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Peds midterm

lists for midterm

Q:A:
Most common indication for a Fetal echo: Prior family history of CHD (congenital heart defects)
Most common type of ASD: Ostium Secuncdum (70%)
Most common type of VSD: Membranous (perimembranous) (80%) – Infracristal
Most common heart anomaly overall: Bicuspid Aortic Valve
Most common type of Pulmonic Stenosis: Valvular – stenosis of PV cusps
Ebstein’s Anomaly is associated with _____ most commonly (___% of cases) ASD in 75% of cases
5 Indications for a Fetal Echo: 1. Prior family history of CHD (most common) 2. Known exposure to cardiac teratogens 3. Chromosomal abnormalities 4. Maternal conditions 5. Presence of extracardiac anomalies
In fetal transverse position, the _____ is closest to spine: LA is closest to spine
In fetal transverse position, the _____ is closest to anterior chest wall: RV nearest to anterior chest wall
Fetal transverse position provides a ____________ view in echo a four chamber view
PW Doppler of MV and TV obtained from the _______ Four chamber view Apical Four chamber view
Doppler & color flow of foramen ovale obtained from the _______ Four chamber view Subcostal Four chamber view
5 M-mode Measurements obtained from the Fetal Subcostal 4 Chamber view: 1. Heart wall size 2. LV size and function 3. IVS & posterior wall thickness 4. RV internal dimension 5. Sizes of both atria
Anatomy viewed in Long Axis View of Aorta: o Proximal aorta o Anterior aortic wall continuous w/IVS o Posterior aortic wall continuous w/AMVL
Anatomy Obtained in Long Axis View of Pulmonary Artery: • Shortened RV • Pulmonic valve • Pulmonary artery
Measurements obtained in Long Axis View of Pulmonary Artery: PW Doppler & color flow used to evaluate for PI & PS
Anatomy seen in Short Axis of VENTRICLES: RV, LV& IVS
Measurements obtained in Short Axis of VENTRICLES: M-mode measurements of: • Ventricular free wall • IVS • Chamber sizes Color flow Doppler used to evaluate for abnormal VSD’s If found, use PW Doppler to interrogate
Anatomy seen in Short Axis of GREAT VESSELS: • RA, RV, LA • TV, PV • Pulmonary artery and ductus arteriosus *appears same as adult PSAX aortic level
Measurements obtained in Short Axis of GREAT VESSELS: • M-mode – Measure size of PA • PW Doppler and color flow of TV and PV (Also evaluate ductus arteriosus)
Anatomy seen in View of Aortic Arch: • Ascending aorta • Arch & branches (innominate, LCC & LSA) • Descending aorta • Right pulmonary artery • Foreshortened LA
Measurements obtained in View of Aortic Arch: • Color flow and PW to view velocity of aorta • Used to rule out narrowing of aorta
Anatomy seen in View of Ductal Arch: • Ductus arteriosus • PA, aorta • PV, RVOT • AV, TV, LA
Measurements obtained in View of Ductal Arch: Doppler to assess ductus arteriosus
Anatomy seen in View of IVC & SVC: RV, RA, TV, IVC, SVC
Measurements obtained in View of IVC & SVC: PW Doppler and color flow to assess venous flow
5 Types of ASD: 1. Ostium Primum (20%) 2. Ostium Secuncdum (70%) 3. Sinus Venosus (10%) 4. Coronary Sinus ASD (RARE!) 5. Common Atrium (RARE!)
Ostium Primum ASD located in _____ portion of ______ Inferior portion of IAS
Ostium Secuncdum ASD located in _____ portion of ______ Mid portion of IAS
Sinus Venosus ASD located in _____ portion of ______ superior portion of IAS near junction of SVC and RA
Coronary Sinus ASD located in _____ area close to ______ The inferior septal area close to coronary sinus
Ostium Primum – Associated anomaly: deformed MV
Sinus Venosus – Associated anomaly: Partial anomalous pulmonary venous return (*pulmonary veins do not enter the LA*)
The hemodynamic effect depends on these 3 things: 1. Size and direction of shunt 2. Compliance of ventricles 3. Response of pulmonary vascular bed to increased blood flow
5 Types of VSD: 1. Inlet septum (3-5%) – Infracristal 2. Trabecular (5-20%) – Infracristal 3. Outlet septum (3-5%) – Supracristal 4. Membranous (perimembranous) (80%) – Infracristal (Most common type) 5. Malaligned septum
Complete Endocardial Cushion Defect Consists of all 3 of the following: 1. Ostium primum ASD 2. Perimembranous VSD 3. Straddling AV valves (Anterior MV & septal TV create one valve)
Only ONE the following need to be present to be considered PARTIAL Endocardial Cushion Defect: • Ostium primum ASD with a cleft MV OR • Endocardial inlet VSD only
Ductus arteriosus Functionally closes ______ after birth and Structurally closes ______ after birth Functionally closes 15 hrs after birth and Structurally closes 2-3 weeks after birth
Persistent Truncus Arteriosus accounts for ______% of all congenital heart defects only 0.4-2.8%
Persistent Truncus Arteriosus – 4 Classifications: Type I – A short main PA arising from truncus Type II – Separate but closely positioned PAs arising from the posterior portion of the truncus Type III – Widely separated PAs arising laterally from truncus Type IV – PAs arise from the DAo
Created by: lefut