Murmurs

Question 1

Wide splitting

Answer 1

pulmonic stenosis, RBBB

Question 2

Fixed splitting

Answer 2

ASD

Question 3

Paradoxical splitting

Answer 3

Delayed aortic valve close (aortic stenosis, LBBB)

Question 4

What can you hear in Aortic Area (right sternal border)?

Answer 4

Aortic Stenosis,

Question 5

What can you hear on the left sternal border?

Answer 5

Aortic regurgitation, Pulmonic regurgitation, HCM

Question 6

What can you hear in the tricuspid area? Left lower sternal border

Answer 6

Tricuspid regurg, tricuspid stenosis, ASD, VSD

Question 7

What murmurs increase with inspiration

Answer 7

Increased right heart sounds

Question 8

What murmurs increase with Hand grip?

Answer 8

Increased afterload increases MR, AR, VSD murmurs

Question 9

What murmurs decrease with Hand grip?

Answer 9

Decreased afterload decreases HCM

Question 10

What murmurs increase with Valsalva and standing?

Answer 10

Decreasing preload decreases intensity of all murmurs except HCM

Question 11

What murmurs decrease with rapid squatting?

Answer 11

Increase preload and increased afterload decreases HCM, and increases AS.

Question 12

What causes long QT?

Answer 12

A: Antiarrythmics (class Ia, III) 
B: Antibiotics (macrolides) 
C: Antipsychotics (haldol) 
D: Antidepressants (TCA)
E: Antiemetics (Ondansetron)