Heart & Blood Vessel TEST 1

Question 1

What is S1 and what causes it?

Answer 1

The ‘lub’ sound, caused by closure of AV valves (tricuspid and mitral), marks beginning of systole.

Question 2

What is S2 and what causes it?

Answer 2

The ‘dub’ sound, caused by closure of SL valves (aortic and pulmonic), marks end of systole.

Question 3

What causes a heart murmur?

Answer 3

Turbulent blood flow due to increased velocity, decreased viscosity, or structural defects.

Question 4

What is an S3 heart sound, when is it abnormal, and how do you hear it?

Answer 4

A ventricular filling sound in early diastole; abnormal in adults over 35, suggests CHF, volume overload (possibly due to pregnancy), or thyroid disease. Use the BELL

Question 5

What changes occur in the aging heart?

Answer 5

LV wall thickens, decreased cardiac output during exertion, increased arrhythmias.

Question 6

What are signs of heart failure in infants?

Answer 6

Persistent tachycardia, tachypnea, hepatomegaly (liver enlargement).

Question 7

What are normal auscultation points for heart sounds (APE To Man)?

Answer 7

Aortic, Pulmonic, Erb’s point, Tricuspid, Mitral.

Question 8

What symptoms suggest cardiovascular disease?

Answer 8

Chest pain, dyspnea, fatigue, cyanosis, edema, palpitations, syncope.

Question 9

What cardiovascular considerations are unique in pregnancy?

Answer 9

Increased blood volume, possible S3 or mammary souffle, elevated HR.

Question 10

What is a venous hum in children?

Answer 10

Benign turbulent flow in the jugular venous system, common and often insignificant.

Question 11

What grade of murmur does the thrill appear?

Answer 11

4 or higher, loud

Question 12

What are common signs in children of cardiac issues?

Answer 12

Squatting, central cyanosis, or peripheral cyanosis after the first few days of life, poor weight gain, poor feeding. Murmurs after 2-3 years of age, though may be normal, reevaluate.

Question 13

What is the most common MI symptom in women?

Answer 13

Fatigue!

Question 14

What is mammary souffle?

Answer 14

A murmur like sound heard over the 2nd, 3rd or 4th intercostal spaces near the sternum due to increased blood flow and vascular engorgement of the mammary arteries. Common in late pregnancy and early postpartum.

Question 15

Presentation of bacterial endocarditis?

Answer 15

Sudden on set CHF with SOB and ankle edema, fever, fatigue, murmur, neurologic dysfunction, Janeway lesions (small erythmatous or hemorrhagic macules on palms and soles), Osler nodes (painful, red, raised lesions on fingertips caused by septic emboli)

Question 16

Presentation of pericarditis?

Answer 16

sharp stabbing chest pain that is worse with cough, swallowing, deep breathing, movement or laying flat, pain in the back neck or left shoulder, dry cough. Scratchy friction rub on auscultation just left of the sternum in 3rd and 4th intercostal spaces.

Question 17

Cardiac tamponade presentation?

Answer 17

Chest pain sometimes relieved by leaning forward or sitting upright, syncope, SOB, swelling of abdomen arms or neck veins. (Beck’s triad: JVD, hypotension, muffled heart sounds)

Question 18

Cor pulmonale presentation?

Answer 18

fatigue, tachypnea, exertional SOB, cough/hemoptysis, evidence of pulm disease (wheezes/crackles/increased A:P) loud S2 exaggerated in pulmonic region

Question 19

What is ventricular septal defect (VSD) and what are the symptoms?

Answer 19

Opening between the right and left ventricles. Recurrent respiratory infections, if large tachypnea, poor growth, CHF symptoms, arterial pulse is small, holosystolic murmur loud course and high pitched, left peristernal lift.

Question 20

What is tetrology of fallot and what are the symptoms?

Answer 20

Ventricular septal defect, pulmonic stenosis, dextroposition of the aorta, and right ventricular hypertrophy together. Dyspnea with feeding, poor growth, dyspnea with syncopy or hypercyanotic episode, parasternal heave and precordial prominince, systolic ejection murmur, older children clubbing of fingers and toes.

Question 21

What is patent ductus arteriosus what are the symptoms?

Answer 21

Blood flows from the aorta through the ductus to the pulmonary artery during systole and diastole increasing pulmonary vascular pressure causing R heart strain/hypertrophy. HOW BLOOD FLOWS WHEN IN UTERO.

Poor eating, poor growth, sweating with crying or eating, tachypnea, tachycardia.

