General Diagnosis 4 Flashcards

(58 cards)

1
Q

S1 heart sounds

A

closure of AV (mitral and tricuspid) valves

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2
Q

S2 heart sounds

A

closure of semilunar (pulmonary and aortic) valves

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3
Q

S3 heart soudns

A

ventricular gallop
normal in children, young adults, and athletes
>40 years earliest sign of CHF

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4
Q

S4 heart sounds

A

atrial gallop

similar to S3 and is related to stiffness of ventricular myocardium to rapid filling

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5
Q

aortic valve location

A

right sternal border at 2nd intercostal space

best auscultated with patient seated, leaning forward, and exhaling

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6
Q

pulmonic valve location

A

left sternal border at 2nd intercostal space

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7
Q

erb’s point location

A

left sternal border at 3rd intercostal space

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8
Q

tricuspid valve location

A

left sternal border at 4th or 5th intercostal space

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9
Q

mitral valve location

A

mid-clavicular line at 5th intercostal space

best auscultated in left lateral decubitus position

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10
Q

stenosis

A

valve has trouble opening and blood swirls through a narrow opening
murmur has a low pitch and is best heard with bell of stethoscope

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11
Q

regurgitation

A

valve is insufficient and blood seeps or squirts back into the chamber
this murmur has a high pitch and is best heard with diaphragm of stethoscope

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12
Q

ARMS&PRTS

A

occurs in diastole

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13
Q

patent ductus arteriosus

A

failure of shunt to close between the aorta and left pulmonary artery
creates a continuous/machinery like murmur that can be heart in both phases of heart cycle

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14
Q

tetrology of fallot

A

dextraposition/overriding of aorta, right ventricular hypertrophy, interventricular septal defect and pulmonic stenosis
creates a loud ejection murmur during systole and severe cyanosis

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15
Q

coarctation of aorta

A

constriction of descenting aorta

causes higher blood pressure in upper extremity by 20mmHg when compared to lower extremity

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16
Q

subclavian steal syndrome

A

proximal stenosis of subclavian artery

seen in younger females who faint while exercising

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17
Q

left sided heart failure

A

MC cause of left sided heart failure is HTN (35-55yo)

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18
Q

early signs of left sided heart failure

A

pulmonary edema, shorteness of breath, orthopnea

fluid collects at costophrenic angles

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19
Q

right sided heart failure

A

MC cause is left sided heart failure

increased heart rate, S3 gallop, decreased BP

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20
Q

MC cause of mitral stenosis

A

rheumatic fever

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21
Q

cor pulmonale

A

when right side fails by itself

baks up to SVC and down IVC

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22
Q

right sided heart failure leads to?

A

edema and fluid in extremities, jugular vein distention (SVC), liver/spleen enlargement, +hepatojugular reflex, ascites, caput medusa, pitting edema, stasis dermatits

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23
Q

aortic dissection

A

an interruption of infima allowing blood into the vessel wall with immeidate “tearing” pain
acute surgical emergency
associateed with HTN, arteriosclerosis (descending aorta) and marfan’s (ascending aorta)

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24
Q

marfan’s syndrome

A

inherited CT disorder with ventricular weakinging and enlargement
presents with tall, long fingers/limbs, lens subluxation, cardiovascular and lung problems

25
angina pectoris-coronary vasospasm
comes on with exertion printzmetal angina comes on with rest (atypical) relieved by vasodilators under tongue
26
MI
acute heart failure comes on with rest caused by atherosclerosis CK-MB is elevated, increased LDH, increased SGOT
27
aneurysm
abnormal widening that involves all 3 layers | defect in elastic-media tissues
28
p wave
normal atrial depolarization
29
qrs complex
depolarization of ventricles | repolarization of atria hidden here
30
t wave
repolarization of ventricles
31
u wave
repolarization of papillary muscles
32
increased PR interval
prolonged AV nodal delay | primary heart block
33
two P waves before QRS
weinkbochs-block of bundle of HIS | seondary heart block
34
ST segment enlarged or inverted
MI (acute heart failure)
35
no QRS pattern
complete heart block | ventricular contraction
36
no P wave
atrial fibrillation
37
echocardiaogram/doppler
used to evaluate heart valves
38
increased bowel sounds
early intestinal obstruction
39
absent bowel sounds
late intestinal obstruction | adynamic (paralytic) ileus
40
hematamesis
vomiting blood
41
hemoptysis
coughing up lood
42
hematochesia
blood instool
43
tests non specific for liver
increased alkaline phosphatase SGOT/AST aspartate transaminase LDH
44
tests classic for liver
GGT | SPGT/ALT
45
tests for liver and kidneys
BUN
46
jaundice
ywllowing of the skin, sclera, mucous membranes | can occur with liver disorder
47
what is the most common cause of liver cirrhosis
alcoholism
48
cirrhosis causes?
HTN ascites esophageal varices
49
mallory weiss syndrome
coughing tearing esophageal blood vessels hematamesis with palmar rash due to bile salts
50
wernicke-korsakoff syndrome
thiamin deficiency from alcoholism that leads to dementia
51
beri beri
thiamin deficinecy without alcoholism
52
s/s of hepatitis
liver may be tender and enlarged but the adge ramins soft and smooth
53
hepatitis a
from food through fecal/oral rout, self lmiting, not a carrier
54
hepatits b
dirty needles and sexual contact, carrier for life, most common to become liver cancer
55
hepatitis c
blood transfusions, illegal drug use
56
liver cancer
most common site for metastatic disease | liver is enlarged, with a hard and irregular border
57
alpha fetoprotein
a tumor marker spwcific for hepatocellular carcinoma
58
how do we definitively diagnose liver cancer?
biopsy