Pedia 3B - Applied Cardio

Question 0

Systolic murmur starting a few ms into systole, peaking in mid-systole and ending before second heart sound =

Answer 0

Mid-systolic murmur “Flow Murmur”

Early systolic = Ejection murmur

Question 1

Splitting of 2nd heart sound is best appreciated

Answer 1

Pulmonic Area

2nd Upper left sternal border

Question 2

Louder murmur w/thrill

Answer 2

Grade IV

INSERT Grades here 
I 
II 
III loudest w/o thrill 
IV louder w/thrill 
V Audible w/portion of diaphragm off chest 
VI Audible w/stethoscope held off chest

Question 3

Thrill and radiation of murmur away from point of origin indicate an ______ murmur

Answer 3

Organic

Question 4

Twaning string murmur of Still is musical and best heard

Answer 4

Mid-precordium

Left of lower sternum

Question 5

Apex beat corresponds to ___-most and ____-most point of cardiac impulse

Answer 5

Lowermost

Outermost

Question 6

High frequency heart sounds are best heard w/the ____ of the stethoscope
Low frequency heart sounds are best heard w/the ____ of the stethoscope

Answer 6

High frequency - Diaphragm

Low frequency - Bell

Question 7

Clicking sound in diastole immediately ff 2nd sound (indicating stenotic mitral valve w/mobile anterior leaflet:

Answer 7

Opening snap

Question 8

Purring sensation under palm over precordium in the presence of certain organic heart diseases is called

Answer 8

THRILL

Question 9

First heart sound is short and sharp and caused by simultaneous closure of the

Answer 9

Mitral
Tricuspid valve

2nd Heart Sound - Pulmonary and Aortic Valves
3rd -
4th -

Question 10

Chest circumference < Head in the first _____ months

Answer 10

4-6 or 9-12 depending on where in Silverman

Question 11

Dullness of percussion is noticed normally over the liver on the right side at the

Answer 11

10th intercostals space on midclavicular line
8th rib on mid-axillary line
10th rib posteriorly

Question 12

3rd Heart sound

• Normally heard during _____ over the ____ area
• Best heard when patient is in the _____ position
• Loudest during ______
• _______ intensity is often associated w/hyperdynamic state

Answer 12

3rd Heart sound

• Normally heard during diastole over the apex area
• Best heard when patient is in the LLD position
• Loudest during EXP
• INC intensity is often associated w/hyperdynamic state

Question 13

Continuous musical sound which may be high-pitched or low-pitched

Answer 13

Wheezes

Question 14

To-and-fro murmur over L infra-clavicular area radiating to 2nd and 3rd L intercostal spaces para-sternally is seen in

Answer 14

PDA

Question 15

Clinical Observation: 4 month old w/head > chest

Clinical Conditions:

Answer 15

Normal

H>C up to 6 months

Question 16

Clinical Observation: 12 month old w/Head > Chest

Clinical Conditions:

Answer 16

Marasmus

Hydrocephalus

Question 17

Clinical Observation: Rapid pulse during INSP and slower at EXP
Clinical Conditions:

Answer 17

Sinus arrhythmia

Question 18

Clinical Observation: Noisy musical sound on respiration heard even w/o stethoscope
Clinical Conditions:

Answer 18

Wheeze

Question 19

Clinical Observation: Unsteady gait secondary to failure of muscle coordination
Clinical Conditions:

Answer 19

Ataxia

Question 20

Vocal Fremitus DEC in which

• Atelectasis
• Pleural Effusion
• Consolidation

Answer 20

Atelectasis

Pleural effusion

Question 21

Percussion is a ______ method in examining heart size

• Poor
• Preferred

Answer 21

POOR

Question 22

Splitting of 2nd heart sound is best heard over the

Answer 22

Pulmonary Area

Question 23

Murmur heard throughout systole

Answer 23

Holosystolic

• VSD
• MR

Question 24

______ murmur ALWAYS indicates a PATHOLOGICAL state

Answer 24

Diastolic Murmur = ABNORMAL

Question 25

Abdominal Breathing is normal until ____ years old

Answer 25

4-5 years old

Question 26

Pigeon chest

Answer 26

Rickets

Question 27

Head bobbing is synchronous w/patient's respiration

Answer 27

Bobbing - Respiration Nodding - Heart Rate DOUBLE CHECK

Question 28

Manifests w/visible pulsations on R side of chest - Dextrocardia - Scoliosis - R Pneumothorax - Enlarged R V

Answer 28

Dextrocardia Scoliosis Enlarged R V

Question 29

2nd heart sound accentuated in

Answer 29

Pulmonary HPN

Question 30

3rd heart sound is heard in

Answer 30

Normal adolescent | _____ ????

Question 31

Percussion in children may be useful in finding - Heart size - AR - Pericardial effusion - MS

Answer 31

Pericardial effusion

Question 32

PDA characterized by

Answer 32

CONTINUOUS murmur

Question 33

Murmur: Pulmonary Stenosis | Systolic/Diastolic:

Answer 33

Systolic

Question 34

Murmur: Aortic Stenosis | Systolic/Diastolic:

Answer 34

Systolic

Question 35

Murmur: Mitral stenosis | Systolic/Diastolic:

Answer 35

Diastolic

Question 36

Murmur: Aortic regurgitation | Systolic/Diastolic:

Answer 36

Diastolic

Question 37

Murmur: Mitral Regurgitation | Systolic/Diastolic:

Answer 37

Systolic

Question 38

Murmur: Functional murmur | Systolic/Diastolic:

Answer 38

Systolic

Question 39

Murmur: Atrial Septal Defect | Systolic/Diastolic:

Answer 39

Systolic

Question 40

Fremitus: INC | Clinical Implication:

Answer 40

Consolidation | Lobar Pneumonia

Question 41

Fremitus: DEC/Absent | Clinical Implication:

Answer 41

Pleural Effusion Pleural Thickening Pneumothorax Atelectasis

Question 42

Vocal resonance is ____ in emphysema

Answer 42

DECREASED

Question 43

__________ crackles are indicative of restrictive lung disease

Answer 43

End/Late INSP crackles

Question 44

End/Late INSP crackles are indicative of

Answer 44

Restrictive lung disease Interstitial Pneumonia

Question 45

Abdominal respiration is expected until _____ years old

Answer 45

4-5 years old

Question 46

Chest expansion can be accurately measured using a

Answer 46

Tape measure

Question 47

In ______ brochovesicular breath sounds are normally heard over the entire chest wall

Answer 47

Neonates

Question 48

Indications of upper airway obstruction (3)

Answer 48

INSP stridor Supra-sternal retractions Supra-clavicular retractions