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PCM II Exam 1 > Pitcher > Flashcards

Pitcher Flashcards

1
Q

thrill

A

vibration - valve problem

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2
Q

LLSB

A

tricuspid

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3
Q

apex

A

mitral

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4
Q

2nd ICS right and left

A

aortic and pulmonic

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5
Q

left lateral decubitus

A

accentuates mitral murmurs

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6
Q

murmur

A

turbulence across valve

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7
Q

bruit

A

turbulence outside heart - periphery

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8
Q

grade 4/6

A

thrill palpable

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9
Q

grade 6/6

A

stethoscope OFF chest

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10
Q

grade 5/6

A

stethoscope partially off chest

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11
Q

aortic stenosis

A

radiate to carotid arteries
-bruit

carotid stenosis vs. aortic stenosis - listen to heart - if abnormal - aortic stenosis

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12
Q

atherosclerosis

A

bruit - if 70%

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13
Q

stills murmur

A

innocent

  • mid systolic, louder supine
  • in kids
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14
Q

S1

A

mitral and tricuspid

timed with carotid pulse

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15
Q

S2

A

aortic and pulmonic

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16
Q

split S1

A

normal variant or abnormal from RBBB or PVC

if both split

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17
Q

split S2

A

with inspiration - normal

wide or fixed - delayed pulmonic closure from stenosis, RBBB

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18
Q

S3

A

early diastolic
-kentucky

transition of rapid to slow ventricular filling

LV myocardial damage causing systolic dysfunction from dilated cardiomyopathy**

sudden limitation of normal ventricular relaxation during filling stage in diastole

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19
Q

S3

A

with MI

-to CHF

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20
Q

S4

A

vibration of LV from atrial kick

  • hits less compliant ventricular wall
  • thicker heart**
  • poorly treated HTN

aortic/pulmonic stenosis, HTN, MI wall damage, thick ventricle wall from higher work load, and some stiffening

decreased ventricular distensibility

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21
Q

transmits to carotids

A

aortic stenosis

-dyspnea on exertion, angina, syncope

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22
Q

aortic stenosis

A

systolic crescendo/decrescendo pattern

often associated S4

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23
Q

gallop rhythm

A

all 4 sounds

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24
Q

ejection click

A

sound occurring moment of max pressure with sudden tensing of a valve root

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25
aortic ejection click
early systolic - onset of left V ejection - aortic root suddenly stretched dilated aneurysm, coarc, HTN
26
aortic regurg
austin-flint early diastolic - high pitch blowing decrescendo dilates LV - S3 high puls pressure rheumatic disease, congenital bicuspid valve, endocarditis
27
pulmonic ejection click
early systole pulmonary HTN, aneurysm dilation sudden root tensioning
28
pulmonic stenosis
systolic crescendo-decrescendo 2nd ICS left exertional dyspnea, chest pain, syncope can hear S4 usually congenital
29
graham steel
pulmonic regurg softer diastolic decrescendo from pulmonary HTN
30
tricuspid regurg
holosystolic at left sternal border high pitch, blowing no radiation inspiration accentuates murmur
31
mitral valve opening snap
diastole -snap to LV right before atrial blood flows in stenotic mitral leaflets
32
mitral valve stenosis
diastolic murmur - opening snap pulmonary HTN, elevated JVP, RV hypertrophy
33
group A beta hemolytic strep and strep viridans
mitral valve subacute endocarditis
34
mitral valve prolapse
mid systolic click followed by murmur high pitch / short murmur - mitral regurg increased with valsalva decreased with valsalva release young women, anxious, panic attacks
35
valsalva
decreased volume getting to heart
36
mitral valve regurg
holosystolic murmur loud, high pitch, at apex radiates to left axilla
37
rheumatic heart disease
mitral valve
38
machine like
patent ductus arteriosus
39
apex
mitral murmurs
40
pulmonic area
pulmonic murmurs ASD PDA
41
obstructive cardiomyopathy
thicker IV septum systolic murmur can be heard
42
leaning forward
accentuate aortic murmurs and pericarditis
43
squatting
increases venous return decrease mitral prolapse increase aortic stenosis lessens hypertrophic obstructive cardiomyopathy
44
standing
decreased venous return increased mitral prolapse reduce aortic stenosis increases hypertrophic cardiomyopathy
45
valsalva
decreased venous return
46
IHSS
idiopathic hypertrophic subaortic stenosis hypertrophic obstructive cardiomyopathy LV and IV septum hypertrophy sudden cardiac death exercise induced dyspnea, angina, or syncope
47
hypertrophic obstructive cardiomyopathy
systolic ejection murmur - left sternal border and apex - increased with standing and valsalva (vs. aortic stenosis) sudden death potential
48
only systolic murmur increasing with valsalva
murmur of IHSS
49
PDA
fistula - aorta and pulmonary a machine like murmur 2nd ICS
50
innocent after PDA closes
systolic ejection | -majority - benign pulmonary branch stenosis
51
path murmur in kid
loud (>grade 3) harsh pan systolic
52
pericardial knock
constrictive pericarditis diastolic - blood to ventricles stops abruptly - vibrates wall
53
rub
inflamed pericardial surfaces more in systole accentuate - lean forward
54
TTE
transthoracic echo
55
TEE
transesophageal echo
56
third spacing
body effort to lower work load on heart by pushing fluid out of artery and vein - often lower legs, lungs
57
tilting disc valve
anticoag for life
58
small dense LDL
worst
59
intermittent claudication
occlusive arterial disease of limbs with walking - goes away when rest mechanism - ischemia poor pulses, ulcers, palor, cool, shiny, hairless skin, bruit A/B ratio <0.9 - Dx** Tx - stop smoking
60
severe PAD
ABI < 0.4
61
normal ABI
0.9-1.3
62
pseudoaneurysm
dilation or hematoma that may or may not involve layers of vessel wall -contained and does not dissect
63
true aneurysm
involve all three layers of vessel wall
64
aneurysm treatment
beta blockers elective graft
65
raynaud
paroxysmal constriction/dilation of small arteries/arterioles 80% women disease - no association phenomenon - associated with other disorders - ie/ scleroderma**
66
scleroderma
with raynauds
67
vasculitis
inflammation and damage to vessels large vessel - takayasu medium - polyarteritis nodosa / wegeners small - henoch schonlein
68
polyarteritis nodosa
necrotizing vasculitis of medium arteries fatigue, weakness, fever, weight loss HA, abdominal pain, elevated ESR, elevated neutrophil WBC count Dx confirmed by biopsy**
69
4 main risk factors with vascular disease
HTN DM hyperlipidemia smoking
70
PAD
disease of ischemia in peripheral artery
71
how long listen at each post
2-3 beats
72
onset of systole
S1 closure of mitral valve
73
open during diastole
tricuspid and mitral
74
split S2
inspiration | -right heart filling
75
well trained athletes
S4
76
early dilated HF
S3
77
first to identify when listening to murmur
ID S1 and S2
78
crescendo decrescendo
aortic | pulmonic
79
common presentation of mitral prolapse
palpitations anxious young woman at risk for arrhythmia - dilated left atria
80
31yo SOB, bronchitis 5 days ago, lungs CTA, comfy sitting up and leaning forward
pericarditis
81
imaging for abdominal aneurysm
ultrasound MRA

PCM II Exam 1 (6 decks)

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