CV-PV exam

Question 1

What measurements above the RA and above the Sternal angle is considered an elevated Jugular venous pressure

Answer 1

RA >8cm, Sternal angle >3cm at head of bed 30degrees

Question 2

How to tell carotid from jugular pulsations/oscillations

Answer 2

jugular vein oscillations will obliterate with pressure while carotid pulsations will not

Question 3

Lifts and heaves signify?

Answer 3

LA/LV enlargement

Question 4

Thrills signify

Answer 4

valvular dysfunction, vibration

Question 5

PMI should be found

Answer 5

5th ICS/ MCL

Question 6

PMI lateral displacement shows

Answer 6

cardiomyopathy, LV enlargement

Question 7

Auscultation aortic valve

Answer 7

2nd ICS, RSB

Question 8

Auscultation pulmonic valve

Answer 8

2nd ICS, LSB

Question 9

Auscultation Tricuspid valve

Answer 9

3rd/4th ICS, LLSB

Question 10

Mitral valve area

Answer 10

5th ICS, MCL

Question 11

S1

Answer 11

beginning of systole, AV/PV open, MV/TV closed, heard all over, loudest at apex

Question 12

S2

Answer 12

beginning of diastole, MV/TV open, AV/PV closed, loudest at the base 2nd-3rd ICS

Question 13

Split S1 caused by

Answer 13

one ventricle depolarizing before the other, can not be caused by inspiration

Question 14

Split S2 caused by

Answer 14

can be caused by inspiration

Question 15

Midsystolic click

Answer 15

most common, MVP

Question 16

Aortic ejection click

Answer 16

Early systole, AS, Bicuspid aortic valve

Question 17

Pulmonic ejection click

Answer 17

early systole, pulmonary stenosis, pulmonary HTN

Question 18

Opening snap

Answer 18

Early diastole, LSB, MVS

Question 19

S3

Answer 19

low pitch, early diastole, volume overload, heart failure,

Question 20

S4

Answer 20

late diastole, atrial ejection into a distended ventricle, cardiomyopathy, delayed conduction

Question 21

Pericardial friction rub

Answer 21

inflammation of pericardium, high pitched scratchy

Question 22

Grading murmurs

Answer 22

Grade I through Grade VI

Question 23

Grade I

Answer 23

Barely audible

Question 24

Grade II

Answer 24

audible, but soft

Question 25

Grade III

Answer 25

Easily audible

Question 26

Grade IV

Answer 26

easily audible and associated with a thrill

Question 27

Grade V

Answer 27

Easily audible, associated with a thrill and still heart with the stethoscope only lightly on the chest

Question 28

Grade VI

Answer 28

Can be heard without the stethoscope

Question 29

Murmurs during systole

Answer 29

aortic stenosis Mitral regurgitation pulmonic stenosis tricuspid regurgitation

Question 30

Murmurs during diastole

Answer 30

aortic regurgitation mitral stenosis pulmonic regurgitation tricuspid stenosis

Question 31

Aortic stenosis

Answer 31

mid systolic, medium pitch, crescendo-decrescendo pattern, Harsh and Raspy, 2nd ICS at right sternal border, often radiates to the neck (key distinguishing factor), sitting and leaning forward, squatting increases the intensity

Question 32

mitral regurgitation

Answer 32

Pan-systolic (holosystolic), medium to high pitch, harsh, blowing, may be associated with an S3, Apical, radiates to left axillary region

Question 33

Pulmonic stenosis

Answer 33

Midsystolic, medium pitch, crescendo-decrescendo, Harsh, 2-3 ICS, LSB, Radiates to left shoulder, neck region, Pathologic S2 splitting

Question 34

Tricuspid regurgitation

Answer 34

Holosystolic, medium pitch, blowing, left lower sternal border, radiates to right sternum, diploid process and possibly left MCL, increases with inspiration

Question 35

Aortic regurgitation

Answer 35

Decrescendo diastolic, grade I-III, high pitch, blowing, 2nd-4th ICS, LSB, Holding breath after exhalation, holding hand-letting go

Question 36

Mitral Stenosis

Answer 36

Mid-late diastolic, Grade I-VI, low pitch, diastolic rumble, Decrescendo (opening snap follows S2)

Question 37

Pulmonic regurgitation

Answer 37

Early diastolic, Grade I-VI, High pitch, Decrescendo, Blowing, LSB

Question 38

Tricuspid stenosis

Answer 38

mid-late diastolic, Grade I-VI, Low pitch diastolic rumble, Decrescendo (opening snap follows S2), rumbling

Question 39

Venous stasis

Answer 39

Brown discoloration (hemosiderin deposits), medial malleoli ulcers d/t bacterial invasion of poorly drained tissue,

Question 40

Arterial insufficiency

Answer 40

Arterial ulcers usually occur on the tip of the toes, metatarsal heads and lateral malleoli, hair loss

Question 41

0 pulses

Answer 41

Absent

Question 42

+1 pulses

Answer 42

diminished

Question 43

+2 pulses

Answer 43

Normal

Question 44

+3 pulses

Answer 44

Full

Question 45

+4 pulses

Answer 45

Bounding

Question 46

Pulsus Alternans

Answer 46

Pulses alternating strong and weak, can be found in left ventricular dysfunction

Question 47

pulses paradoxus

Answer 47

Cardiac tamponade, volume stronger with expiration

Question 48

Bounding

Answer 48

Warm sepsis

Question 49

Bisferiens

Answer 49

double systolic peak, aortic stenosis and aortic regurgitation