Pediatric Cardiovascular Diseases NP Frequently Tested Actual
Questions and Answers
Question 1.
History and Con- genital heart defects Symptoms
Correct Answer: Symptoms vary according to the alteration of blood flow Key
questions:
Timing: Rest or activity Onset: gradual or acute Termination: gradual or acute
Precipitating and relieving factors
Question 2.
Important History to obtain from parent of NB
Correct Answer: Exposure to teratogen during pregnancy: rubella Drugs or
medication: thalidomide, anticonvulsants, lithium -Excessive weight gain,
proteinuria, edema -Kidney infection -Group A strep -Alcohol
- over 40
Question 3.
Important History to obtain from parent and or observe from newborn
Correct Answer: -Change in color/crying during feeding
- Can they eat without getting tired -Activity level appropriate
- how do they feel during exercise -Squatting spells
Question 4.
Symptoms of increased pulmonary blood flow
Correct Answer: Cyanosis Squatting Loss of consciousness Older child:
dizziness Syncope
Question 5.
Symptoms of decreased pulmonary blood flow
Correct Answer: tachypnea with activity or feeding Diaphoresis Poor weight gain
Older child: exercise intolerance, dyspnea on exertion
Question 6.
Cardiac defects in Genetic syndromes
Correct Answer: Downs: AVSD Turner: aortic valve, coarctation, hypertension
Noonan: pulmonic valve Marfan syndrome: MVP, MR Alcohol syndromes: VSD,
ASD Maternal rubella: PDA, PPS, Dilated aortic root, tortuous arteries
, Question 7.
Cardiovascular exam: inspection and Palpation
Correct Answer: Chest conformation in supine position -Palpate for Lift,
heave,diffuse MPI or precordial thrill Lift: right ventricular Heave: left Thrill:
grade 4 or 5
Question 8.
Cardiovascular: auscultation
Correct Answer: S1: AV closure LSB S2: semilunar valves closing, upper LSB
Split S1 S2: is it narrow or wide wide: RV overload, ASD (septal defect) Pulm
valve stenosis Narrow: pulmonary HTN, atresia -S3: early diastole, LV filling,
diminishes when supine to sit or stand. Doesn't: pathologic poor cardiac
circulation -S4: Atrial contraction and increased pressure. Indicates diastolic
dysfunction. Hypertrophic or cardiomyopathy -Click: ejection, related to dilate
great vessels or valve. Early, mid or late. May vary with respiration. Mid to late
click is typically mitral valve prolapse. Early click is pulmonic
Question 9.
Murmur
Correct Answer: All heart murmur should be described by the following
-Location: where best heard and radiation -Relationship to cardiac cycle:
Systolic ejections: after S1 crescendo or decrescendo Pansystolic: occurring
throughout systole Diastolic Continuous -Intensity:
1: soft, difficult 2: soft but easily heard
3. Loud w/o thrill 4loud with precordial thrill
5. Loud and with thrill, audible with edge of stethoscope 6: loud and no
stethoscope -Quality harsh, musical, rough, high, medium, or low in pitch
Variation:
Position changes change pitch or intensity 5lous
Questions and Answers
Question 1.
History and Con- genital heart defects Symptoms
Correct Answer: Symptoms vary according to the alteration of blood flow Key
questions:
Timing: Rest or activity Onset: gradual or acute Termination: gradual or acute
Precipitating and relieving factors
Question 2.
Important History to obtain from parent of NB
Correct Answer: Exposure to teratogen during pregnancy: rubella Drugs or
medication: thalidomide, anticonvulsants, lithium -Excessive weight gain,
proteinuria, edema -Kidney infection -Group A strep -Alcohol
- over 40
Question 3.
Important History to obtain from parent and or observe from newborn
Correct Answer: -Change in color/crying during feeding
- Can they eat without getting tired -Activity level appropriate
- how do they feel during exercise -Squatting spells
Question 4.
Symptoms of increased pulmonary blood flow
Correct Answer: Cyanosis Squatting Loss of consciousness Older child:
dizziness Syncope
Question 5.
Symptoms of decreased pulmonary blood flow
Correct Answer: tachypnea with activity or feeding Diaphoresis Poor weight gain
Older child: exercise intolerance, dyspnea on exertion
Question 6.
Cardiac defects in Genetic syndromes
Correct Answer: Downs: AVSD Turner: aortic valve, coarctation, hypertension
Noonan: pulmonic valve Marfan syndrome: MVP, MR Alcohol syndromes: VSD,
ASD Maternal rubella: PDA, PPS, Dilated aortic root, tortuous arteries
, Question 7.
Cardiovascular exam: inspection and Palpation
Correct Answer: Chest conformation in supine position -Palpate for Lift,
heave,diffuse MPI or precordial thrill Lift: right ventricular Heave: left Thrill:
grade 4 or 5
Question 8.
Cardiovascular: auscultation
Correct Answer: S1: AV closure LSB S2: semilunar valves closing, upper LSB
Split S1 S2: is it narrow or wide wide: RV overload, ASD (septal defect) Pulm
valve stenosis Narrow: pulmonary HTN, atresia -S3: early diastole, LV filling,
diminishes when supine to sit or stand. Doesn't: pathologic poor cardiac
circulation -S4: Atrial contraction and increased pressure. Indicates diastolic
dysfunction. Hypertrophic or cardiomyopathy -Click: ejection, related to dilate
great vessels or valve. Early, mid or late. May vary with respiration. Mid to late
click is typically mitral valve prolapse. Early click is pulmonic
Question 9.
Murmur
Correct Answer: All heart murmur should be described by the following
-Location: where best heard and radiation -Relationship to cardiac cycle:
Systolic ejections: after S1 crescendo or decrescendo Pansystolic: occurring
throughout systole Diastolic Continuous -Intensity:
1: soft, difficult 2: soft but easily heard
3. Loud w/o thrill 4loud with precordial thrill
5. Loud and with thrill, audible with edge of stethoscope 6: loud and no
stethoscope -Quality harsh, musical, rough, high, medium, or low in pitch
Variation:
Position changes change pitch or intensity 5lous
