Cardiac OSCE

Question 1

normal carotid feels

Answer 1

like sharp knock

abnormal is weak nudge

Question 2

pulse alternans

Answer 2

alternating strong and weak pulses at femoral or radial

Question 3

water hammer pulse

Answer 3

due to large SV and blackflow of blood from aorta into LV

Question 4

paradoxical pulse

Answer 4

can be used to assess pericarditis or tamponade when there is varied pulse strength and amplitude as Pt breathes

Question 5

kussmaul’s sign

Answer 5

normal JVP shows decline in inspiration but wave amplitutde increases

if there is increased JVP or no change with JVP on inspiration this indicates impaired venous return to RA

Question 6

hyperkinetic impulse may occur

Answer 6

hyperthyroidism
severe anemia
pressure overload from ventricular hypertension or aortic stenosis
aortic regurg leading to volume overload

Question 7

aortic stenosis systolic, diastolic?

Answer 7

systolic

Question 8

aortic regurgitation systolic, diastolic?

Answer 8

diastolic

Question 9

mitral regurgitation systolic, diastolic?

Answer 9

systolic

Question 10

mitral stenosis systolic, diastolic?

Answer 10

diastolic

Question 11

pulmonary stenosis systolic, diastolic?

Answer 11

systolic

Question 12

pulmonary insufficiency systolic, diastolic?

Answer 12

diastolic

Question 13

tricuspid insufficiency systolic, diastolic?

Answer 13

systolic

Question 14

tricupsid stenosis systolic, diastolic?

Answer 14

diastolic

Question 15

straining/valsava causes

Answer 15

increased chance of hearing mitral regurgitation

Question 16

left lateral decubitis

Answer 16

increase chance of hearing mitral stenosis

Question 17

abdominojugular reflex

Answer 17

hepatojugular reflex

used as adjunct to measure JVP