Murmurs - Valve Disease + Congenital Defects

Question 1

Why are murmurs heard?

Answer 1

Turbulent blood flow against valves

Question 2

What murmurs are in time with the carotid pulse?

Answer 2

Systolic

Question 3

Right-sided murmurs are louder on…?

Answer 3

Inspiration

Question 4

What is a thrill?

Answer 4

A palpable murmur

Question 5

What is a heave?

Answer 5

Buzz due to VH

Question 6

What valve disease causes malaria flush?

Answer 6

Mitral stenosis

Question 7

Pan-systolic that radiates to axilla

Answer 7

Mitral regurgitation

Question 8

Tapping apex

Answer 8

Mitral stenosis

Question 9

Water-hammer pulse

Answer 9

Aortic regurgitation

Question 10

Ejection systolic radiates to carotids

Answer 10

Aortic stenosis

Question 11

Caused by papilla rupture

Answer 11

Mitral regurgitation

Question 12

Opening snap

Answer 12

Mitral stenosis

Question 13

High pitched murmur, blowing in nature

Answer 13

All regurgitations

Question 14

Associated with AF

Answer 14

Mitral stenosis

Question 15

Associated with hypertrophic cardiomyopathy

Answer 15

Aortic stenosis

Question 16

S4

Answer 16

Aortic stenosis

Question 17

Displaced apex

Answer 17

MR + AR

Question 18

SAD triad of symptoms

Answer 18

Aortic stenosis - syncope, angina and dyspnoea

Question 19

Heaving apex

Answer 19

Aortic stenosis

Question 20

Mid-diastolic rumbling murmur

Answer 20

Mitral stenosis

Question 21

Early diastolic murmur

Answer 21

Aortic regurgitation

Question 22

Ankle swelling as a result of

Answer 22

Mitral regurgitation

Question 23

Slow-rising pulse

Answer 23

Aortic stenosis

Question 24

Collapsing pulse

Answer 24

Aortic regurgitation + PDA

Question 25

Loud pan-systolic murmur with no radiation

Answer 25

Ventricular septal defect

Question 26

Tetralogy of Fallot

Answer 26

VSD, overriding aorta, pul stenosis (RV outflow obstruction + RVH

Question 27

Eisenmenger's complex

Answer 27

L-->R shunt of VSD is changed to R --> L

Question 28

Shunt of VSD

Answer 28

L-->R (before eisenmenger's)

Question 29

Shunt of PDA

Answer 29

L-->R

Question 30

Connection between aorta and pulmonary artery

Answer 30

PDA

Question 31

Bounding pulse

Answer 31

PDA

Question 32

Radial-radial delay

Answer 32

Coarctation of aorta, aortic dissection

Question 33

Diminished, absent lower limb pulses

Answer 33

Coarctation of aorta

Question 34

Rib-notching on CXR

Answer 34

Coarctation of aorta

Question 35

Causes of coarctation of aorta

Answer 35

Bicuspid aortic valve, circle of Willis aneurysm

Question 36

Pan-systolic murmur --> low left sternal edge, loudest on inspiration

Answer 36

Tricuspid regurgitation

Question 37

Valve disease of IVDU

Answer 37

Tricuspid regurgitation

Question 38

Late systolic at apex radiating to axilla

Answer 38

Mitral prolapse

Question 39

Mid-systolic click

Answer 39

Mitral prolapse

Question 40

Continuous, machine-like murmur

Answer 40

PDA

Question 41

What is the transposition of great vessels

Answer 41

RV --> aorta, LV --> pul artery

Question 42

Baby born cyanosed

Answer 42

Transposition of great vessels

Question 43

Dyspnoea, exercise intolerance, atrial arrhythmias, pulmonary mid-systolic murmur with RV heave

Answer 43

Atrial septal defect

Question 44

3 types of ASD

Answer 44

Sinus venous defect, ostium secundum defect, ostium primium

Question 45

Sinus venous defect, where?

Answer 45

Superior septum near SVC, inferior septum near IVC

Question 46

Ostium secundum defect

Answer 46

Mid-septum (fossa ovals)

Question 47

Ostium primium

Answer 47

Lower part of atrial septum

Question 48

What is the pattern of congenital heart defects?

Answer 48

Predominantly male (ASD and PDA females)

Question 49

Treatment of MS

Answer 49

Balloon valvotomy | Diuretics, B-blockers, digoxin

Question 50

Treatment of MR

Answer 50

Diuretics and ACEI | Surgery

Question 51

Treatment of AS

Answer 51

Balloon valvotomy (/TAVI for frail)

Question 52

Treatment of AR

Answer 52

Diuretics and ACEI

Question 53

Caused by Marfan's or UC

Answer 53

Aortic regurgitation

Question 54

Caused by SLE

Answer 54

Aortic regurgitation