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Questions and Answers
Which maternal illness during the first 7 weeks of pregnancy carries a 50% risk of defects including PDA and pulmonary branch stenosis?
Which condition has a 10% risk of congenital heart disease, with VSD and cardiomyopathy being the most common defects observed?
Which diagnostic procedure is essential for assessing cardiac defects and is particularly useful in identifying issues like pulmonary stenosis?
Which condition is characterized by an overriding aorta and a VSD, often leading to desaturation spells and cyanosis?
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A newborn presenting with pulmonic stenosis is likely to exhibit signs of which of the following upon inspection?
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In post-procedural care after a diagnostic procedure, what should be monitored for equality, especially below the catheterization site?
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What is a common symptom due to right ventricular hypertrophy often seen in infants with certain congenital heart defects?
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During pre-procedural care for cardiac interventions, what is crucial to prevent infections and ensure proper healing post-procedure?
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What is a common sign observed on palpation in infants with various congenital heart defects due to abnormal blood flow through cardiac chambers?
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What is the primary anatomical defect described in the text for which surgical correction involves ligation of the patent vessel?
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Why does narrowing of the aorta in the described condition put strain on the left ventricle?
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In the mentioned condition, why is the pressure in the upper extremities higher than in lower extremities?
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What is a key difference between congenital and acquired heart disorders?
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Which cardiac disorder involves a hole in the septum that divides the upper chambers of the heart?
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Which clinical manifestation is unique to the condition with an overriding aorta, VSD, pulmonary stenosis, and right ventricle hypertrophy?
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What complication is a child at risk for due to disease processes causing muscle hypertrophy and congestive heart failure?
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In fetal circulation, where does most of the newly oxygenated blood from the placenta enter the fetus?
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What is a common sign seen in infants with congenital heart defects due to abnormal blood flow through cardiac chambers?
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What is a common symptom of heart failure associated with congenital heart diseases?
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Which fetal shunt allows blood to bypass the liver in fetal circulation?
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Which structure connects the pulmonary artery to the descending aorta in fetal circulation?
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What is the approximate percentage of CHD seen in infants with Fetal Alcohol Syndrome?
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Which viral illness during pregnancy can result in cardiac defects in the newborn, including PDA and pulmonary branch stenosis?
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What is a common sign of digoxin toxicity that can be observed on an electrocardiogram (ECG) in patients receiving this medication?
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What is the primary cause of Congenital Heart Disease in infants with an IDM (Infant of Diabetic Mother)?
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Which aspect is NOT part of the post-procedural care after a cardiac diagnostic procedure?
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What is a common characteristic noted on inspection in infants with Congenital Heart Disease?
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In infants born to mothers with Rubella infection early in pregnancy, what are common cardiac defects observed in approximately 50% of cases?
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In the management of digoxin toxicity at home, what is the recommended action if a child vomits after taking a dose of digoxin?
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What is the significance of monitoring potassium levels in patients receiving digoxin, especially if they are taking Lasix concurrently?
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Which nursing diagnosis is associated with heart failure and indicates the patient's inability to perform physical activities due to the disease process?
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What is a crucial aspect of managing heart failure in children that involves educating the family about the child's condition?
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What is the primary cause of Acute Rheumatic Fever (ARF) in young people, typically affecting late school-age children and adolescents?
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What is the primary objective of the study conducted by Green et al., 2020?
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Which of the following is NOT mentioned as part of the management plan for acute rheumatic fever?
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Which joints are typically affected in acute rheumatic fever?
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What skin manifestation is commonly observed in patients with acute rheumatic fever?
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Why is treating acute rheumatic fever with antibiotics important?
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What is the recommended prophylactic therapy after treating acute rheumatic fever?
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Study Notes
Tetralogy of Fallot
- Growth delay/retardation is a common clinical manifestation
- Recurrent upper respiratory infections occur due to the condition
- Tet spells are a characteristic of Tetralogy of Fallot
- Squatting positions can help increase pulmonary artery blood flow
Management of Tetralogy of Fallot
- Palliative shunt is performed to increase pulmonary artery blood flow
- Total repair is usually done after the completion of one year
Pathophysiology
- The pulmonary artery leaves the left ventricle
- The aorta leaves the right ventricle with no communication between the systemic and pulmonary circulation
Clinical Manifestations
- Poor feeding and fatigue are common
- Sweating, even when at rest, worsens when feeding
- Generalized edema, respiratory distress, and crackles or wheezing on lung auscultation are characteristic
- Jugular vein distention (JVD) and poor peripheral pulse may be present
Management of Heart Failure
- Physical assessment includes respiratory and cardiac evaluation
- Improve cardiac function with medications such as Digoxin, ACE, and B-blockers
- Remove fluid excess with diuretics like Furosemide
- Oxygen supplement reduces respiratory effort
- Monitor potassium levels as it affects Digoxin
- Monitor intake and output strictly and weigh daily
- Implement fluid and salt restrictions, depending on appetite
- Activity as tolerated reduces oxygen consumption
- Semi-fowler's position reduces respiratory effort
Cyanotic Heart Defects Classification
- Based on hemodynamic characteristics, there are four types:
- Increased pulmonary blood flow (signs of HF)
- Decreased pulmonary blood flow (e.g., Tetralogy of Fallot)
- Obstruction of blood flow (e.g., Coarctation of Aorta, Aortic stenosis, Pulmonic stenosis)
- Mixed blood flow (e.g., Transposition of Great Arteries)
Atrial Septal Defect (ASD)
- Pathophysiology: abnormal connection between two sides of the heart
- Increased volume on the right side of the heart
- Increased pulmonary blood flow
- Decreased systemic blood flow
- Clinical manifestations: asymptomatic, characteristic murmurs, atrial arrhythmias, signs of congestive heart failure, and pulmonary emboli
- Management: surgical patch closure repair usually done before school age
- Prognosis: good with very low operative mortality (<1%)
Ventricular Septal Defect (VSD)
- Anatomy: abnormal opening between the right and left ventricles
- Either membranous (80%) or muscular
- Size varies from a small pinhole to absence of the septum
- 20%-60% of cases may close spontaneously
- Pathophysiology: left-to-right shunt occurs due to high pressure in the left ventricle and low pressure in the right ventricle
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Description
Learn about the management and pathophysiology of Tetralogy of Fallot, a congenital heart defect characterized by four anatomical abnormalities. Topics covered include growth delay, recurrent upper respiratory infections, Tet spells, squatting positions, palliative shunt, and total repair.
