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PE midterm > Cardio 2 > Flashcards

Cardio 2 Flashcards

1
Q

What bony structure does the aorta pass beneath?

A

manubrium

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2
Q

What is considered normal JVP height?

A

<5cm

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3
Q

what is normal BP?

A

<120/80

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4
Q

what is pre-HTN?

A

120-139/80-89

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5
Q

What is stage 1 HTN?

A

140-159/90-99

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6
Q

What is stage 2 HTN?

A

>160/>100

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7
Q

What happens to pulse and BP as we age?

A

pulse decreases, BP increases

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8
Q

what are heaves/lifts?

A

very strong beats that can be visualized with inspection

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9
Q

what eye changes are associated with hepatic congestion?

A

scleral icterus, scleral jaundice

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10
Q

what disease states are edema of the eyes associated with?

A

HF, low protein states, nephrotic syndrome

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11
Q

What respiratory condition does not cause clubbing?

A

COPD

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12
Q

what grade murmur presents with thrill?

A

at least 4/6

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13
Q

What part of the hand is used to palpate a thrill?

A

palmar aspect of MCP joints

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14
Q

When should the carotid be palpated on PE?

A

during initial auscultation to match up systole

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15
Q

What is auscultated with the patient in left lateral decubitus position?

A

the apex with the bell

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16
Q

where are mitral murmurs heard best?

A

left lateral decubitus position

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17
Q

When can S2 splitting best be heard?

A

patient sitting and leaning forward during full exhalation - listen of aortic and pulmonic areas with diaphragm

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18
Q

what can cause a murmur?

A

increased flow over a normal valve, partially obstructed flow (stenosis), regurgitation, flow into a dilated chamber, shunting

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19
Q

grade 1/6 murmur

A

very faint, barely audible

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20
Q

grade 2/6 murmur

A

clearly audible but quiet

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21
Q

grade 3/6 murmur

A

moderately loud

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22
Q

grade 4/6 murmur

A

loud-palpable thrill

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23
Q

grade 5/6 murmur

A

very loud, may be heard with the stethescope partially off the chest

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24
Q

grade 6/6 murmur

A

may be heard without a stethescope

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25
Q

what does a pericardial friction rub sound like?

A

triphasic - 2 atrial and 1 ventricular

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26
Q

what causes mechanical clicks?

A

prosthetic valves (prosthetic aortic valve heard in S2

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27
Q

what are the 3 layers of an artery

A

intima, media (SM), adventitia

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28
Q

What is an atheroma?

A

begins in the intima as a lipid filled foam cell that turns into fatty streaks which weaken the media and are covered with a fibrous smooth muscle and collagen matrix - rupture = thrombosis

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29
Q

true or false: veins are distensable and contain twice as much blood

A

TRUE

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30
Q

Why don’t veins develop atheromas?

A

they don?t have an endothelial intima

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31
Q

what is a variscosity of the testes called?

A

variocele

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32
Q

what allows veins to respond to physiologic changes?

A

elastic tissue and smooth muscles

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33
Q

Which veins carry most of LE blood?

A

deep veins (90%)

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34
Q

what are the superficial leg veins?

A

greater and small saphenous

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35
Q

which vein is used for bypass grafting?

A

greater saphenous

36
Q

What type of pressure mediates interactions between arterioles, venules and lymph?

A

hydrostatic

37
Q

if there is a cool limb what does it mean?

A

arterial insufficiency

38
Q

What bony prominences are palpated over to check for peripheral edema?

A

medial malleolus, lateral malleolus, pre-tibial, dorsum of foot

39
Q

Grade 1+ pitting edema

A

slight, disappears rapidly (2mm)

40
Q

grade 2+ pitting edema

A

deeper than 1+, disappears in 10-15 seconds (4mm)

41
Q

grade 3+ pitting edema

A

noticeably deep, >1minute, extremely swollen (6mm)

42
Q

grade 4+ pitting edema

A

deep pit, lasts 2-5 minutes, gross swelling (8mm)

43
Q

where can pitting be observed?

A

dependent areas: feet, lower back, anisarka = pitting all over

44
Q

where is one of the first places to pit in CHF?

