Infective Endocarditis
Embryology of the CV System
Congenital Heart Diseases
100

Name 5 clinical findings in a patient with infective endocarditis

Fever

Achiness

Weight loss

Conjunctival hemorrhage

Splinter hemorrhages

Janeway lesions

Osler nodes

Roth spot

Mycotic aneurysm

Brain abscesses

Spinal osteomyelitis/discitis

100

What are the three shunts during fetal circulation?

Foramen ovale

Ductus arteriosus

Ductus venosus

100

A healthy newborn baby has a continuous, machine-like murmur. This murmur is most likely caused by blood flow into which of the following structures?

  1. Aorta

  2. Pulmonary artery

  3. Right atrium

  4. Left atrium

  5. Right ventricle

pulmonary artery

200

Name two indications for surgery in infective endocarditis

Persistently positive blood cultures

Refractory CHF

Evidence of heart block (abscess)

Recurrent embolic phenomena

Fungal and certain drug resistant organisms

200

Which changes occur in SVR and PVR in a baby after he/she is delivered compared to in utero?


D

200

A 2-day old baby is evaluated in the newborn nursery for agitation. The nurse reports the baby suddenly began crying and writhing in the crib. Respirations and rapid and labored. There is a blue discoloration of the lips and nail beds. On cardiac exam, there is a systolic ejection murmur at the left sternal border an a single S2. Echocardiography findings demonstrate right ventricular outflow obstruction and a ventricular septal defect. What is the ratio of pulmonary to systemic blood flow in this baby? (e.g. Qp/Qs)

0.5 : 1

300

A 76-year old man develops fevers, chills, and night sweats. Echocardiography shows vegetation on the mitral valve. Blood cultures grow gram-positive cocci that are catalase-positive and coagulase-negative. Which of the following is most likely present in this man's history?

  1. Recent dental work

  2. Urinary catheterization

  3. Exposure to farm animals

  4. Prior cardiac surgery

  5. Exposure to cats

prior cardiac surgery

300

Neural crest cells are involved in the formation of which parts of the heart (3)?

Aorticopulmonary septum

Membranous part of the interventricular septum

Semilunar valves

300

A 24-year old man presents for routine evaluation. He is physically active and has no complaints. BP is 178/92 mmHg. He is noted to have delayed femoral pulses compared with radial pulse. Physical exam is otherwise normal. He is referred for an echocardiogram which reveals aortic coarctation. Which of the following is true of blood flow in this man's upper extremities compared with lower extremities?

Upper extremity > lower extremity

Upper extremity < lower extremity

Upper extremity = lower extremity

blood flow cannot be determined

Upper extremity > lower extremity

Upper extremity < lower extremity

Upper extremity = lower extremity

blood flow cannot be determined

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