Cardio I

Question 1

Pt p/w difficulty breathing, increasing fatigue, and orthopnea two months post-MI

Answer 1

Heart failure

Question 2

A diastolic heart sound is heard when the patient lies in the left lateral decubitus position

Answer 2

S3

Question 3

A low frequency sound that occurs immediately following S2 during the phase of rapid passive ventricular filling

Answer 3

S3

Question 4

If you suspect that a patient has left ventricular systolic failure, what finding on PE might you expect? how would you accentuate this finding? why?

Answer 4

Have the patient lie in the left lateral decubitus position and exhale completely, which makes S3 more audible y by decreasing the volume of the lungs and bringing the heart closer to the chest wall.

Question 5

When would you ask a patient to do a Valsalva maneuver during the cardiac PE?

Answer 5

The straining phase of the Valsalva maneuver (bearing down against a closed glottis) and the standing position can be used to differentiate between the various causes of a systolic murmur in the left heart (murmurs associated with mitral prolapse and HCM become louder and AS murmur becomes quieter).

Question 6

What affect does a Valsalva maneuver have on the heart?

Answer 6

Decreased venous return to the heart –> reduced left ventricular volume and BP (MVP and HCM louder and AS quieter)

Question 7

Furosemide

Answer 7

Diuretic –> decreased end-systolic ventricular volume

Question 8

Amyl nitrate inhalation causes

Answer 8

vasodilation, decreased BP, and transient decrease in venous return

Question 9

What drugs cause lupus?

Answer 9

Hydralazine
Procainamide
Isoniazid
Minocyline
Quinidine