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