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Part 2/3 boards > General Diagnosis 4 > Flashcards

General Diagnosis 4 Flashcards

1
Q

S1 heart sounds

A

closure of AV (mitral and tricuspid) valves

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2
Q

S2 heart sounds

A

closure of semilunar (pulmonary and aortic) valves

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3
Q

S3 heart soudns

A

ventricular gallop
normal in children, young adults, and athletes
>40 years earliest sign of CHF

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4
Q

S4 heart sounds

A

atrial gallop

similar to S3 and is related to stiffness of ventricular myocardium to rapid filling

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5
Q

aortic valve location

A

right sternal border at 2nd intercostal space

best auscultated with patient seated, leaning forward, and exhaling

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6
Q

pulmonic valve location

A

left sternal border at 2nd intercostal space

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7
Q

erb’s point location

A

left sternal border at 3rd intercostal space

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8
Q

tricuspid valve location

A

left sternal border at 4th or 5th intercostal space

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9
Q

mitral valve location

A

mid-clavicular line at 5th intercostal space

best auscultated in left lateral decubitus position

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10
Q

stenosis

A

valve has trouble opening and blood swirls through a narrow opening
murmur has a low pitch and is best heard with bell of stethoscope

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11
Q

regurgitation

A

valve is insufficient and blood seeps or squirts back into the chamber
this murmur has a high pitch and is best heard with diaphragm of stethoscope

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12
Q

ARMS&PRTS

A

occurs in diastole

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13
Q

patent ductus arteriosus

A

failure of shunt to close between the aorta and left pulmonary artery
creates a continuous/machinery like murmur that can be heart in both phases of heart cycle

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14
Q

tetrology of fallot

A

dextraposition/overriding of aorta, right ventricular hypertrophy, interventricular septal defect and pulmonic stenosis
creates a loud ejection murmur during systole and severe cyanosis

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15
Q

coarctation of aorta

A

constriction of descenting aorta

causes higher blood pressure in upper extremity by 20mmHg when compared to lower extremity

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16
Q

subclavian steal syndrome

A

proximal stenosis of subclavian artery

seen in younger females who faint while exercising

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17
Q

left sided heart failure

A

MC cause of left sided heart failure is HTN (35-55yo)

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18
Q

early signs of left sided heart failure

A

pulmonary edema, shorteness of breath, orthopnea

fluid collects at costophrenic angles

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19
Q

right sided heart failure

A

MC cause is left sided heart failure

increased heart rate, S3 gallop, decreased BP

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20
Q

MC cause of mitral stenosis

A

rheumatic fever

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21
Q

cor pulmonale

A

when right side fails by itself

baks up to SVC and down IVC

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22
Q

right sided heart failure leads to?

A

edema and fluid in extremities, jugular vein distention (SVC), liver/spleen enlargement, +hepatojugular reflex, ascites, caput medusa, pitting edema, stasis dermatits

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23
Q

aortic dissection

A

an interruption of infima allowing blood into the vessel wall with immeidate “tearing” pain
acute surgical emergency
associateed with HTN, arteriosclerosis (descending aorta) and marfan’s (ascending aorta)

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24
Q

marfan’s syndrome

A

inherited CT disorder with ventricular weakinging and enlargement
presents with tall, long fingers/limbs, lens subluxation, cardiovascular and lung problems

25
Q

angina pectoris-coronary vasospasm

A

comes on with exertion
printzmetal angina comes on with rest (atypical)
relieved by vasodilators under tongue

26
Q

MI

A

acute heart failure
comes on with rest
caused by atherosclerosis
CK-MB is elevated, increased LDH, increased SGOT

27
Q

aneurysm

A

abnormal widening that involves all 3 layers

defect in elastic-media tissues

28
Q

p wave

A

normal atrial depolarization

29
Q

qrs complex

A

depolarization of ventricles

repolarization of atria hidden here

30
Q

t wave

A

repolarization of ventricles

31
Q

u wave

A

repolarization of papillary muscles

32
Q

increased PR interval

A

prolonged AV nodal delay

primary heart block

33
Q

two P waves before QRS

A

weinkbochs-block of bundle of HIS

seondary heart block

34
Q

ST segment enlarged or inverted

A

MI (acute heart failure)

35
Q

no QRS pattern

A

complete heart block

ventricular contraction

36
Q

no P wave

A

atrial fibrillation

37
Q

echocardiaogram/doppler

A

used to evaluate heart valves

38
Q

increased bowel sounds

A

early intestinal obstruction

39
Q

absent bowel sounds

A

late intestinal obstruction

adynamic (paralytic) ileus

40
Q

hematamesis

A

vomiting blood

41
Q

hemoptysis

A

coughing up lood

42
Q

hematochesia

A

blood instool

43
Q

tests non specific for liver

A

increased alkaline phosphatase
SGOT/AST
aspartate transaminase
LDH

44
Q

tests classic for liver

A

GGT

SPGT/ALT

45
Q

tests for liver and kidneys

A

BUN

46
Q

jaundice

A

ywllowing of the skin, sclera, mucous membranes

can occur with liver disorder

47
Q

what is the most common cause of liver cirrhosis

A

alcoholism

48
Q

cirrhosis causes?

A

HTN
ascites
esophageal varices

49
Q

mallory weiss syndrome

A

coughing
tearing esophageal blood vessels
hematamesis
with palmar rash due to bile salts

50
Q

wernicke-korsakoff syndrome

A

thiamin deficiency from alcoholism that leads to dementia

51
Q

beri beri

A

thiamin deficinecy without alcoholism

52
Q

s/s of hepatitis

A

liver may be tender and enlarged but the adge ramins soft and smooth

53
Q

hepatitis a

A

from food through fecal/oral rout, self lmiting, not a carrier

54
Q

hepatits b

A

dirty needles and sexual contact, carrier for life, most common to become liver cancer

55
Q

hepatitis c

A

blood transfusions, illegal drug use

56
Q

liver cancer

A

most common site for metastatic disease

liver is enlarged, with a hard and irregular border

57
Q

alpha fetoprotein

A

a tumor marker spwcific for hepatocellular carcinoma

58
Q

how do we definitively diagnose liver cancer?

A

biopsy

Part 2/3 boards (16 decks)

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