Cardiovascular

Question 1

Location of the apex beat

Answer 1

5th left ICS or within 1-2cm medial to MCL or 7-9cm lateral to MSL

Question 2

S1 is due to

Answer 2

Closure or mitral and triscuspid valve

Question 3

Exertional chest pain with radiation to the left aide of the neck down to the arm

Answer 3

Angina pectoris

Question 4

Sharp pain radiating into the back or into the neck

Answer 4

Aortic dissection

Question 5

Chest pain that improves when leaning forward

Answer 5

Pericarditis

Question 6

Transient skips and flipflops

Answer 6

Premature contraction

Question 7

Rapid regular beating of sudden onset and offset

Answer 7

Paroxysmal supraventricular tachycardia

Question 8

Orthopnea suggest

Answer 8

Left ventricular heart failure

Mitral stenosis

Question 9

Significant right to left shunting at the level of the heart or lung

Answer 9

Central cyanosis

Question 10

Tender raised nodules on the pars of fingers or toes

Ouchler

Answer 10

Osler’s nodes

Question 11

Non tender, slightly raises hemorrhage on the palms and soles

Answer 11

Janeaway

Question 12

Linear petechiae in the mid position of the nail bed

Answer 12

Splinter hemorrhage

Question 13

Due to the presence of right to left shunting

Answer 13

Clubbing

Question 14

genetic disorder with atrial septal defect

Answer 14

Holt oram syndrome

Question 15

Reflects right atrial presystolic contraction

Preceding S1

Answer 15

A wave

Question 16

Defines the fall in right atrial pressure after inscription of the a wave

Answer 16

X descent

Question 17

Interrupts this x descent and is followed by a further descent

Answer 17

C wave

Question 18

Represents atrial filling (atrial diastole)

Occurs during ventricular systole

Answer 18

V wave

Question 19

What does the JVP reflext

Answer 19

Right atrial pressure

Question 20

An increase in JVP suggest what

Answer 20

Right sided heart failure

Question 21

Prominent A wave signifies what

Answer 21

Tricuspid stenosis

Hypertrophied RV

Question 22

Absent A wave

Answer 22

Atrial fibrillation

Question 23

Level of pulsation usually descends with inspiration

Answer 23

Kussmaul sign

Question 24

Where is the atrial pulse best appreciated

Answer 24

Carotid level

Question 25

Delayed carotid upstroke weak

Answer 25

Aortic stenosis

Question 26

Sharp rise and rapid fall off

Answer 26

Corrigans | Water hammer pulse

Question 27

Hypertrophic cardiomyopathy

Answer 27

Bifid pulse

Question 28

If the apical impulse is not detected, what do you do next

Answer 28

Use the bell at the apex in left lateral decubitus

Question 29

In what condition is the PMI displaced upward and to the left

Answer 29

Pregnancy | High left diaphragm

Question 30

Lateral displacement could be due to what

Answer 30

``` CHF Cardiomyopathy Ischemic heart disease Displacement of the thorax Mediastinal shift ```

Question 31

An increase of amplitude may signify what

Answer 31

Hyperthyroidism Severe anemia Aortic stenosis Mitral regurgitation

Question 32

Sustained high amplitude impulse that is normally located

Answer 32

Hypertension

Question 33

Sustained low amplitude

Answer 33

Dilated cardiomyopathy

Question 34

Palpable brief middiastolic impulse

Answer 34

S3

Question 35

Palpable impulse just before the systolic apical beat

Answer 35

S4

Question 36

Marked increase in amplitude with little or no change in duration

Answer 36

Atrial septal defect

Question 37

When is S2 palpable

Answer 37

Pulmonary hypertension

Question 38

Ejection sounds or systolic clicks

Answer 38

Extra sounds of systole

Question 39

Physiologic S3 and S4

Answer 39

Athletes

Question 40

Sounds like kentucky

Answer 40

Pathologic S3 or ventricular gallop

Question 41

Mitral valve prolapse Squatting can delay it Standing moves it closer to S1

Answer 41

Systolic click

Question 42

Indicate valvular disease but can be normal

Answer 42

Systolic murmur

Question 43

Harsh and machinery like quality

Answer 43

PDA

Question 44

Quality can be obliterared by pressure

Answer 44

Venous hum