CARDIO/EKG

Question 1

PR Interval > 0.2 seconds
asymptomatic, no tx

Answer 1

First degree AV block

Question 2

lengthening PR intervals until a ventricular beat is dropped “longer longer longer drop”
-PR interval resets itself

asymptomatic, no tx

Answer 2

Second degree Mobitz type 1 block, wenckebach

Question 3

PR interval constant before an “occasional” dropped QRS beat.
-some p waves do not produce QRS

**referred for permanent pacemaker

Answer 3

Second degree AV block, Mobitz 2

Question 4

P waves and QRS complexes, but NO association between the two (no association btw atria/ventricles)

*medical emergency, emergent meds: atropine

Answer 4

Third degree AV block, Complete heart block

Question 5

EKG leads V1-V2, SEPTAL

Answer 5

LAD

Question 6

EKG leads V3-V4, ANTERIOR

Answer 6

LAD

Question 7

EKG leads I, aVL, V5, V6- LATERAL

Answer 7

Left Circumflex

Question 8

EKG leads II, III, aVF- INFERIOR

Answer 8

Right Coronary

Question 9

EKG leads V1-V3, posterior leads V7-V9- POSTERIOR

Answer 9

Posterior descending artery

Question 10

Holosystolic High pitched
Loudest at apex, radiate to axilla

Answer 10

Mitral valve regurgitation

Question 11

Holosystolic High pitched
Loudest at LLSB

Answer 11

Tricuspid valve regurgitation

Question 12

crescendo-decrescendo systolic ejection
Loudest at heart base radiating to carotids

Answer 12

Aortic stenosis

Question 13

Holosystolic, harsh sounding murmur
Loudest at LLSB

Answer 13

VSD

Question 14

Late systolic crescendo with mid systolic click
best heard over apex

Answer 14

MVP

Question 15

High pitched early diastolic blowing decrescendo murmur
-pulsation of uvula orally: Muller sign
-pulsation of capillaries in fingernails w/ pressure: Quincke sign
-pulsating pistol shot heard over femoral arteries: Traube sign
-rapidly rise/falling arterial pulse w/ wide pulse pressure: Corrigan/ water hammer pulse

Answer 15

Aortic Regurgitation

Question 16

Opening snap with delayed rumble, late diastolic

Answer 16

Mitral stenosis

Question 17

Continuous machine like murmur
best heard at left infraclavicular area

Answer 17

PDA

Question 18

Systolic murmurs

Answer 18

MVR
TVR
AS
VSD
MVP

Question 19

Diastolic murmurs

Answer 19

AR
MS

Question 20

enhanced with expiration

Answer 20

Mitral stenosis

Question 21

enhanced with hand grip (3)

Answer 21

AR
VSD
MVR

Question 22

click occurs with valsalva or standing

Answer 22

MVP

Question 23

enhanced by inspiration

Answer 23

TVR

Question 24

DECREASED by valsalva

Answer 24

AS

Question 25

enhanced by squatting AND hand grip

Answer 25

MVR

Question 26

rheumatic heart disease (JONES) is result of immune mediated damage to what cardiac valve

secondary to streptococcal derived M protein activation of T and B lymphocytes (anti-streptolysin ab, elevated streptozyme titers)

Answer 26

Mitral valve

Question 27

what is the best dx test for pulmonary embolism/blood clot

Answer 27

CT pulmonary angiography

Question 28

decrease SBP >20, DBP >10
INC HR >10

when going from supine to standing, from hypovolemia, drugs, autonomic insufficiency

Answer 28

orthostatic syncope

Question 29

no drop in BP from sit –> stand
cough, sneeze bring on fainting spell
emotion tied to it, tunnel vision
“common faint”

Answer 29

Vasovagal syncope

Question 30

HR <60 / min

Answer 30

bradycardia

Question 31

HR >100/ min

Answer 31

tachycardia

Question 32

regular sinus rhythm at rate <60/min
P wave before every QRS
normal PR and QRS intervals

Answer 32

sinus bradycardia

Question 33

normal sinus rhythm at rate 60-100 /min
P wave before every QRS
normal PR and QRS intervals, T waves

Answer 33

normal sinus rhythm