | VSD |
What heart sound changes are heard in VSD? | Pansystolic murmur @ LLSB, loud S2, thrill |
How do you treat a small VSD vs. a large VSD? | Small= monitor (will likely close by 10yo). Large= monitor nutrition, CHF (Rx ACEi, diuretics, digoxin), flu vaccine, surgery if still sick |
What is the difference in S2 sound between ASD and VSD? | ASD= fixed split S2. VSD= loud S2 |
In ASD pt, you give ______ prophylaxis | ABx |
ASD pt's will often have large _______ artery markings | Pulm arteries |
What happens if ASD goes untreated? | L->R shunt eventually becomes R->L (Eisenmenger's Syndrome) |
How do you treat PDA? | Indomethacin. (come IN and CLOSE the door) |
What test is used to Dx PDA? | Echo |
If a pt has TGA, what other congenital defects can help them survive? | VSD or PDA(->give PGE2 to these neonates to keep PDA open) |
What syndromes have predilection for causing TGA? | Apert's, Down, cri-du-chat, trisomy 13/18 |
Boot-shaped heart occurs in what 2 cong heart defects? | Truncus Arteriosus + Tet of Fallot |
Endocardial cushion defect is found in what disorder? | Down Syndrome |
What are the 4 components of Tetrology of Fallot? | VSD, RV outflow obstruction, RVH, overriding Aorta |
What is unique about S2 in Tetralogy of Fallot? | There is a single S2 (no split) |
Ebstein's anomaly is ass. w/ _________ use. It causes a hypoplastic _______, along with abnormal _________ valve. | Lithium use. Right Ventricle. Tricuspid. |
Ebstein's anomaly has increased risk of SVT or WPW because of ________________ | dilated RA |