Cardio

Question 1

Physiologic splitting occurs in normal physiology during _______ and is secondary to delayed closure of the _______ valve from the ________ ventricle

Answer 1

Occurs during inspiration
pulmonic valve
Right ventricle

Question 2

Wide splitting is seen in conditions that delay ______ ventricle emptying

Answer 2

RIGHT

Question 3

What are some causes of wide splitting?

Answer 3

Pulmonic stenosis
Right BBB

***delays the pulmonic sound

Question 4

Fixed splitting is heard in ______

Answer 4

ASD

Question 5

Paradoxical splitting is heard in conditions that delay ______ valve closure

Answer 5

Aortic

Question 6

What are some of the causes of paradoxical splitting

Answer 6

Aortic Stenosis

LBBB

Question 7

What does a paradoxical split sound like on auscultation?

Answer 7

P2 occurs before the A2 sound

Can be heard with expiration

Question 8

What does the standing valsalva maneuver do to the CV system?

Answer 8

Decreases preload and decreases the LV volume

Question 9

What murmurs will increase with the standing valsalva maneuver?

Answer 9

Mitral Valve prolapse

Hypertrophic cardiomyopathy

Question 10

What murmurs will decrease with the standing valsalva maneuver?

Answer 10

Most murmurs

Question 11

What is the CV effect of the passive leg raise?

Answer 11

Increases preload

Question 12

What murmurs will increase with the passive leg raise?

Answer 12

Most murmurs

Question 13

What murmurs will decrease with the passive leg raise

Answer 13

MVP

hypertrophic cardiomyopathy

Question 14

What is the CV effect of squatting?

Answer 14

Increases the preload

Increases the after load

Question 15

What murmurs will increase with squatting?

Answer 15

Most murmurs

Question 16

What murmurs will decrease with squatting?

Answer 16

MVP

hypertrophic cardiomyopathy

Question 17

What is the effect of the hand grip maneuver on the CV system?

Answer 17

Increases the after load

Question 18

What murmurs will increase with the hand grip maneuver?

Answer 18

Left sided murmurs: AR, MR, VSD

Question 19

What murmurs will decrease with the hand grip maneuver?

Answer 19

AS

hypertrophic cardiomyopathy: increased LV volume

Question 20

What is the effect of inspiration on the CV system?

Answer 20

Venous return to the right heart and decrease venous return to the left

Question 21

What murmurs will increase with inspiration?

Answer 21

Right sided murmurs

Left sided will decrease

Question 22

This murmur is a crescendo decrescendo systolic ejection murmur that is loudest at the base and radiates to the carotids

Answer 22

aortic Stenosis

Question 23

Describe aortic stenosis murmur

Answer 23

This murmur is a crescendo decrescendo systolic ejection murmur that is loudest at the base and radiates to the carotids

Question 24

What are some of the symptomatic findings that can be seen with aortic stenosis?

Answer 24

Syncope
Angina
Dyspnea

Question 25

What are the main causes of aortic stenosis?

Answer 25

Aging- calcification | bicuspid valve like in Turner syndrome

Question 26

This murmur is a holosystolic blowing murmur that is high pitched and is loudest at the apex with radiation to the axilla

Answer 26

mitral regurgitation

Question 27

What are some of the causes of mitral regurgitation?

Answer 27

Post MI MVP LV dilation Rheumatic fever or infective endocarditis can cause

Question 28

Describe a mitral regurgitation murmur

Answer 28

This murmur is a holosystolic blowing murmur that is high pitched and is loudest at the apex with radiation to the axilla

Question 29

This murmur is a holosystolic blowing murmur that is high pitched and is loudest at the tricuspid area

Answer 29

Tricuspid regurgitation

Question 30

What are some causes of Tricuspid regurgitation?

Answer 30

RV dilation Rheumatic fever or infective endocarditis can cause

Question 31

Describe a Tricuspid regurgitation murmur

Answer 31

This murmur is a holosystolic blowing murmur that is high pitched and is loudest at the tricuspid area

Question 32

This murmur is a late systolic crescendo murmur with a mid systolic click. It is best heard over the apex and is loudest before S2

Answer 32

mitral valve prolapse

Question 33

What causes the mid systolic click?

Answer 33

sudden tensing of the chordae tendonae as mitral leaflets prolapse into the LA

Question 34

What are some of the causes of a mitral valve prolapse?

Answer 34

myxomatous degeneration connective tissue disorder rheumatic fever chordae rupture Can predispose to infectious endocarditis

Question 35

This murmur is a holosystolic harsh murmur that is loudest at the tricuspid area

Answer 35

Ventricular septal defect

Question 36

What are the systolic murmurs>

Answer 36

aortic stenosis mitral or tricuspid regurgitation mitral valve prolapse VSD

Question 37

This murmur is a high pitched blowing early diastolic decrescendo murmur that is best heard at the base or the left sternal border

Answer 37

Aortic regurgitation

Question 38

What are some of the associated symptoms with aortic regurgitation?

Answer 38

When severe or chronic can present as a long diastolic murmur with a hyper dynamic pulse. Head bobbing can also be seen Wide pulse pressure

Question 39

What are some of the causes of aortic regurgitation?

Answer 39

bicuspid aortic valve endocarditis aortic root dilation rheumatic fever

Question 40

This murmur is a mid to late systolic murmur that follows an opening snap

Answer 40

Mitral stenosis

Question 41

__________ interval with S2 and opening snap correlates with ___________ severity (increased or decreased)

Answer 41

Decreased interval with S2 and opening snap correlates with increased severity

Question 42

What are the causes of mitral stenosis

Answer 42

late sx of rheumatic fever Chronic MS Afib Ortner syndrome

Question 43

This murmur is a. continuous machine like murmur rear is best heard at the left infraclavicular area and is loudest at S2

Answer 43

PDA

Question 44

A patient comes into the office and a procedure is done where a catheter is inserted into the smallest branches of the pulmonary artery. What is this testing for? What does the result of this test tell you?

Answer 44

They are measuring the pulmonary wedge pressure Tells you the pressure that is in the left atria