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What is the primary cause of septicemia?
What is the primary cause of septicemia?
Which of the following is a characteristic of early onset sepsis in neonates?
Which of the following is a characteristic of early onset sepsis in neonates?
What term describes the abnormal distribution of blood flow in small blood vessels due to severe infection?
What term describes the abnormal distribution of blood flow in small blood vessels due to severe infection?
Which maternal risk factor is least likely to be associated with neonatal sepsis?
Which maternal risk factor is least likely to be associated with neonatal sepsis?
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Which condition is categorized as a leading cause of perinatal death among those related to sepsis?
Which condition is categorized as a leading cause of perinatal death among those related to sepsis?
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What is the main reason neonates are at higher risk for infections?
What is the main reason neonates are at higher risk for infections?
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Which antibody is the only one that crosses the placenta to provide immunity to term infants?
Which antibody is the only one that crosses the placenta to provide immunity to term infants?
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What does a decrease in pulmonary blood flow generally lead to in terms of cardiac circulation?
What does a decrease in pulmonary blood flow generally lead to in terms of cardiac circulation?
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Which of the following is NOT a sign of sepsis or septic shock in the pediatric population?
Which of the following is NOT a sign of sepsis or septic shock in the pediatric population?
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What is the significance of gestational age in relation to IgG levels in preterm infants?
What is the significance of gestational age in relation to IgG levels in preterm infants?
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What is the primary focus of sepsis management in a pediatric setting?
What is the primary focus of sepsis management in a pediatric setting?
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Which condition represents the most severe form among SIRS, sepsis, and septic shock?
Which condition represents the most severe form among SIRS, sepsis, and septic shock?
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Why are neonates particularly susceptible to sepsis?
Why are neonates particularly susceptible to sepsis?
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What is the direction of blood flow in a left to right shunt?
What is the direction of blood flow in a left to right shunt?
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What can excess fluid in the lungs due to increased pulmonary blood flow lead to?
What can excess fluid in the lungs due to increased pulmonary blood flow lead to?
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Which of the following conditions is NOT associated with increased pulmonary flow?
Which of the following conditions is NOT associated with increased pulmonary flow?
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What occurs to the pulmonary artery when there is increased volume from the right ventricle?
What occurs to the pulmonary artery when there is increased volume from the right ventricle?
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What happens after birth to the ductus arteriosus as aortic pressure increases?
What happens after birth to the ductus arteriosus as aortic pressure increases?
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How is a patent ductus arteriosus (PDA) maintained to sustain life in certain defects?
How is a patent ductus arteriosus (PDA) maintained to sustain life in certain defects?
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What kind of shunt does a patent ductus arteriosus create after birth?
What kind of shunt does a patent ductus arteriosus create after birth?
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Which condition results in increased workload on the left side of the heart?
Which condition results in increased workload on the left side of the heart?
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Which side of the heart pumps deoxygenated blood to the lungs?
Which side of the heart pumps deoxygenated blood to the lungs?
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What primarily determines the flow of blood in circulation?
What primarily determines the flow of blood in circulation?
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What happens in right-sided heart failure?
What happens in right-sided heart failure?
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In a normal heart, which side experiences greater systemic resistance?
In a normal heart, which side experiences greater systemic resistance?
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Which of the following conditions is likely a result of left-sided heart failure?
Which of the following conditions is likely a result of left-sided heart failure?
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What effect does higher resistance have on the rate of blood flow?
What effect does higher resistance have on the rate of blood flow?
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The left ventricle pumps blood out against which type of resistance?
The left ventricle pumps blood out against which type of resistance?
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What is the definition of heart failure?
What is the definition of heart failure?
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What happens to blood pressure before and after an obstruction caused by stenosis?
What happens to blood pressure before and after an obstruction caused by stenosis?
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What is a potential consequence of severe stenosis in obstructive defects?
What is a potential consequence of severe stenosis in obstructive defects?
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How does the heart adapt to increased resistance in obstructive defects?
How does the heart adapt to increased resistance in obstructive defects?
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Which statement correctly describes the effects of decreased pulmonary blood flow?
Which statement correctly describes the effects of decreased pulmonary blood flow?
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What are the primary effects of left-to-right shunting in congenital heart defects?
What are the primary effects of left-to-right shunting in congenital heart defects?
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Which of the following is associated with pulmonary stenosis?
Which of the following is associated with pulmonary stenosis?
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What is the outcome of decreased effectiveness of thicker smooth muscle in the heart?
What is the outcome of decreased effectiveness of thicker smooth muscle in the heart?
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What type of defect is coarctation of the aorta classified as?
What type of defect is coarctation of the aorta classified as?
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Study Notes
Increased Pulmonary Blood Flow
- Left to right shunt occurs if there is an abnormal opening between left and right chambers of the heart.