Question 22

What is atrial septal defect (ASD) what are the symptoms?

Answer 22

Same as Foramen ovale. Often asymptomatic, heart failure may occur if large in children, often occurs in adults. Diamond shaped systolic murmur, systolic thrill felt over the murmur with palpable parasternal thrust.

Question 23

What is senile cardiac amyloidosis and what are the symptoms?

Answer 23

amyloid protien produced by chronic inflammation or neoplastic disease deposits in the heart decreasing contractility and heart failure. Lower extremity edema, ascites or hepatomegaly, arrhythmia, pleural effusion, EKG thickened LV and possibly RV.

Question 24

What does brown discoloration of the legs indicate?

Answer 24

Chronic venous stasis and hemosiderin deposits.

Question 25

Where do arterial ulcers commonly occur?

Answer 25

Tips of toes, metatarsal heads, lateral malleoli.

Question 26

Where do venous ulcers commonly occur?

Answer 26

Medial malleolus due to poor drainage and bacterial invasion.

Question 27

What does unilateral leg swelling suggest?

Answer 27

Venous obstruction or inflammation.

Question 28

What are signs of chronic venous insufficiency?

Answer 28

Edema, varicosities, brown discoloration, ulcers at medial malleolus.

Question 29

What does a bruit over the carotid artery suggest?

Answer 29

Turbulent blood flow, possibly from stenosis.

Question 30

Which percussion sound would mark the cardiac border?

Answer 30

Dullness (The change from resonance to dullness note marks the cardiac border)

Question 31

Which condition would increase the intensity of the S2 heart sound?

Answer 31

Arterial hypotension (A shock-like state causes a loss of valvular vigor which increases the intensity of the S2 heart sound)

Question 32

Which finding would be expected in the patient diagnosed with an arteriovenous fistula?

Answer 32

Edema

Question 33

What is kawasaki disease, what are the symptoms?

Answer 33

serious illness primarily affecting children, causing inflammation of the blood vessels. It's often diagnosed in children under 5, but can occur in older children as well. High fever: Lasting at least five days. Rash: Often on the back, chest, and groin. Swollen hands and feet: With red, peeling skin. Red, bloodshot eyes: Without pus or discharge. Red, cracked lips: And a red, "strawberry" tongue. Swollen lymph nodes: Usually in the neck.

Question 34

What is sick sinus syndrome and what are the assessment findings?

Answer 34

Arrhythmia is caused by a malfunction of the sinus node. Dysrhythmia, signs of CHF, fainting, transient vertigo, seizures, palpitations, and angina.

Question 35

What are the assessment findings supporting acute rheumatic fever?

Answer 35

Fever, inflamed swollen joints, flat or slightly raised painless rash with pink margins and pale centers, jerky movements, chest pain, fatigue, shortness of breath. Recent scarlet fever, positive throat culture for group a streptococci Murmurs, cardiomegaly, friction rub of pericarditis, signs of CHF.

Question 36

What is temporal arteritis, how does it present, how is it assessed?

Answer 36

An inflammatory disease of the branches of the aortic arch, including the temporal arteries. Generally older than 50, flu-like symptoms, polymalagia, headache in the temporal region on one or both sides, or headache in any region, loss of vision, tongue, pain and jaw claudication. Temporal area may be red, swollen tender, and nodular. Temporal pulse may be strong, weak or absent.

Question 37

What is coarctation of the aorta, what assessment findings support it?

Answer 37

(children) A stenosis seen most commonly in the descending aortic Arch near the origin of the left subclavian artery and ligamentum arteriosum. Maybe asymptomatic if mild, severe cases: hypertension or vascular insufficiency. Seen as differences in systolic blood pressure between arm and leg, femoral pulses are weaker than radial pulses, or femoral pulses are absent.

Question 38

What extra heart sound would be heard during diastole?

Answer 38

Increased S3, increased S4, mitral valve opening snap

Question 39

What additional assessment would be performed when examining a pediatric heart condition?

Answer 39

Change them body weight, clubbing of fingers and toes, auscultation for S4, cyanosis

Question 40

What is wide splitting?

Answer 40

Delayed contraction or emptying of the right ventricle.

Question 41

What is paradoxical splitting?

Answer 41

Delayed closure of the aortic valve

Question 42

What is fixed splitting?

Answer 42

Delayed closure of the pulmonic valve. It is fixed when it is unaffected by respiration.

Question 43

Myocarditis would cause what change in rate or rhythm?

Answer 43

Gallop rhythms