CVS PE

Question 1

Indicates presence of central R to L shunting

Answer 1

Clubbing

Question 2

Unopposable, “fingerized” thumb

Answer 2

Holt-Oram Syndrome

Question 3

Arachnodactyly and positive wrist and thumb

Answer 3

Marfan Syndrome

Question 4

Posterior calf pain on active DORSIFLEXION of the foot against resistance

Answer 4

Homan’s Sign

Question 5

Caused by R to L shunting at the level of the heart or lungs and seen in tongue or lips

Answer 5

Central cyanosis

Question 6

Related to ↓ extremity blood flow due to small vessel constriction and can be seen in patients with severe heart failure, shock and peripheral vascular disease

Answer 6

Peripheral cyanosis (Acrocyanosis)

Question 7

Also seen in patients with advanced mitral stenosis or scleroderma

Answer 7

Malar telangiectasia

Question 8

High-arched palate

Answer 8

Marfan syndrome

Question 9

Bifid uvula

Answer 9

Loeys-Diets syndrome

Question 10

Orange tonsils

Answer 10

Tangier disease

Question 11

Hypertelorism, low set ears, micrognathia

Answer 11

Congenital Heart Disease

Question 12

Blue sclerae

Answer 12

Osteogenesis Imperfecta

Question 13

SYSTOLIC pulsations over the LIVER signify

Answer 13

severe tricuspid regurgitation

whhyyyy

Question 14

The single most important bedside measurement from which to estimate the volume status

Answer 14

Jugular Venous Pressure

Question 15

Venous waveform that signifies atrial CONTRACTION

Answer 15

a wave

Question 16

Seen in px with reduced right ventricular compliance

Answer 16

prominent a wave

Question 17

Seen in px with AV dissociation and RA contraction against a closed tricuspid valve

Answer 17

cannon a wave

Question 18

Venous waveform that signifies atrial RELAXATION

Answer 18

x descent

Question 19

Venous waveform that occurs when closed tricuspid valve is pushed into the RA during early right ventricular systole

Answer 19

c wave

Question 20

Venous waveform that signifies atrial FILLING (atrial diastole)

Answer 20

v wave

Question 21

Venous waveform that signifies venous EMPTYING

Answer 21

y descent

Question 22

Rise or lack of fall of the JVP with inspiration

Answer 22

Kussmaul’s sign

Question 23

Very low (even 0 mmHg) diastolic pressure is seen in px with

Answer 23

chronic severe aortic regurgitation

large arteriovenous fistula

Question 24

large a wave

Answer 24

tricuspid stenosis
pulmonary stenosis
pulmonary hypertension

Question 25

cannon wave

Answer 25

complete heart block VVI pacing ventricular tachycardia

Question 26

steep “x”, “y” descent

Answer 26

constrictive pericarditis | cardiac tamponade

Question 27

large “v” wave, “cv” wave

Answer 27

tricuspid regurgitation

Question 28

White coat HPN

Answer 28

Defined by: at least 3 separate clinic based measurement >140/90 mmHg AND at least 2 non-clinic based measurements <140/90 mmHg in the absence of any evidence of target organ damage

Question 29

Masked HPN

Answer 29

Suspected when normal or even low blood pressures are recorded in patients with advanced atherosclerotic disease especially when evidence of target organ damage is present or bruits are available

Question 30

Orthostatic hypertension

Answer 30

This is defined by a FALL in systolic pressure >20mmHg and diastolic pressure >10 mmHg in response to assumption of the upright posture from a supine position within 3 min

Question 31

Performed routinely before instrumentation of the radial artery

Answer 31

Allen's Test

Question 32

Pulsus magnus

Answer 32

Pulse that is STRONG and BOUNDING

Question 33

Pulsus parvus

Answer 33

Pulse that is THREADY

Question 34

Pulvus Parvus et Tardus

Answer 34

Pulse that is WEAK and DELAYED seen in SEVERE AORTIC STENOSIS

Question 35

Corrigan’s or water-hammer pulse

Answer 35

Carotid upstroke that has sharp rise and rapid fall off CHRONIC SEVERE AORTIC REGURGITATION

Question 36

Hypertrophic Obstructive Cardiomyopathy (HCOM)

Answer 36

With BIFID pulse and inscription of percussion and tidal wave

Question 37

Coincides with the closure of mitral and tricuspid valves and best heard at the apex–

Answer 37

1st Heart Sound (S1)

Question 38

Coincides with the closure of aortic and pulmonic valves and best heart at the base

Answer 38

2nd Heart Sound (S2)

Question 39

Aortic area

Answer 39

2nd ICS at the right sternal border

Question 40

Pulmonic area

Answer 40

2nd ICS at the left sternal border

Question 41

Tricuspid area

Answer 41

Between 3rd to 5th ICS at the left sternal border

Question 42

Mitral area

Answer 42

Near the apex of the heart at the 5th ICS at the left midclavicular line

Question 43

Murmur that coincides with carotid upstroke

Answer 43

Systolic murmur

Question 44

Begins after S1 and ends before S2

Answer 44

Midsystolic murmur

Question 45

Starts with S1 and stops at S2

Answer 45

Pansystolic (Holosystolic) murmur

Question 46

Usually starts in mid or late systole and persists up to S2

Answer 46

Late systolic murmur

Question 47

Wide splitting

Answer 47

RBBB | severe MR

Question 48

Unusual narrow split or singular S2

Answer 48

pulmonary arterial HPN

Question 49

Fixed splitting

Answer 49

secundum ASD

Question 50

Reversed or paradoxical splitting

Answer 50

``` LBBB right ventricular pacing severe AS HOCM acute Mi ```

Question 51

Tricuspid Regurgitation

Answer 51

Early systolic murmur that increases in intensity with inspiration (Carvallo sign) –

Question 52

Tricuspid regurgitation

Answer 52

Systolic murmur at the 4th ICS left parasternal border which increased on inspiration

Question 53

Midsystolic ejection murmur

Answer 53

Aortic stenosis (AS) or pulmonic stenosis (PS)

Question 54

Systolic click with mid-to-late systolic murmur

Answer 54

mitral valve prolapse

Question 55

Holosystolic murmur

Answer 55

ventricular septal defect, chronic MR or TR

Question 56

This murmur always signify structural heart disease

Answer 56

Diastolic murmur

Question 57

Soft, early diastolic murmur

Answer 57

acute severe aortic regurgitation

Question 58

Decrescendo, blowing diastolic murmur

Answer 58

chronic severe aortic regurgitation

Question 59

Mid-late diastolic murmur/rumble with OPENING SNAP

Answer 59

Mitral stenosis

Question 60

Begins in systole and extends into all part of diastole

Answer 60

Continuous murmur

Question 61

Austin Flint murmur

Answer 61

Low-pitched mid-to-late apical diastolic murmur of chronic severe AR

Question 62

Graham Steel Murmur

Answer 62

High-pitched, decrescendo diastolic blowing murmur along the left sternal border heard in PULMONIC REGURGITATION secondary to dilatation of the RV outflow tract

Question 63

100 % specific for diagnosis of acute pericarditis

Answer 63

Pericardial Friction Rub

Question 64

High-pitched diastolic sound in constrictive pericarditis produced by the abrupt halt in early ventricular filling

Answer 64

Pericardial Knock

Question 65

Lower-pitched diastolic sound in atrial myxoma caused by prolapse of the mass through mitral orifice

Answer 65

Tumor Plop