A

penis/scrotum

45
Q

does lymphedema pit?

A

no

46
Q

what causes lymphedema?

A

lymphatic dysfunction of disturbance in hydrostatic or osmotic pressures

47
Q

what disease is characterized by severe lymphedema?

A

elephantitis

48
Q

what position is the patient in to check for varicose veins?

A

standing - use compression to map the vein

49
Q

when are carotid upstrokes present?

A

aortic stenosis

50
Q

where is the internal jugular vein located?

A

between the 2 heads of the SCM

51
Q

what angle should the bed be in during JVP testing?

A

30 degrees, distension decreases as head and torso are elevated

52
Q

define bruit

A

audible vibrations caused by partial obstruction of flow

53
Q

why does the pt hold their breath when auscultating bruits?

A

to reduce tracheal sounds

54
Q

what end of the stethescope should you use to auscultate bruits?

A

the bell

55
Q

What are the most common sites for arterial auscultation?

A

temporals, carotids, renal arteries, abdominal aorta, iliacs, femorals

56
Q

what can a bruit indicate?

A

stenosis, aneurysm

57
Q

what are the restroperitoneal organs?

A

ureters, kidneys, aorta, duodenum, pancreas (best heard on the back)

58
Q

normal adult heart rate

A

70-100

59
Q

what types of rhythm could be present?

A

regular, regularly irregular, irregularly irregular

60
Q

no more than 3 PVCs in a row and … in a minute

A

6

61
Q

grade 4+ pulse

A

bounding, increased (aortic stenosis and regurgitation)

62
Q

grade 3+ pulse

A

full, increased

63
Q

grade 2+ pulse

A

expected

64
Q

grade 1+ pulse

A

diminished (HOTN, syncope)

65
Q

grade 0 pulse

A

absent, not palpable - check with doppler

66
Q

what pulses are gathered on PE?

A

carotid, brachial, radial, femoral, popliteal, dorsalis pedis, posterior tibial

67
Q

what should be done before palpation of the carotid?

A

auscultate for bruits

68
Q

if dorsalis pedis pulse is present what other pulse should be present?

A

posterior tibial - due to collateral circulation

69
Q

6 P’s of acute arterial occlusion

A

pain, pallor, pulselessness, paresthesias, paralysis, poikilothermia

70
Q

what is compartment syndrome?

A

increased pressure in a compartment

71
Q

causes of acute arterial occlusion

A

snake bites, afib, IE, pelvic fracture, aneurysm, arterial dissections, fat embolism, trauma

72
Q

what arteries does acute mesenteric ischmia affect?

A

superior/inferior mesenterics

73
Q

what pressure is diagnostic of compartment syndrome?

A

>15mmHg

74
Q

skin changes in chronic arterial insufficiency?

A

prolonged capillary refill, loss of hair, thinning of skin, shiny skin, dependent rubor, painful ulcers

75
Q

PVD warning signs

A

claudication, fatigue, erectile dysfunction, poorly healing LE wounds, rest pain in foot or LE

76
Q

describe the appearance of a chronic arterial ulcer

A

painful, punched out, smaller, diminished pulses, distal coldness

77
Q

describe the appearance of a diabetic ulcer

A

punched out over malleoli and plantar feet - painless

78
Q

what can cause stasis ulcers

A

poor circulation common with CVD - dermatitic first, wide and undulating adges with clean base

79
Q

signs of DVT

A

warmth, erythema, posterior calf tenderness, Homan’s sign, swelling (measure circumference)

80
Q

how to r/o DVT?

A

2 negative US

81
Q

what is the normal diameter of an infrarenal aorta?

A

>3cm

82
Q

what diameter is it necessary to intervene with a AAA

A

>5.5cm

83
Q

risk factors for AAA?

A

>65, smoking, CVD, PVD, HTN, hyperlipidemia

84
Q

who should be screened for AAA?

A

smokers >65 with US

85
Q

when should pts be referred with AAA?

A

>4cm, palpable, enlargements

86
Q

description of AA on XR?

A

ballooning with calcifications

PE midterm (10 decks)

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