Cardio Exam

Question 1

Heart Sounds - S4

When does it occur?

What does it signify?

Causes?

Answer 1

Tennesee

Hypertrophied or non-compliant Ventricle

Always Pathological

Seen in HF, Cardiomyopathy, Hypertension, MI

Question 2

Heart Sounds - S3

When does it occur?

What does it signify?

Causes?

Answer 2

S3

Can be physiological in under 30 year old

If pathological - Stiff or dilated ventricle

HF, HTN, MI, Cardiomyopathy, Volume overload (MR,AR), Constrictive pericarditis

Question 3

Signs of SBE

Hands

Eyes

Heart

Abdomen

Answer 3

Hands - splinter haemorrhages, clubbing, Janeway lesions (non-painful, erythematous due to septic emboli; soles and palms), Osler’s nodes (painful, palpable papules on pads of fingers and toes)

Eyes - Roth’s spots - retinal haemorrhages with white centres

Heart - ? worsening murmure

Abdomen - splenomegaly, ? microscopic HU

Question 4

Clubbing

Stages of clubbing?

Causes?

Answer 4

1. F - Increased fluctuancy of nail bed
2. A - loss of nail/finger angle
3. C - increased curvature of nail
4. E - Expansion of distal phalanx (drum-sticking)

Idiopathic, Familial, Hyperthyroid

CVS - cyanotic heart disease, SBE, atrial myxoma

RS - Suppurative lung disease (bronchiectasis, empyema, CF, abscess), Lung cancer, ILD

Gastro - IBD, Cirrhosis