Cardiac

Question 1

Systolic Murmurs

Answer 1

Mitral regurgitation and aortic stenosis (heard at 2nd right ICS radiating to neck)

Occur between S1 and S2

Associated with mechanical systolic and ventricular ejection

Question 2

Diastolic Murmurs

Answer 2

Mitral stenosis and aortic regurgitation (blood flow from aorta to left ventricle, heard over right upper sternum/left 3rd ICS)

Occur after S2 and before S1

Associated with ventricular relaxing and filling

Question 3

HTN (the silent killer) Stages

Answer 3

Prehypertensive: 120-139/80-89

Stage 1: 140-150/90-99 (either one) in adults who aren’t acutely ill or on antihypertensive meds

Stage 2: >160/>100

Question 4

PVD

Answer 4

S/s: painful cramping, numbness, weakness and coldness of LE

RFs: 50yo, smoking and HLD

Question 5

Chronic venous insufficiency

Answer 5

S/s: brownish discoloration, cool to touch, aching relieved by elevation

Question 6

PE

Answer 6

S/s: CP into arm, jaw or neck, anxiety, clammy skin and irregular heart beat

Question 7

Pacemaker

Answer 7

Post op: can’t raise arms above for 2w and can’t play golf for 4w

Question 8

Left sided HF

Answer 8

Left ventricle pumps O2 rich blood to body

S/s: dyspnea, coarse rales (fluid overload),

Question 9

Right sided HF

Answer 9

Usually the result of left sided HF

s/s: systemic symptoms such as edema, abdominal fullness, hepatomegaly

Question 10

Diastolic HF

Answer 10

Resistance to filling of ventricles

S4 can be heard with diastolic HF, left ventricular hypertrophy and active MI

Question 11

Heart sounds

Answer 11

S1 and S2 are normal

S3 indicative of high fluid state such as pregnancy

• heard at apex/5th ICS
• blowing holosystolic murmur
• associated c mitral regurgitation
• serious causes mitral valve prolapse, heart defects, hx rheumatic fever and autoimmune diseases, HF

S4 can be heard with diastolic HF, left ventricular hypertrophy and active MI