Cardiology

Question 1

sound pattern of increasing intensity caused by increased blood velocity

Answer 1

crescendo

Question 2

site farthest from the location of greatest intensity at which the sound is still heard; usually transmitted in the direction of blood flow

Answer 2

radiation

Question 3

heart and stomach are to the right and the liver to the left

Answer 3

situs inversus

Question 4

forms most of the anterior surface of the heart

Answer 4

right ventricle

Question 5

location of the apical pulse

Answer 5

5th L ICS at the midclavicular line

Question 6

AV valves

Answer 6

tricuspid (R) & mitral (L)

Question 7

number of cusps of the semilunar valves

Answer 7

3

Question 8

produces S1 heart sound

Answer 8

closure of the mitral & tricuspid valves at the beginning of systole

Question 9

produces S2 heart sound

Answer 9

closure of the pulmonic & aortic valves
A2 is produced by the aortic (occurs first)
P2 is produced by the pulmonic

Question 10

sound heard when atria contract to eject any remaining blood

Answer 10

S4

Question 11

sound produced by ventricular filling

Answer 11

S3

Question 12

refers to two distinct components to diastolic sounds

Answer 12

split S2 (A2 then P2)

Question 13

atrial depolarization on ECG

Answer 13

P wave

Question 14

time from initial stimulation of atria to initial stimulation of ventricles (0.12-0.20 sec)

Answer 14

PR interval

Question 15

spread of the stimulus through the ventricles

Answer 15

QRS complex (<0.10 sec)

Question 16

ventricular repolarization on ECG

Answer 16

T wave

Question 17

When does the ductus arteriosus close?

Answer 17

typically 24-48 hrs after birth

Question 18

yellowish tumor on upper & lower eyelids

Answer 18

xanthelasma

Question 19

if apical pulse is more vigorous than expected it should be characterized as

Answer 19

heave or lift

Question 20

apical pulse that is more forceful & widely distributed, fills systole or is displaced laterally & downward may indicate

Answer 20

increased CO or left ventricular hypertrophy

Question 21

cause of lift along left sternal border

Answer 21

right ventricular hypertrophy

Question 22

fine, palpable, rushing vibration over the base of the heart and in the area of the R or L 2nd ICS

Answer 22

thrill

indicates turbulence

Question 23

What pulse is synchronous with S1

Answer 23

carotid

Question 24

intensity of sound increases with handgrip

Answer 24

mitral regurgitation

Question 25

murmur increases in intensity with inspiration & decreases during expiration

Answer 25

right-sided

Question 26

valsalva increases the intensity of this murmur

Answer 26

hypertrophic

Question 27

location for auscultation of the aortic valve

Answer 27

R 2nd ICS | The pulmonic is at the same level but on the left

Question 28

location for auscultation of tricuspid

Answer 28

L 4th ICS

Question 29

When is split S2 heard?

Answer 29

inspiration

Question 30

Which heart sound suggests pathology & needs additional investigation?

Answer 30

S4

Question 31

mid-to-late nonejection systolic clicks

Answer 31

mitral prolapse

Question 32

rhythm sounds like TEN-nes-see

Answer 32

S4 (atrial gallop)

Question 33

rhythm sounds like Ken-TUCK-y

Answer 33

S3 (ventricular gallop)

Question 34

produces an opening "snap"

Answer 34

valvular stenosis

Question 35

causes a pericardial friction rub

Answer 35

inflammation of the pericardial sac

Question 36

best position to auscultate for s3 or S4

Answer 36

left lateral

Question 37

Grading of Heart murmurs

Answer 37

``` I: barely audible in quiet room II: quiet but clearly audible III: Moderately loud IV: loud, associated with thrill V: very loud with palpable thrill VI: Very loud & audible without stethoscope contact with skin ```

Question 38

low diastolic rumble with no radiation palpable thrill at apex in late diastole opening snap decreased arterial pulse amplitude

Answer 38

mitral stenosis

Question 39

mid-systolic ejection murmur crescendo-decrescendo palpable S4

Answer 39

aortic stenosis

Question 40

``` murmur fills systole diamond-shaped palpable thrill in systole brisk arterial pulse prominent JVP ```

Answer 40

subaortic stenosis

Question 41

systolic murmur heard over pulmonic area & radiating into neck almost always congenital cause

Answer 41

pulmonic stenosis

Question 42

diastolic rumble in early and late diastole decreased arterial pulse amplitude prominent JVP caused by rheumatic heart disease, congenital defect

Answer 42

tricuspid valve stenosis

Question 43

holosystolic high-pitched blowing sound that obliterates S2 radiates to base or left axilla caused by rheumatic fever, MI, myxoma, rupture of chordae

Answer 43

mitral regurgitation

Question 44

late systolic murmur preceded by midsystolic clicks

Answer 44

mitral valve prolapse

Question 45

early diastolic, high pitch sounds vary with blood pressure caused by rheumatic heart disease, endocarditis, Marfan, syphilis

Answer 45

aortic regurgitation

Question 46

holosystolic murmur over right ventricle blowing congenital defects, bacterial endocarditis (esp in IV drug users), pulmonary HTN

Answer 46

tricuspid regurgitation

Question 47

characterized by exaggerated decrease in the amplitude of pulsation during inspiration and increased amplitude in expiration Can be caused by pericardial effusion, constrictive pericarditis, emphysema, asthma

Answer 47

pulsus paradoxus

Question 48

Pulse amplitude descriptions

Answer 48

``` 4 = bounding 3 = full, increased 2 = expected 1 = diminished, barely palpable 0 = absent, not palpable ```

Question 49

pain from muscle ischemia

Answer 49

claudication

Question 50

intact system capillary refill time

Answer 50

< 2 sec

Question 51

normal pulse pressure range

Answer 51

30-40 mm Hg

Question 52

when would bp in the legs be measured?

Answer 52

if suspect coarctation of the aorta or if diastolic > 90 mm Hg

Question 53

redness, thickening or tenderness along a superficial vein

Answer 53

thrombophlebitis

Question 54

complaint of pain when flex the knee with one hand and dorsiflex the foot with the other

Answer 54

+ Homan sign | may indicate venous thrombosis

Question 55

very deep pit that lasts 2-5 min after compression, coupled with gross distortion of the dependent extremity

Answer 55

4+ pitting edema

Question 56

Why is HTN a common process of aging?

Answer 56

blood vessels lose elasticity

Question 57

is essential HTN symptomatic?

Answer 57

typically no

Question 58

ascites & peripheral edema

Answer 58

evidence of Rt heart failure

Question 59

stenosis in the descending aortic arch near the origin of the left subclavian artery and ligamentum arteriosum

Answer 59

coarctation of the aorta

Question 60

sleeping on more than one pillow to breathe

Answer 60

orthopnea

Question 61

outward movement of the sternal/parasternal area

Answer 61

lift

Question 62

outward movement of prolonged duration, increased amplitude

Answer 62

heave

Question 63

inward movement of the chest wall

Answer 63

retraction

Question 64

outward chest movement

Answer 64

thrust

Question 65

low-pitched murmurs are heard best with the

Answer 65

bell

Question 66

observe to evaluate arterial & venous insufficiency

Answer 66

skin color, skin texture, skin temperature, hair distribution