Term
hallmarks of innocent murmurs |
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Definition
asymptomatic pt soft blowing murmur systolic murmur left sternal edge |
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Term
what are the left to right shunts? |
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Definition
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Term
a fixed widely split S2 implies what? |
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Definition
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Term
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Definition
pansystolic murmur at LLSE loud murmur implies smaller defect no pulmonary HTN lesions close spontaneously |
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Term
ejection systolic murmur best heard at upper left sternal edge fixed splitting of s2 what is it? |
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Definition
ASD
if there is a pan systolic murmur at apex then this is partial AVSD
mx: catheter device closue for secundum ASD surgery for partial AVSD. both done at 3years. |
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Term
continous murmur at upper left sternal edge with bounding pulses. what defect am i? |
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Definition
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Term
describe the murmur of VSD |
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Definition
pansystolic murmur and left lower sternal edge |
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Term
what is different between a small and large VSD? |
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Definition
small VSD murmur louder and no pulmonary HTN large VSD, quiete murmur and presence of pulmonary HTN. |
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Term
what is the hyperoxia nitrogen washout test? |
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Definition
used to determine the presence of heart disease in a cyanosed neonate place infant in 100% for 10mins if right radial artery PaO2 from ABG remains low <15kPa after this time then a diagnosis of cyanotic congenital heart disease is made. |
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Term
signs of tetralogy of fallout on CXR? |
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Definition
boot shaped heart and concave pulmonary artery bay on the left hand side. |
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Term
if CXR reveals a narrow upper mediastinum with an egg on the side appearance of the cardiac shadow what are you thinking? |
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Definition
transposition of the great arteries. |
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Term
name 3 cyanotic congenital heart disease |
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Definition
TOF TGA eisenmengers syndrome |
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Term
list the left to right shunts |
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Definition
ASD partial and secundum VSD small and large PDA |
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Term
name cyanotic congenital heart disease |
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Definition
TOF EISENMENGERS TGA
these are also call right to left shunts |
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Term
name common mixing heart conditions |
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Definition
AVSD complex disease e.g. tricuspid atresia |
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Term
causes of outflow obstruction in a well child |
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Definition
aortic stenosis pulmonary stenosis adult type coarction of aorta |
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Term
left heart outflow obstruction in a sick child - duct dependent lesions |
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Definition
coarction of aorta interruption of aortic arch hypo plastic left heart syndrome |
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Term
what is important in duct dependent lesions? |
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Definition
prostaglandin infusion to keep the PDA open. |
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Term
how would you use the pulse to differentiate between hypo plastic left heart syndrome and correction of the aorta? |
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Definition
there is weakness or absence of all pulses in hypo plastic left heart syndrome
in coarction of aorta there are weak femoral pulses. |
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Term
mx of hypo plastic left heart syndrome? |
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Definition
neonatal Norwood procedure followed by glenn or Hemi Fontan at ~6 months and again Fontan at 3 years |
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Term
describe the cyclical change in heart rate with respiration |
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Definition
acceleration with inspiration slowing on expiration |
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Term
rx of complete heart block |
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Definition
infants usually have anti-to and anti-la antibodies all children with symptoms need endotracheal pacemaker |
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Term
features of long QT syndrome |
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Definition
AD inheritance with many phenotypes has been associated with erythromycin therapy, electrolyte disorders and head injury |
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Term
jones criteria what is needed to diagnose endocarditis? |
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Definition
two major
or one major and two minor |
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Term
major manifestations of endocarditis jones criteria |
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Definition
pancarditis polyarthritis sydenham chorea erythema marginatum subcutaneous nodules: mainly on extensor, painless |
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Term
describe the erythema marginatum rash which condition is it found in? |
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Definition
rash on trunks and limbs pink macules spread outwards causing pink border with fading centre borders may unite to give a map like outline |
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Term
describe features of the minor jones criteria |
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Definition
fever polyarthralgia hx of rheumatic fever raised acute phase reactant, ESR, CRP leucocytosis prolonged PR interval on ECG |
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Term
what is the most common murmur in IE? |
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Definition
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Term
how should blood cultures be taken to ix IE? |
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Definition
3 sets of bloods from peripheral sites with at least 6 hours between them before Abx have been commenced
in those with acute presentation and septic shock take 2 sets of cultures within different times of the hour before starting ABx |
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Term
what is required from the modified DUKES criteria to diagnose IE? |
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Definition
two major or one major 3 minor or 5 minor |
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Term
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Definition
positive blood culture from 2 sets evidence of endocardial involvement positive echo for IE |
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Term
mx for native valve endocarditis? |
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Definition
amoxicillin and gentamicin |
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Term
mx for prosthetic valve endocarditis? |
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Definition
vancomycin, gentamicin and rifampicin |
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Term
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Definition
due to vegetations on mitral valve in IE |
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Term
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Definition
due to severe aortic regurg |
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