- Blood flows from high to low pressure, meaning it will flow from the left chamber to the right chamber.
- Increased blood flow to the right ventricle increases the volume of blood pumped to the lungs via the pulmonary artery.
- Excess fluid accumulating in the lungs can lead to heart failure due to the inability of the body to remove the fluid as quickly as it accumulates.
Causes of Increased Pulmonary Flow
- Atrial septal defect (ASD)
- Ventricular septal defect (VSD)
- Patent ductus arteriosus (PDA)
Atrial Septal Defect (ASD)
- ASD is a heart defect where there is a hole in the wall that separates the upper chambers of the heart, known as the atria.
- ASD can be caused by a variety of factors, including genetic syndromes, exposure to certain toxins, and infection during pregnancy.
Ventricular Septal Defect (VSD)
- VSD is a heart defect where there is a hole in the wall that separates the lower chambers of the heart, known as the ventricles.
- VSD can be caused by a variety of factors, including genetic syndromes, exposure to certain toxins, and infection during pregnancy.
Patent Ductus Arteriosus (PDA)
- PDA is a heart defect where the ductus arteriosus, a blood vessel that connects the aorta and pulmonary artery in the fetus, does not close after birth.
- PDA can be caused by a variety of factors, including premature birth, certain medications, and infection.
- Oxygenated blood is recirculated to the lungs when a PDA is present.
- This can result in an increased workload on the left side of the heart and pulmonary vascular congestion leading to heart failure.
- PDA can allow blood to shunt from the aorta to the lungs for oxygenation.
Sepsis in Neonates and Infants
- Sepsis is a life-threatening condition that occurs when the body's response to infection causes widespread inflammation and organ dysfunction.
- Sepsis is one of the most significant causes of neonatal morbidity and mortality.
- Neonates have immature immune systems with limited infection-fighting ability due to:
- IgM does not cross the placenta
- IgG is the only antibody to cross the placenta and in term infants is equivalent to maternal levels
- IgG levels in preterm infants correlate with gestational age
- Sepsis can be caused by bacteria, viruses, or fungi.
- Early onset sepsis typically occurs within 24-48 hours after birth and has a 50% mortality rate.
- Late onset sepsis occurs between 7-30 days after birth.
- Septicemia (bacteraemia) is an infection in the blood caused by bacteria.
- Common causes of neonatal sepsis:
- Pneumonia
- Bacterial Meningitis
- Gastroenteritis
Cardiovascular System
- Blood flow occurs across a gradient from high pressure to low pressure.
- Higher gradients lead to a higher rate of flow.
- Resistance also impacts the rate of flow; higher resistance leads to a lower rate of flow.
- The right side of the heart pumps deoxygenated blood from the body to the lungs while the left side pumps oxygenated blood from the lungs to the body.
- The left side of the heart is under greater pressure than the right side because it pumps against greater system resistance.
Heart Failure
- Heart failure is the inability of the heart to pump an adequate amount of blood to the body.
- Right-sided heart failure involves the right ventricle and results in increased pressure in the right atrium and systemic venous circulation.
- Left-sided heart failure involves the left ventricle and results in increased pressure in the left atrium and pulmonary veins.
Obstructive Defects
- Coarctation of the aorta
- Pulmonic stenosis
Coarctation of the Aorta
- Coarctation of the aorta is a narrowing of the aorta, which can lead to an increase of pressure in the heart and a decrease of pressure in the lower body.
- This can result in blood flow issues, leading to shortness of breath, chest pain, and fainting.
Pulmonic Stenosis
- Pulmonic stenosis is a heart defect where the pulmonary valve is narrowed making it difficult for the right ventricle to pump blood to the lungs.
- This results in an increase in pressure in the right ventricle and a decreased oxygen flow to the lungs.
Cardiac Hypertrophy
- Cardiac hypertrophy is the thickening of the heart muscle due to increased workload.
- Increased resistance causes the heart to pump harder, leading to thicker heart muscles.
Summary of CHD Types
- Decreased Pulmonary Blood Flow - Less blood gets oxygenated, which can lead to cyanosis (bluish discoloration of the skin due to low blood oxygen levels).
- Increased Pulmonary Blood Flow - L →R shunt leads to fluid overload and heart failure.
-
Obstructive Impediment to Blood Flow from the Ventricles:
- Left side - Backs up into the lungs, leading to fluid overload and heart failure.
- Right side - Less blood gets oxygenated, leading to heart failure and cyanosis.
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Description
Test your knowledge on the causes and implications of increased pulmonary blood flow, specifically focusing on left to right shunts like atrial septal defect (ASD) and ventricular septal defect (VSD). This quiz covers essential concepts regarding heart defects and their effects on pulmonary circulation.
