Week 7

Question 1

S1

Answer 1

ventricular contraction
closure of Tricuspid and Mitral valves
time it with carotid pulse to identify

Question 2

S2

Answer 2

Closure of Aortic and Pulmonic valves

ventricular filling

Question 3

S3

Answer 3

ventricular filling may cause this

Question 4

S4

Answer 4

May be produced by atrial contractions

Question 5

sinus 6 syndrome

Answer 5

malfunction of the sinus node

may cause arrhythmia

Question 6

systole

Answer 6

contraction

Question 7

diastole

Answer 7

relaxation

Question 8

lipid profile screening

Answer 8

every 5 years starting at age 20

Question 9

CHADS2 scores

Answer 9

Afib & stroke risk

Question 10

split S1

Answer 10

Usually normal,

best heard in tricuspid area

Question 11

split S2

Answer 11

physiologic if it resolves with deep expiration

Question 12

pediatric chest pain

Answer 12

usually musculoskeletal, pleuritic, GI

Question 13

thrill

Answer 13

turbulent blood flow

Question 14

coarction of aorta

Answer 14

pulses stronger in upper extremities than lower extremities

Question 15

Chest XR

Answer 15

size, shape, congestion

Question 16

ECG

Answer 16

identify rate, rhythm,

Question 17

echo

Answer 17

shows congenital defects

Question 18

Screening for LVH

Answer 18

increases risk for sudden cardiac death

would need echocardiogram for every patient

Question 19

Hypertension screening

Answer 19

start at age 3

Question 20

Cyanotic Heart Disease

Answer 20

Pulmonary artery stenosis 
Pulmonary atresia 
Tetralogy of fallot 
Tricuspid atresia
truncus arteriosus 
hypoplastic L heart syndrome
transposition of great arteries

Question 21

Acyanotic heart disease

Answer 21

blood shunts L to R which is less dangerous. 
Oxygenated blood is coming back over to deoxygenated side
patent ductus arteriosus 
atrial-septal defect
Ventricular septal defect
Coarction of aorta 
Aortic stenosis 
Pulmonary Artery stenosis 
Patent foramen ovale

Question 22

Patent ductus arteriosus

Answer 22

in utero, shunts blood away from lungs so ti bypasses lungs

shunts into hole in aorta

Question 23

Tricuspid atresia

Answer 23

blood cant get through into ventricle, so it goes into L side of heart (where deoxygenated blood is)

Question 24

Truncus arteriosus

Answer 24

Great vessels don’t develop as they should

Question 25

hypoplastic L heart syndrome

Answer 25

not compatible with life | L side way smaller than R side

Question 26

Transpositions of Great Arteries

Answer 26

aorta and pulmonary artery are flip-flopped, leads to cyanosis

Question 27

coarction of aorta

Answer 27

aorta is tortuous

Question 28

Ventricular septal defect

Answer 28

hole in septum of ventricles

Question 29

atrial-septal defect

Answer 29

hole in septum between atrium | left pumps to right- ok since its oxygenated blood going into deoxygenated blood

Question 30

Patent foramen ovale

Answer 30

opening between septal walls of the 2 chambers of the heart | ok because L side has higher pressure

Question 31

R to L shunt

Answer 31

dangerous because deoxygenated blood flows into pulmonary system

Question 32

JVP

Answer 32

reflects right atrial pressure, which in turn equals central venous pressure + R ventricular end diastolic pressure

Question 33

Syndromes caused by acute myocardial ischemia

Answer 33

Unstable angina, non ST elevation MI, ST elevation MI

Question 34

Acute Aortic Dissection

Answer 34

anterior chest pain, often tearing or ripping pain into back or neck

Question 35

Causes of Swelling

Answer 35

R or L ventricular dysfunction, pulmonary htn, obstructive lung disease

Question 36

anasarca

Answer 36

severe generalized edema extending to sacrum and abdomen

Question 37

6 Criteria for preventing heart disease

Answer 37

``` Lean BMI not smoking physically active, healthy diet untreated total cholesterol <200 untreated BP <120/80 fasting BG <100 ```

Question 38

JVP pulse

Answer 38

best assessed in R internal jugular vein dominant movement is inward

Question 39

absent a waves

Answer 39

aFib

Question 40

increased V waves

Answer 40

tricuspid regurgitation atrial septal defects constrictive pericarditis

Question 41

Causes of decreased carotid pulsations

Answer 41

decreased stroke volume (shock, MI) local atherosclerotic narrowing pressure on carotid sinus (bradycardia, drop in BP)

Question 42

Pulsus Alternans

Answer 42

Pulse is regular bigeminal pulse that varies beat to beat paradoxical pulse, varies with respiration Alternating loud + soft Korotkoff sounds indicates left ventricular failure

Question 43

Paradoxical Pulse

Answer 43

a difference between levels of 10 to 12 mmHg | acute asthma, COPD, acute PE, pericardial tamponade

Question 44

Bruit

Answer 44

Caused by atherosclerotic stenosis, tortuous carotid artery | do not correlate with any clinically significant diseases

Question 45

High pitched cardiac sounds

Answer 45

S1, S2, murmurs of aortic and mitral regurgitation, pericardial friction rubs *use diaphragm

Question 46

Low pitched sounds

Answer 46

S3, S4, mitral valve murmurs *use bell

Question 47

Auscultory sounds

Answer 47

S1 louder with rapid heart rates | S2 persistently single

Question 48

Expiratory splitting

Answer 48

valvular abnormality

Question 49

P2

Answer 49

suggests pulmonary htn

Question 50

most common extra heart sound

Answer 50

systolic click of mitral valve prolapse

Question 51

Diastolic murmurs

Answer 51

reflect regurgitant

Question 52

Bisferiens Pulse

Answer 52

normal beat alternating with premature contraction increased arterial pulse with double systolic peak causes: aortic regurgitation