Physical Diagnosis Shelf

Question 1

bitter almond breath

Answer 1

cyanide poisoning

Question 2

garlic breath

Answer 2

arsenic and parathion

Question 3

rotten egg breath

Answer 3

hydrogen sulfide mercaptans

Question 4

camphor breath

Answer 4

naphthalene

Question 5

first line tx for pericarditis

Answer 5

NSAIDs

Question 6

common cause of split S1

Answer 6

RBBB (causes delayed tricuspid valve closure)

Question 7

murmur in young adult in neck (internal jugular vein), in diastole, sitting

Answer 7

venous hum

Question 8

patients w/ ST elevation MI need what procedure

Answer 8

percutaneous coronary intervention

Question 9

first thing to give in acute MI

Answer 9

chewable aspirin or other anti platelet agent

Question 10

pressure on liver causes distended neck veins. what valve disorder?

Answer 10

tricuspid regurg

Question 11

what heart sound will you not have with a fib

Answer 11

S4 (associated w/ effective atrial contraction)

Question 12

which heart sound indicates impairment of ventricular function

Answer 12

S3

Question 13

what to do to diagnose arterial occlusion

Answer 13

ankle brachial index (compare systolic pressures)

Question 14

two strong systolic pulse waves

Answer 14

pulsus bisferiens

Question 15

pulsus bisferiens caused by

Answer 15

aortic insufficiency

hypertrophic cardiomyopathy

Question 16

pulsus alternans (one large and one small pulse) seen in

Answer 16

LV decompensation

cardiac tamponade

Question 17

diastolic sound variable from cycle to cycle

Answer 17

atrial myxoma

Question 18

harsh, holosystolic murmur at left lower sternal border

Answer 18

VSD

Question 19

systolic murmur and fixed split S2

Answer 19

ASD

Question 20

JVD doesn’t fall with inspiration

Answer 20

constrictive pericarditis

Question 21

diff bp on left and right arms

Answer 21

aortic dissection

Question 22

exaggerated a waves due to

Answer 22

right atrium contracting against increased resistance (PS, TS, complete heart block)

Question 23

what venous wave is not present in a fib

Answer 23

a wave

Question 24

a wave signifies

Answer 24

vnous dissension caused by atrial contraction

Question 25

c wave signifies

Answer 25

ventricular contraction, which forces TV back toward atrium

Question 26

what venous waveform corresponds to the carotid pulse

Answer 26

c wave

Question 27

large v wave signifies

Answer 27

TR

Question 28

downward x slow signifies

Answer 28

atrial filling

Question 29

y slope signifies

Answer 29

open TV and rapid filling of ventricle

Question 30

hypotension + soft or absent heart sounds + JVD

Answer 30

cardiac tamponade

Question 31

best way to dx abdominal aortic aneurysms

Answer 31

abdominal US

Question 32

best way to dx thoracic aortic aneurysms

Answer 32

transthoracic echo

Question 33

autoimmune complication after MI

Answer 33

dressler syndrome

Question 34

standing decreases all murmurs except

Answer 34

MVP hypertrophic cardiomyopathy

Question 35

fixed splitting of S2

Answer 35

ASD

Question 36

coarse holosystolic murmur in 3rd to 5th interspaces on LSB, often with thrill or heave

Answer 36

VSD (can be caused by MI)