ABSITE cardiac ch 26.txt

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ABSITE cardiac ch 26.txt
2010-01-11 11:06:31
cardiac ABSITE

ABSITE ch 26 cardiac
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  1. Shunts causing cyanosis
    Right to left
  2. Compensatory measure children use to increase SVRI and decrease R to L shunt
  3. Complications of cyanosis (5)
    Polycythemia, stroke, brain abscess, endocarditis, hypertrophic osteoarthropathy
  4. Shift in shunt from left to right, to right to left as pulmonary vascular resistance increases
    Eisenmenger�s syndrome
  5. Shunts causing failure to thrive
    Left to right
  6. First sign of CHF in children
  7. VSD, ASD, PDA
    Left to right shunts
  8. Tetralogy of fallot, TGA, truncus arteriosus
    Right to left shunts
  9. Connection between descending aorta and left pulmonary artery
    Ductus arteriosus
  10. Connection between portal vein and IVC
    Ductus venosum
  11. Number of placental arteries and veins (normal)
    2 arteries, one vein
  12. most common congenital heart defect
  13. Medical treatment of VSD
    Diuretics, digoxin
  14. Timing of VSD repair if not spontaneously closed
    Before school age
  15. Most common ASD; centrally located patent foramen ovale
    Ostium secundum
  16. Atrioventricular septal defects, or endocardial cushion defects
    Ostium primum
  17. Timing of ASD repair if not spontaneously closed
    Before school age
  18. Woods units that contraindicate repair of ASD or VSD
  19. Tetralogy of Fallot
    VSD, pulmonic stenosis, overriding aorta, RV hypertrophy
  20. Most common congenital heart defect resulting in cyanosis
    Tetralogy of Fallot
  21. Medical treatment of Tetralogy
    Beta blocker
  22. Palliative procedure to delay definitive tetralogy repair
    Blalock-Toussig shunt
  23. Most common cyanotic congenital heart defect diagnosed in the 1st week of life
    Transposition of the great vessels
  24. Medical treatment of transposition
    Atrial septostomy, PGE1 for ductus
  25. Surgical repair of transposition
    Early switch with coronary reimplant (unless LVOT is present)
  26. Congenital heart defect with associated VSD and 80% one-year mortality
    Truncus arteriosus
  27. Medical treatment of truncus arteriosus
    Diuretics, digoxin, fluid restriction, afterload reduction
  28. Drug that causes PDA to close
  29. Drug that keeps PDA open
  30. Location of coarctation of aorta
    Just distal to left subclavian
  31. Chest x-ray finding in coarctation
    Notching of ribs from IMA/intercostal collaterals
  32. Procedure used in univentrical hearts
  33. Prerequisates for fontan (PA pressure and PVR)
    Normal PA pressure (<20mmHg) and normal PVR (<2 Woods units)
  34. Procedure for hypoplastic left heart
  35. Fontan procedure (describe)
    Attach RA and SVC to PA
  36. Norwood procedure (describe)
    Aorta augmented with allograft artery and attached to PA. Distal PA�s supplied through BT shunt
  37. Associated defect with TAPVR (total anomalous pulmonary venous return)
  38. Treatment of double aortic arch
    Ligate smaller arch
  39. Most common cause of death in US
    Heart disease
  40. Pattern where Posterior descending artery comes off of right coronary
    Right dominant circulation
  41. Pattern where posterior descending artery comes off of circumflex coronary
    Left dominant circulation
  42. Most common pattern of coronary circulaion
    Right dominant
  43. S/p MI, now with pansystolic murmur: dx?
    Papillary muscle rupture, free wall rupture
  44. Most common time for free wall rupture after MI
    3-7 days
  45. post MI complication seen most ofter after large, transmural, anterior MI
    LV aneurysm
  46. Restenosis rate of PCTA
    20-30% 1 year
  47. 5-year patency rate of saphenous vein graft
  48. best conduit for CABGs
    internal mammary
  49. solution that causes arrest of heart in diastole
    potassium and cold solution cardioplegia
  50. indications for CABG (3)
    left main disease, LAD plus proximal left complications, 3-vessel disease (2-vessel in diabetics), 2-vessel disease plus proximal LAD and LVEF <50%, 1-2 vessel disease with stable angina, arrhythmia, or unstable angina
  51. most common valve lesion
    aortic stenosis
  52. most common disease causing valve disfunction
    rheumatic heart disease
  53. good candidates for tissue valve
    potential to become pregnant, contraindication to anticoagulation, frequent falls
  54. contraindication to tissue valve
    children/young patients, chronic renal dialysis
  55. valvular lesion that can cause pulmonary congestion and mural thrombi
    mitral stenosis
  56. cardinal symptoms of aortic stenosis
    angina, syncope, heart failure
  57. most common site of prosthetic valve infections
    aortic valve
  58. most common site of native valve infections
    mitral valve
  59. patients who get right sided endocarditis
    IV drug users
  60. Most common organism causing endocarditis
    S. aureus
  61. Patients needing periprocedural endocarditis prophylaxis (5)
    Prosthetic valve, rheumatic heart disease, congenital cardiac malformations, mitral valve prolapse, previous hx of endocarditis
  62. Most common benign tumors of heart
  63. Most common malignant tumor of heart
  64. Most common metastatic tumor of heart
    Lung ca
  65. Swelling of upper extremities and face, often secondary to lung cancer invading the SVC
    Superior vena cava syndrome
  66. Mediastinal tube output mandating re-exploration
    >500cc/1st hour, >250cc/hr for 4 hours
  67. risk factors for mediastinitis
    use of bilateral internal mammaries, diabetes
  68. disease with symptoms of fever, chest pain, SOB, and pericardial friction rub
    postpericardiotomy syndrome
  69. EKG findings of postpericardiomyotomy syndrome
    Diffuse ST segment elevation
  70. 1st sign of tamponade on echo
    decreased RA diastolic filling