Cyanotic CHD Flashcards¶
Anki-compatible flashcards for Cyanotic Congenital Heart Disease board review.
Q: What are the "5 T's" of cyanotic congenital heart disease? A: Tetralogy of Fallot, Transposition of Great Arteries, Tricuspid Atresia, Total Anomalous Pulmonary Venous Return, Truncus Arteriosus Tags: cyanotic-chd, 5ts, high-yield
Q: What is the most common cyanotic congenital heart defect? A: Tetralogy of Fallot (TOF) - ~10% of all CHD Tags: cyanotic-chd, tof, epidemiology, high-yield
Q: What are the 4 components of Tetralogy of Fallot? A: 1) VSD (large, malalignment), 2) Overriding aorta, 3) RV outflow tract obstruction, 4) RV hypertrophy Tags: cyanotic-chd, tof, anatomy, high-yield
Q: What is the classic CXR finding in TOF? A: "Boot-shaped heart" (coeur en sabot) - upturned apex due to RVH, concave main PA segment Tags: cyanotic-chd, tof, cxr, high-yield
Q: What is the first step in managing a hypercyanotic (Tet) spell? A: Knee-chest position (increases SVR, decreases R→L shunting) Tags: cyanotic-chd, tof, tet-spell, high-yield
Q: What is the medication sequence for refractory Tet spell? A: Morphine → IV fluids → Phenylephrine → Propranolol → Emergent surgery Tags: cyanotic-chd, tof, tet-spell, treatment
Q: What is the classic presentation of D-TGA in a newborn? A: Profound cyanosis within hours of birth, minimal/no murmur, single loud S2, tachypnea without respiratory distress Tags: cyanotic-chd, tga, presentation, high-yield
Q: What is the CXR finding in D-TGA? A: "Egg on a string" - narrow mediastinum due to great vessel relationship, enlarged heart Tags: cyanotic-chd, tga, cxr, high-yield
Q: What 3 interventions are needed for D-TGA management? A: 1) PGE1 to maintain ductal patency, 2) Balloon atrial septostomy (BAS) for mixing, 3) Arterial switch operation (definitive repair) Tags: cyanotic-chd, tga, treatment, high-yield
Q: Why is 100% O2 potentially harmful in TGA? A: May accelerate ductal closure and worsen mixing between circuits Tags: cyanotic-chd, tga, caution
Q: What is the surgical correction of D-TGA? A: Arterial switch operation (Jatene procedure) - performed in first 1-2 weeks of life Tags: cyanotic-chd, tga, surgery
Q: What type of TAPVR is a surgical emergency? A: Obstructed TAPVR (usually infracardiac type) - presents with cyanosis + pulmonary edema + respiratory distress at birth Tags: cyanotic-chd, tapvr, emergency, high-yield
Q: What is the CXR finding in unobstructed supracardiac TAPVR? A: "Snowman" or "figure of 8" silhouette (dilated vertical vein and SVC) Tags: cyanotic-chd, tapvr, cxr
Q: What syndrome is associated with Truncus Arteriosus? A: DiGeorge syndrome (22q11 deletion) - 30-35% of truncus patients Tags: cyanotic-chd, truncus, genetics, high-yield
Q: What is the hallmark of tricuspid atresia? A: Absent tricuspid valve → hypoplastic RV → obligate R→L shunt at atrial level (ASD required for survival) Tags: cyanotic-chd, tricuspid-atresia, anatomy
Q: What is the hyperoxia test used for? A: To distinguish cardiac from pulmonary causes of cyanosis - if PaO2 remains <100 mmHg on 100% FiO2, suspect cyanotic CHD Tags: cyanotic-chd, diagnosis, hyperoxia-test, high-yield
Q: What is the initial dose of PGE1 for ductal-dependent lesions? A: 0.05-0.1 mcg/kg/min IV continuous infusion Tags: cyanotic-chd, pge1, treatment, high-yield
Q: What are the major side effects of PGE1? A: Apnea, hypotension, fever, flushing - apnea may require intubation Tags: cyanotic-chd, pge1, side-effects
Q: What lesions are ductal-dependent for pulmonary blood flow? A: Severe TOF, pulmonary atresia, tricuspid atresia, critical PS, some Ebstein anomaly Tags: cyanotic-chd, ductal-dependent
Q: When in doubt about ductal-dependent lesion, what should you do? A: START PGE1 - side effects are manageable; missing a ductal-dependent lesion is fatal Tags: cyanotic-chd, pge1, high-yield