Absite review 26 cardiac incomplete

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Absite review 26 cardiac incomplete
2011-01-31 20:17:04
absite review second edition chap cardiac

cards from absite review book, second edition, chapter 26, cardiac
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  1. Associate the good consequence to the good type of cardiac shunt:
    A) R → L shunts
    B) L → R shunts

    1) Cyanosis
    2) congestive heart failure
    • R → L shunts give cyanosis
    • L → R shunts give congestive heart failure
  2. Name 5 consequences of cyanosis
    • Polycythemia
    • Strokes
    • brain abcesses
    • endocarditis
    • hypertrophic osteoarthropathy
  3. What is Eisenmenger's syndrome?
    A shift from L→R shunt to R →L shunt
  4. Is Eisenmnger's syndrome reversible?
    Generally no
  5. What means Eisenmenger's syndrome at the pulmonary level?
    it is a sign of increasing pulmonary vascular resistance and pulmonary HTN
  6. What is the first sign of congestive heart failure in children?
  7. 3 causes of L→R shunts
    • VSD (ventricular septal defect)
    • ASD (atrial septal defect)
    • PDA (patent ductus arteriosus)
  8. 3 causes of R→L shunts
    • tetralogy of Fallot
    • transposition of the great vessel
    • truncus arteriosus
  9. To wich structures the ductus arteriosus is connected?
    • descending aorta
    • left pulmonary artery
  10. What is the purpose of the ductus venosus in utero?
    blood shunt away from liver
  11. To wich structures the ductus venosus is connected?
    • inferior vena cava
    • portal vein
  12. In wich direction is the blood travelling in the 2 umbilicals arteries?
    from fetal circulation to placenta
  13. In wich direction is the blood travelling in the umbilical vein?
    From placenta to fetal circulation
  14. What is the most commun congenital heart defect?
    VSD (venticular septal defect)
  15. When does VSD symptoms usually begins?
    4-6 weeks of life (as pulmonary vascular resistance decrease and shunt increase)
  16. What are the clinical elements (4) found in large ventricular septal defects
    • congestive heart failure
    • failure to thrive
    • tachypnea
    • tachycardia
  17. What are the 2 elements of medical tx of ventricular septal defects?
    • diuretic
    • digoxin
  18. What are the indications to repair a ventricular septal defect?
    • - CHF resulting in failure to thrive (most commun reason)
    • - before school age if doesn't close spontaneously
    • - pulmonary vascular resistance more than 4-6 Woods unit
    • - Attention! if more than 10 Woods units contreindication, try vasodilatator first and if reversible can repair
  19. What is the direction of the shunt in:
    a) VSD
    b) ASD
    c) Tetralogy of Fallot
    d) Transposition of the great vessels
    e) Truncus arteriosus
    f) Patent ductus arteriosus
    • a) L→R
    • b)L→R
    • c) R→L
    • d) R→L
    • e) R→L
    • f) L→R
  20. What are the 2 kinds of atrial septal defects?
    • ostium primum (also called atrioventricular septal defect or endocardial cushion defect, more inferior defect)
    • ostium secondum (central defect, most commun)
  21. Name 3 anomalies in venous return that can be found in ostium secundum ASD
    • 1) pulmonary venous return in IVC
    • 2) pulmonary venous return in right atrium
    • 3) IVC connect to the left atrium
  22. Name the 2 elements of the medical tx of ASD
    • diuretic
    • digoxin
  23. What are the indications to repair a atrial septal defect?
    • -volume overload (Qp/Qs more than 1.5)
    • -before shool age if doesn't close spontaneously
    • -pulmonary venous resistance more than 10-12 Woods unit is a contraindication
    • - all ostium primum defects