Congenital Heart Disease Exam 4 Flashcards

1
Q

In fetal development, how are the common atrium and ventricles formed?

A

The tube rotates upon itself and forms the atrium and ventricles.

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2
Q

In fetal development, what separates into the pulmonary arteries and aorta?

A

the common truncus arteriosus

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3
Q

What term describes the formation of the atrioventricular canal separating the atria from ventricles?

A

Endocardial cushions. They are two thicker areas that develop into the walls (septum) that divide the four chambers of the heart.

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4
Q

T/F. The aorta and pulmonary veins have a common trunk called the Truncus Arteriosis

A

False. It is the aorta and pulmonary arteries that have Truncus Arteriosis

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5
Q

In fetal circulation, 75% of blood from ductus venosus and IVC are directed through the ____ ____ into the left atria.

A

Foramen ovale

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6
Q

Why do fetuses have a ductus arteriosis?

A

because the lungs are not used while a fetus is in the womb, baby gets oxygen directly from the mother’s placenta.

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7
Q

The incomplete formation of the atrial septum is called _____.

A

Atrial septal defect

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8
Q

The incomplete formation of the ventricular septum is called _______.

A

Ventricular septal defect

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9
Q

Tetralogy of Fallot is caused by the malalignment of the conal septum separating the ______ from the ______ outflow tracts.

A

pulmonary from the aortic

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10
Q

T/F Persistent Truncus Arteriosis is the failure of septation between the pulmonary veins and pulmonary arteries.

A

False. It’s between the aorta and pulmonary arteries.

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11
Q

What is the most common type of CHD in children?

A

ventricular septal defect (VSD)

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12
Q

T/F the most common type of CHD in adults is ventricular septal defect.

A

False. It’s atrial septal defect (ASD)

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13
Q

The congenital cardiac lesion in which there is complete mixing of deoxygenated and oxygenated blood is called what?

A

Admixture lesion. MC example is truncus arteriosis

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14
Q

T/F- ASD has to be surgically corrected.

A

False, it has a high spontaneous closure rate

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15
Q

T/F- Patients with ASD are usually asymptomatic

A

True. However, adults may be easily fatigued and also have exertional dyspnea

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16
Q

ASD causes ____ to ____ shunt

A

left to right d/t higher pressure in left atria

17
Q

What diagnostic lab/imaging should you order to differentiate between VSD and ASD?

A

Echo, then order 2-D color doppler for eval.

18
Q

The most common isolated congenital cardiac malformation is ______. And it accounts for __ % of all congenital cardiac anomalies

A

VSD. 20%

19
Q

Why are LA, LV, and pulmonary a. enlarged in VSD?

A

Volume overload. Same reason why there is RV and right artery HTN

20
Q

What is Eisenmenger syndrome and why is it rare?

A

When a long standing L -> R shunt causes pulmonary HTN, resulting in flip of shunt, oxygen-poor blood to flow from the R -> L ventricle and then to the body, causing cyanosis. The high pressure also causes the wall of your heart’s right ventricle to hypertrophy.

21
Q

When the atrial septum, ventricular septum, and mitral/tricuspid valves have a defect resulting in incomplete closure is called ______.

A

Endocardial cushion defect or AV cushions.

22
Q

What CHD sounds like a machine murmur?

A

Patent ductus arteriosis, blood is flowing from aorta to pulmonary a. during systole and diastole

23
Q

In what patients is patent ductus arteriosis most seen?

A

Premature babies, infant exposed to hypoxemia, birth at high alt, and rubella exposure early on in infancy.

24
Q

Obstruction of the ductal region of aorta is called ______. What are some physical findings?

A

Coarctation of aorta. UE HTN, absent LE pulses, systolic murmur heard in left sternal border

25
Q

In coarc, blood gets beyond by anastomoses of what arteries?

A

costcocervical trunk, intercostal, lateral thoracic, internal thoracic.

26
Q

Why does rib notching occur in coarc?

A

D/t dilated tortuous intercostal arteries putting pressure on adjacent ribs.

27
Q

If you see a blue baby, they likely have ______ and that’s due to ______ shunt.

A

Tetralogy of fallot d/t R -> L shunt, deoxygenated blood mixing with oxygenated.

28
Q

What is a major defect of tetralogy of fallot?

A

Pulmonic stenosis and right ventricular outflow obstruction.

29
Q

All of the following may be an atrial septal defect (ASD) except for:

a. Ostium primum
b. Ostium secundum
c. Sinus venosus
d. Sinus arteriosis

A

d. Sinus arteriosis

30
Q

In ASD, a fossa ovalis defect is called

a. Ostium primum
b. Ostium secundum
c. Sinus venosus
d. Sinus arteriosis

A

b. Ostium secundum. Defect in mid septum

31
Q

The most common congenital cardiac malformation in 6 month old baby is-

a. ASD
b. VSD
c. Tetralogy of fallot
d. AV cushion defect

A

b. VSD

32
Q

Endocardial (aka AV) Cushion has a high incidence in patients who are-

a. premature
b. young teens
c. down syndrome
d. exposed to viral infections early on

A

c. down syndrome (per Dr. W if you also hear murmur with these pts be concerned)

33
Q

Majority of Patent Ductus Arteriosis close within

a. 4-7 days
b. 7-10 days
c. 14-22 days
d. Never close

A

a. 4-7 days

34
Q

If not by 4-7 days, virtually all Patent Ductus Arteriosis close by-

a. by 6 months
b. by 12 months
c. by 24 months
d. by 48 months

A

b. 12 months (year one)

35
Q

CXR findings in Patent Ductus Arteriosis MAY include:

a. mild cardiomegaly
b. rob notching
c. “E” sign
d. “3” sign

A

a. mild cardiomegaly

36
Q

CXR findings in tetralogy of fallot MAY SHOW-

a. nothing abnormal
b. ceur en sabot
c. boot shaped
d. two of the above
e. all of the above

A

e. all of the above