Cardiobascular

Question 1

General exam for cvd

Answer 1

Breathless
In pain
Hooked up to any drips/monitors
Looking comfortable

Question 2

Hands

Answer 2

Finger clubbing
Splinter haemorrhages
Nicotine staining
Cyanosis
Anaemia

Question 3

Face

Answer 3

General colour 
Xantholasmas
Eyes - corneal arcus 
Flush
Tongue - cyanosis

Question 4

Pulse

Answer 4

Rate rhythm character
Regular or irregular - AF
VOLUME AND CHARACTER - high cardiac output state/ pregnant - high volume

Low volume - low output state - heart failure - hypovolaemia

Question 5

In aortic stenosis regurg

Answer 5

Collapsing pulse - raise patients are - tapping sensation felt if malgnant

Question 6

Internal jugular vein is palpated

Answer 6

Cannot be seen itself - pulsation transmit - examine right side first .
Normal JVP maybe a few cm above the clavicle

Question 7

Heaptojugular reflux

Answer 7

Check for pain
Hand presses firmly over upper abdomen - venous pulse may be seen rising due to increased venous return - sign of heart failure

Question 8

Palpation

Answer 8

Alex beat - midclavicular line 5 th intercostal space

Displacement of apex beat suggests large heart

Question 9

Check for right ventricular heave along left sternal edge

Answer 9

Felt during held in expiration

Left oarasternal heave - right ventricular hyoertrophy - pulmonary hypertension

Question 10

Thrills

Answer 10

A palpable murmur - aortic stenosis - upper chest or neck

Question 11

Auscultation

Answer 11

Apex / mitral - 5th intercostal mid clavicular

Tricuspid left lower sternal edge

Pulmonary - left sternum edge / 2 intercostal space

Aortic area - right stern also edge - 2nd intercostal space

Listen to carotid

Question 12

Mitral stenosis best heard how

Answer 12

Apex with patient on their left side

Question 13

Aortic regurg murmur

Answer 13

Best heard at left eternal edge sitting forward holding breath out