INT MED II

Question 1

Methods of cardiac examination

Answer 1

• Xray!
• ECG!
• Echocardiography!
• Blood pressure measurement!
• Blood test!(ANP, BNP, troponin, endothelin)
• Phonocardiography!
• Nonselective angiocardiography!
• Cardiac catheterization!
• Radionuclide imaging!
• Serology!
• CT,
• MRI!

Question 2

Indications of the ECG

Answer 2

• Arrhythmia!
• Cardiac!enlargement!
• Anesthesia!/surgery!
• Prescription and evaluation of therapy
• Systemic diseases!
• Myocardial damage!

Question 3

What is FRIDA?

Answer 3

• Frequency (heart rate) = pulse rate
• Rhythm!
• Intensity (strength)
• Demarcation (distinctness)
• Adventitious sounds (mumurs)

Question 4

Description of the thorax

Answer 4

• Symmetry
• Shape
• Pain!

Question 5

Grades of murmurs

Answer 5

1. Very soft
2. Soft
3. Moderate intensity
4. Loud
5. Very loud
6. Loudest

Question 6

Which animal has relative/absolute dullness

Answer 6

Absolute: horse, dog

Relative: Cattle, small Ru, Su, Cat

Question 7

Which species has respiratory arrhythmia

Answer 7

?

Question 8

When does the heart rate increase? Which nerve is responsible?

Answer 8

Vagus, during inspiration!

Question 9

Inspection of the cardiac region

Answer 9

Abnormalities of the thorax (injury, malformation)

Heart beat

Question 10

What can decrease the heart rate?

Answer 10

Cardiac insufficiency

Pericardial fluid
Peripleural fluid
Thickened chest wall

Question 11

What can increase the heart rate

Answer 11

Exercise

Cardiac hypertrophy!

Dislocation!

Question 12

Reasons for enlargements of cardiac dullness

Answer 12

1. Dilation, hypertrophy!
2. Dislocation!
3. Pericardial effusion!
4. False enlargement (neighboring organs, friction on auscultation)!

Question 13

Reasons for decreasing dullness

Answer 13

1. Lung emphysema!
2. Skin emphysema!
3. Pneumothorax!
4. Cardiac dislocation!

Question 14

What are the 4 always of murmurs?

Answer 14

1. Pitch!
2. Intensity!
3. Relation to cardiac cycle!
4. Location!

Question 15

Causes of endocardial murmurs!

Answer 15

Morphological: valve deformities, septal or vessel deformation

Functional: anemia, innocent!

Question 16

Indications of blood pressure measurements

Answer 16

1. Reveal secondary hypertension in case of known predisposition factors!
2. Find the cause of ocular, cardiac or CNS alterations!
3. When using ACE inhibitors or hypotensive drugs
4. Cases of severe diseases, shock!
5. Anesthesia monitoring
6. Thrombosis!
7. Reveal essential hypertension!

Question 17

Indications of echocardio

Answer 17

1. Examination of cardiac chambers!
2. Recognition of valvular disorders!
3. Detection of shunts!
4. Quantitative examination (valvular shortening)
5. Defects of blood flow disorders!
6. Detection of pericardial fluid!

Answer 18

Answer 19

Answer 20

Answer 21

Answer 22

Answer 23

Answer 24

Answer 25

Question 26

Bronchial like sound

Answer 26

Question 27

Moist (wet) Rhonchi

Answer 27

Question 28

Crackling sound

Answer 28

Question 29

Dry Rhonchi sound

Answer 29

Question 30

Splashing sound

Answer 30

Question 31

Metallic sound

Answer 31

Question 32

Reason: Sound weaker than normal

Answer 32

Question 33

Sound: Missing

Answer 33

Question 34

Sound louder than normal

Answer 34

Question 35

What is Venturi effect?

Answer 35

Question 37

5 parameters to describe cough

Answer 37

1. Origin 2. Frequency 3. Strength 4. Tone 5. Occurrence 6. Duration 7. Secretion content 8. Painful or painless 9. Deepness 10. Localization of origin 11. The quality of sputum

Question 38

4 Things that differ intracardiac murmur from extra

Answer 38

Endo/intracardial Murmurs * Caused by turbulence * Within the heart * Morphological or functional origin * Most common Extracardial Murmurs: * Outside the heart * Variable * Can be caused by pleuritis * Location, Intensity can be heard during different phases of the cardiac cycle * Can be caused by effusions

Question 39

Causes of Endo/Intracardial murmurs

Answer 39

MORPHOLOGICAL * Valve deformities * Septal or vessel malformations FUCTIONAL * Innocent murmurs * Anemia: Decreased blood viscousity

Question 40

Cause of extra cardial murmurs

Answer 40

DUE TO INFLAMATION

Question 41

Adventious sounds from upper respiratory tract

Answer 41

1. Moist (wet) Rhonchi = **Non musical Rhonchi** 2. **Crepitation** 3. **Crackling** sound 4. **Rattling** sound 5. Dry Rhonchi = **Musical Rhonchi** 6. **Whistling** 7. **Wheezing**

Question 43

Classification of endo/intracardial murmurs

Answer 43

**Localization** **Intensity** **+ 4 constant characteristics** 1. **Timing** (systole/diastole) 2. **Pitch** (low,med.high) **- blowing, whistling, crackling, rough, musical murmurs** 3. **Quality, Shape -** Continious, Crescendo, Decrescendo, crescendo-decrescendo **(DIAMOND)** 4. **Conduction:** yes/no (Systole+pulse+murmur=**Systolic murmur)**

Question 45

Signs of **cardiac disease** for owners

Answer 45

1. **Cyanosis** 2. **Distended abdomen** 3. **Dyspnoea** 4. **Fainting** 5. **Exercise intoreance**

Question 46

Signs of **Right sided heart failure**, Signs of **left-sided heart failure**

Answer 46

**LEFT=** **Congestion** and **Pulmonary oedema** **RIGHT=** **Congestions in periphery, Ascites**

Question 47

Abnormal sounds you hear during **thorax auscultation**

Answer 47

1. Cracling 2. Crepitation 3. Weezing 4. Metalic sound 5. Splashing

Question 48

Characterise a grade 6 murmur

Answer 48

* Palpable **fremitus** * Very loud * Can be heard even with stethoscope away from thorax