APEA Cardiovascular Flashcards
The great saphenous vein enters the deep venous system by way of the:
Inferior vena cava
iliac vein
popliteal vein
femoral vein
femoral vein
The great saphenous vein, which originates on the dorsum of the foot, joins the femoral vein of the deep venous system below the inguinal ligament
What heart sounds are heard during auscultation of a man with Marfan syndrome who has a known mitral valve prolapse?
An opening snap
a mid-systolic click
a flat blowing pitch
a fourth heart sound (s4)
a mid-systolic click
A mid-systolic click is heard with MVP. An opening snap is consistent with mitral stenosis. Auscultation of AS involves a flat blowing pitch or a fourth heart sound.
What sound is heard with MVP?
how about MS?
AS
APEA support card
MVP: mid-systolic click
MS: opening snap
AS: flat blowing pitch or a fourth heart sound
symptoms of orthostatic hypotension include all of the following except:
Syncope
unsteadiness
visual blurring
respiratory rate greater than 30
respiratory rate greater than 30
Pain with walking or prolonged standing, radiating from the spinal area into the buttocks, thighs, lower legs or feet may be seen with:
neurogenic claudication
intermittent claudication
atherosclerotic peripheral vascular disease
Raynaud’s disease
Neurogenic claudication
Intermittent claudication: Pain or cramping in legs that occurs with exertion and that is relieved with rest.
Atherosclerotic Peripheral artery disease: symptomatic limb ischemia with exertion.
Raynauds: numbness / tingling in distal fingers, made worse by cold or emotional stress
A patient presents with chest pain that radiates to the left side of the neck and down the left arm when he chops wood. This type of pain could be suggestive of:
an early onset myocardial infarction
angina pectoris
costochondritis
a dissecting aneurysm
angina pectoris
angina pectoris: exertional pain
MI: retrosternal type pain that radiates to neck, shoulder, jaw, and down to the ulnar aspect of the left arm
costochondritis:
A third heart sound (S3) is autible in a forty-five year old. This S3 may be:
normal for her age group
a sign of valvular heart disease
a sign of heart disease
associated with a jugular venous hum
a sign of valvular heart disease
after age 40, a thrid heart sound (s3) strongly suggests either ventrcular failure or volume overload of the ventricule from valvular heart disease, such as mitral regurgitation
a fourth sound (S4) = decreased ventricular compliance from heart disease.
A jugular venous hum could be associated with murmurs that originate in large blood vessels usually audible in children and young adults
Absent or diminished pulses in the wrist could be indicative of:
varicosities
right-sided heart failure
venous insufficiency
arterial occlusive disease
arterial occlusive disease
ex: buerger’s disease and/or ghromboangitis obliterans.
varicosities, venous insufficiency, and right sided heart failure are consistent with venous conditions
A characteristic finding in the elderly population is:
the increase in diastolic blood pressure after the sixth decade
a tendency toward developing postural hypertension
the development of heart rhythm changes leading to syncope
the susceptibility to hyperthermia
the development of heart rhythm changes leading to syncope
all options are common in the elderly except the one about diastolic
while auscultating the patients heart, a medium, soft murmur is audible. It is pansystolic and loudest at the apex with radiation to the left axilla. These findings are consistent with:
tricuspid regurtitation
mitral regurg
VSD
innocdent murmur
mitral regurgitation
Tricuspid regurgitation = murmur loudest at the left sternal border with radiation to the right sternal border, xiphoid area, or to the left midclavicular line. It produces a blowing sound and is pansystolic.
VSD: murmer high pitch, heard throughout systole
innocent murmur is loudest at mid systole near the second to fourth intercostal spaces between the left sternal border and the apex. It usually decreases or disappears while sitting.
To Assess aortic pulsations in patients with carotid obstruction, assess the pulse using the:
temporal artery
brachial artery
femoral artery
popliteal artery
brachial artery
aortic pulsations are most adcuratly assessed by palpating the carotid arteries. However, if the carotid arteries are obstructed, the brachial artery should be palpated to reflect aortic pulsation.
Pediatric patients with TOF have episoces of bluish skin during crying and feeding that are called:
tachypnea.
Dyspnea
tet spells.
Cheyne-stokes breathing
Tet spells
How long after myocardial infarction can the initial troponon level be detected?
1 hour
3 hours
6 hours
8 hours
3 hours
elevated trop starts at 2-3 hours, peaks at 24 hours and persists for weeks
symptoms of mild heart failure include:
nocturnal dyspnea.
Hypotension.
S3 gallop
frothy sputum
S3 gallop
early mild heart failure sx:fine crackles, S3 gallop, JVD, dyspnea on exertion, nocturia, tachycardia, fatigue and diminished exercise capacity, peripheral edema, weight gain.
Severe: hypotension, frothy sputum
Which of the following is NOT a Virchow’s triad risk factor for DVT?
Hypercoagulability.
Endothelial injury.
Stasis.
Peripheral nervous system damage
Peripheral nervous system damage
Virchow’s triad. Venous stasis, hypercoagulability and endothelial injury
