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YR6 Images + Instruments > Cardiovascular Exam > Flashcards

Cardiovascular Exam Flashcards

1
Q

What is this? What causes this?

A

Janeway lesions
Painless, flat lesions
Haemorrhagic lesions on thenar eminence
Embolic phenomena in Infective Endocarditis

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2
Q

What is seen here? What causes this?

A

Oslers nodes
Painful, raised lesions
Immunological phenomena in Infective Endocarditis

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3
Q

What is seen here? List 4 features

A

Clubbing
Loss of Lovibond’s angle
Increased longitudinal curvature of the nail
Boggy nail bed
Drumsticking of finger nails

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4
Q

List 3 cardiovascular causes of clubbing

A

Atrial myxoma
Congenital cyanotic heart disease e.g. ToF
Infective Endocarditis

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5
Q

What is seen here? What causes this?

A

Tendon xanthomata
Hyperlipidaemia (typically familial hypercholesterolaemia)

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6
Q

3 causes of radio-radial delay

A

Subclavian artery stenosis (e.g. compression by a cervical rib)
Aortic dissection
Aortic coarctation

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7
Q

3 causes of collapsing pulse

A

Normal physiological states: fever, pregnancy
Cardiac lesions: AR, PDA
High output states: anaemia, AV fistula, thyrotoxicosis

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8
Q

3 causes of Narrow pulse pressure

A

AS
Congestive heart failure
Cardiac tamponade.

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9
Q

2 causes of wide pulse pressure

A

Aortic dissection
AR

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10
Q

What is seen here? What causes this?

A

Splinter haemorrhages
Embolic phenomena of infective endocarditis

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11
Q

What is Quincke’s pulse? What causes it?

A

Visible capillary pulsations on compression to fingernail bed
Aortic regurgitation

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12
Q

What causes a slow rising pulse?

A

Aortic stenosis

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13
Q

What causes a bounding pulse?

A

CO2 retention

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14
Q

Give 2 features of a CO2 retention flap. What causes this?

A

Bilateral
Symmetrically timed
Hypercapnia: COPD/ T2 respiratory failure

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15
Q

What is pulsus paradoxus? Give 2 causes

A

varied pulse strength with each inspiration + expiration
Severe asthma
Cardiac tamponade

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16
Q

What is pulsus alternans? Name a cause

A

regular alterations in force of pulse (not varying with respiration)
Severe LVF

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17
Q

When may a jerky pulse be felt?

A

HOCM

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18
Q

What is seen here? List 3 causes

A

Malar flush
Mitral stenosis (CO2 retention causes vasodilation)
SLE
Polycythaemia rubra vera

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19
Q

What is seen here? What causes this?

A

Corneal arcus
If <50: hypercholesterolaemia

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20
Q

What is seen here? What causes this?

A

Xanthelasma
Hypercholesterolaemia

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21
Q

What is seen here? What causes this?

A

Kayser Fleischer Rings
Wilsons disease

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22
Q

What is this man suffering from? What clinical sign would be seen?

A

Superior vena cava obstruction
Raised JVP + absent pulsation

23
Q

What is Kussmauls sign? When is this seen?

A

Paradoxical JVP rise on inspiration
Impaired ventricular filling
Cardiac tamponade, constrictive pericarditis, restrictive cardiomyopathy

24
Q

What are cannon A waves in the JVP? What causes these?

A

Large A waves from simultaneous contraction of RA + RV

3rd degree heart block

25
Q

List 4 causes of raised JVP

A

Fluid overload
Cardiac tamponade
RHF + Cor pulmonale
Constrictive pericarditis

26
Q

What is this? What is it used for?

A

Hickman line
Administer drugs, take blood samples

27
Q

Name the scar. What surgery may have been performed?

A

Midline sternotomy
CABG, aortic valve replacement, mitral valve replacement

28
Q

Name the scar. What surgery may have been performed?

A

Anterolateral thoracotomy scar
Minimally invasive cardiac valve surgery

29
Q

Name the scar. What surgery may have been performed?

A

Posterolateral thoracotomy scar
Mitral valve replacement, Blalock-Taussig shunt, coarctation repair

30
Q

Name the scar. What surgery may have been performed?

A

Mid-axillary scar
ICD insertion

31
Q

Name the scar. What surgery may have been performed?

A

Subclavicular
Pacemaker/ ICD insertion

32
Q

Parasternal heave cause

A

RV hypertrophy

33
Q

S4 cause

A

Atrial contraction against a stiff ventricle

34
Q

S3 cause

A

turbulent ventricular filling

35
Q

AR manoeuvre

A

lean forward + listen to the left 3rd ICS parasternal

36
Q

MS manoeuvre

A

roll onto the left side + listen to 5th ICS MCL with the bell

37
Q

Distinguish between aortic stenosis and aortic sclerosis

A

listen to the carotids with the bell
stenosis radiates a crescendo-decrescendo murmur whilst sclerosis will not

38
Q

Aortic stenosis murmur

A

Ejection systolic, crescendo-decrescendo
Radiates to carotids
Soft/ absent S2
S4
Slow rising pulse
Narrow pulse pressure

39
Q

4 causes of AS

A

Degenerative calcification (most common >65)
Bicuspid aortic valve (most common <65)
Rheumatic heart disease
HOCM

40
Q

Mx of AS

A

Asymptomatic: observe
Symptomatic: valve replacement
Asymptomatic but valvular gradient > 40 mmHg + features e.g. LV systolic dysfunction: consider surgery

41
Q

Aortic regurgitation murmur

A

Early diastolic
High pitch, blowing
Quinckes sign
De Musset’s sign
Collapsing pulse
Wide pulse pressure

42
Q

5 causes of AR

A

Rheumatic heart disease
Infective endocarditis
CTDs: Marfans, EDS
Aortic dissection
Bicuspid aortic valve

43
Q

Mx of AR

A

Medical Mx of any associated HF

Indications for surgery:
symptomatic patients with severe AR
asymptomatic patients with severe AR who have LV systolic dysfunction

44
Q

What is De Musset’s sign?

A

Head bobbing

45
Q

What is an Austin flint murmur?

A

Mid diastolic ‘rumbling’ murmur
Due to severe AR

46
Q

Mitral stenosis murmur

A

Mid diastolic ‘rumbling’
Loud S1
Opening snap
Low volume pulse
AF

47
Q

1 cause of MS

A

RHEUMATIC FEVER

48
Q

Mx of MS

A

If mod-severe MS + AF require anticoagulation with Warfarin

Asymptomatic: regular echos

Symptomatic: Percutaneous mitral balloon valvotomy
or mitral valve surgery (commissurotomy, or valve replacement)

49
Q

Mitral regurgitation murmur

A

Pansystolic
High pitched, blowing
Soft S1
If severe: widely split S2

50
Q

3 causes of MR

A

Post-MI papillary muscle rupture
Infective endocarditis
Rheumatic fever

51
Q

MR Mx

A

Acutely: nitrates, diuretics, positive inotropes + an intra-aortic balloon pump to increase cardiac output

If in HF: ACEi, b-blockers + spironolactone

Acute, severe regurgitation: surgery

Degenerative MR: Repair (over replacement)
If not possible: valve replacement

52
Q

If a patient has a midline sternotomy scar but no leg vein harvest scars, what is the likely explanation?

A

Interior mammary artery graft

53
Q

Where can vessels be harvested from for CABG?

A

Leg (saphenous vein)
Inside chest (internal mammary artery)
Arm (radial artery)

54
Q
A

YR6 Images + Instruments (21 decks)

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