Adult - Cardiology I

Question 1

Murmur

grade I/VI

Answer 1

barely audible

Question 2

Murmur

grade II/VI

Answer 2

audible but faint

Question 3

Murmur

grade III/VI

Answer 3

moderately loud

NO THRILL

Question 4

Murmur

grade IV/VI

Answer 4

ASSOCIATED WITH A THRILL

Question 5

Murmur

grade V/VI

Answer 5

heard with one edge of stethescope off chest wall

Question 6

Murmur

grade VI/VI

Answer 6

heard from across the room

Question 7

Which are the valves that tend to get adults “in the most amount of trouble”?

Answer 7

Mitral
Aortic

the LEFT heart valves

Question 8

Which valve is associated with 2nd intercostal space?

Answer 8

aortic

Question 9

Which valve is associated with 5th intercostal space?

Answer 9

mitral

Question 10

What mnemonic works for diastolic murmur related to valvular disease?

Answer 10

MS ARD

mitral
stenosis
aortic
regurg

diastolic

Question 11

What mnemonic works for systolic murmur related to valvular disease?

Answer 11

MR ASS

mitral
regurg
aortic
stenosis

systolic

Question 12

What are the 4 types of heart failure?

Answer 12

systolic
diastolic
acute
chronic

Question 13

Systolic heart failure has to do with inability to…

Answer 13

contract (which is what happens in systole)

Question 14

In the big picture, what type of medication treats systolic heart failure?

Answer 14

inotrope

Question 15

What do inotropes do?

Examples of inotropes

Answer 15

positive inotropes increase the strength of muscle contractility

(dopamine, dobutamin, digoxin)

Question 16

Diastolic heart failure has to do with inability to…

Answer 16

relax and fill (which is what happens in diastole)

Question 17

In the big picture, what type of medication treats diastolic heart failure?

Answer 17

dilator

Question 18

Acute heart failure usually develops as a result of…

Answer 18

MI or valve rupture

abrupt onset

Question 19

Which side of the heart is affected by acute heart failure?

Answer 19

L

therefore, the blood backs up into the LUNGS

Question 20

What are the signs and symptoms of acute / L heart failure?

Answer 20

LUNG symptoms

rales
wheezing
frothy cough
S3 gallop

Question 21

Chronic heart failure develops as a result of…

Answer 21

inadequate compensatory mechanisms

most common cause of R heart failure is L heart failure

Question 22

What are the signs and symptoms of chronic / R heart failure?

Answer 22

SYSTEMIC symptoms

hepatosplenomegaly
JVD
dependent edema
S3 and/or S4

Question 23

What is the most informative diagnostic test for heart failure and why?

Answer 23

echocardiogram

provides info on valve movement, wall movement, ejection fraction

Question 24

management

Answer 24

x

Question 25

NY Heart Association Heart Failure Classification -

At what stage do symptoms first appear?

Answer 25

stage 2

stage 1 is asymptomatic

Question 26

NY Heart Association Heart Failure Classification -

What is the difference between stage 2 and stage 3?

Answer 26

stage 2 features SLIGHT limitations
stage 3 features MARKED limitations

both are comfortable at rest

Question 27

NY Heart Association Heart Failure Classification -

what is the defining characteristic of stage 4?

Answer 27

symptomatic always, even at rest

Question 28

What will a CXR show in heart failure? (3)

Answer 28

pulmonary edema
Kerley B lines
effusions

Question 29

What is the difference between effusion and infiltrate?

Answer 29

effusion is fluid in the pleural space, which compressed the lung upward

infiltrate is within the lung itself

Question 30

What is atelectasis?

Answer 30

collapse of all or part of the lung - develops when alveoli become deflated

Question 31

What is the non-pharmacologic treatment for heart failure? (3)

Answer 31

sodium restriction
rest/activity balance
weight reduction

Question 32

What is the pharmacologic treatment for heart failure?

Answer 32

ACE inhibitors (-pril)

Diuretics

if A fib also –> anticoagulation therapy