Davies Fetal Echo Review 2023 with complete solution questions and answers

The pacemaker of the heart is the sinoatrial node At what gestational age is a fetus most susceptible to teratogen exposure? 4-8 weeks the fourth aortic arch and common dorsal aorta become the definitive aorta Abnormal looping of the heart tube to the left will result Corrected transposition of the great arteries (l-looping) At what point in heart development does the fetal heart begin to beat 21-28 days In the sequence of fetal heart development, embryologically what is last to form semilunar valves A fully septated fetal heart is achieved by gestation week 8 four separate pulmonary veins are formed when the left right pulmonary veins are absorbed. the four pulmonary veins then normally enter into the left atrium endocardial cushions are involved in the development of the semilunar valves, AV valves membranous septum what syndrome is thought to be a result of a midline development field defect polysplenia and asplenia (ivemark syndrome aka right atrial isomerism) the period of organogenesis occurs between which weeks of gestations 4-8 weeks if the primitive heart tube loops to the right instead of left the result would be normal great artery relationship (d-loop) the partitioning of the embryonic fetal heart into the chambers of the atria and ventricles begins at approximately what gestational day day 28 coarctation of the aorta is thought to be the result of aberrant ductal tissue decreased blood flow through the aortic isthmus failure of the fourth and sixth aortic arch to connect with the descending aorta all of the following are indications for a fetal echo exam EXCEPT family history of congenital heart defect history of tuberous sclerosis extracardiac abnormality echogenic foci exposure to teratogenic medications echogenic foci all of the following are maternal conditions indicitive of a fetal echo exam EXCEPT diabetes connective tissue disorder use of alcohol hyperphenylalainiemia hyperthyrodism hyperthyroidism what are some maternal infections that are indicators for a fetal echo. rubella, CMV, PARVO, coxackievirus Noncardiac fetal anomalies detected on a routine exam may increase the risk for a complex heart defect in that fetus. which fetal anomaly, if found in isolation would not warrent further evaluation with a fetal echo exam? omphalocele gastroschisis renal agenisis dandywalker malformation diaphragmatic hernia gasrochisis of the fetal findings listed below, which one would NOT be an indication for a fetal heart examination oligo poly bradycardia iugr a fetal heart rate of 230pbm oligo maternal exposure to certian medicinal drugs increases a fetus' risk for a congenital heart defect which of the follwing drugs does NOT increase the risk of a heart defect thalidomine trimethadion lithium nifedipine amphetamines nifedipine If there were a family hystory of marfan syndrome would that warrent a fetal echo? yes Of all the live born infants, how many will have a cardiac defect? 8:1000 Exculding bicuspid aortic valve, this heart defect is the most commonly recognized cardiac lesion found in live-born infants. It accounts for 30% of all cardiac defects VSD of all the infants born with a congeital heart defect what percentage of these infants will have an abnormal karyotype? 13% A fetus is diagnosed with CHD during a routine ultrasound exam. The risk that this fetus has an extracardiac defect is 25-45% What is the risk of a heart defect in cases of situs inversus with extreme levocardia? nearly 100% if the fetal abdominal organs are properly arraged but the fetal heart is positioned in the right chest, the risk that the fetus has a heart defect is 95% what is the risk for heart defect if the fetal situs is situs solitus? less that 1% cardiomyopathies acccount for what percentage of all cases of heart disease in live-born patients? 2% the percentage of congenital heart defects associated with T21 is approximately: 40-50% what chromosomal abnormalitiy is associated with AVSD in at least 40% of the cases? T21 ASD constitutes what percentage of all congenital heard defects? 6.7% What maternal use of alcohol, the risk of a heart lesion in the fetus is 25-30% aortic stenosis is associated with what percentage of newborns having a congenital hear defect ? 3-6% in which syndrome(s) will there be a congenital heart defect almost 100% of the time? t13 and t18 if a fetus has a congenital hear defect diagnosed on a fetal ultrasound what is the risk that the fetus will have an abnormal karyotype? 35% what is the recurrence risk for a congenital hear defectif two or more siblings are effected 10% what is the recurrence risk for a congenital heart defect when the mother of the baby is affected? 10-12% what is the reccurence risk for a congenital heart defect when a single sibling is affected? 2-4% what cardiac heart defect has the highest recurrence rate? vsd polysplenia is asociated with other cardiac anomalies in what percentage of cases? 90-95% duodenal atrisia is associated with a congenital heart defect in what percentage of cases? 17.1% Univentricular heart accounts for the following percentage of all cardiac heart defects 1-3% when truncus arteriosus is diagnosed, the association with the follwoing syndrome occurs in 21% of the cases DiGeorge syndrome the american institute of ultrasoundi n medicine guidelines for performing a fetal echocardiogram is 18-22 weeks transvaginal fetal echocardiography may be obtained as early as 12 weeks the initial step in any fetal echocardiographic exam is to establish fetal position after identifying the fetal position, the next step is to identify the location and orientation of the heart what describes a fetal heart that is situated in the fetal right chest with the apex pointing left dextroposition what is the normal heart angle relative to midline 45 degrees to the left (+or- 20 degrees) The view that best demostrates the atrioventricular junction, including the valve leaflets and annulus is apicle four chamber view and subcostal four chamber view when the apex of the heart is pointing to the fetal left chest and the axis is 45 degrees, this is levocardia in the short-axis view of the great vessels, all of the following can be demonstartated EXCEPT foramen ovale pulmonic valve left atrium left ventricle tricuspid valve left ventricle what is the best view to evaluate the number of aortic cusps short axis view of the great vessels when diagnosing a fetal heart defect the four-chamber heart view will be abnormal in what percentage of all defects 60% the best view to evaluating a conoventricular or perimembranous vsd is Subcostal four chamber view