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MRCP > Cardiology > Flashcards

Cardiology Flashcards

1
Q

In what condition are a waves absent from the JVP waveform?

A

Atrial Fibrillation

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2
Q

What conditions cause large a waves in the JVP waveform?

A

Tricuspid stenosis
Right heart failure
Pulmonary hypertension

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3
Q

What conditions cause a cannon a wave in the JVP waveform?

A

Dissociation between atria and ventricles:
Atrial flutter
Atrial tachycardias
3rd degree heart block
Ventricular tachycardia/ectopics

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4
Q

What condition causes giant V waves in the JVP waveform?

A

Tricuspid regurgitation

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5
Q

What conditions cause a steep descent of x wave in JVP waveform?

A

Tamponade
Cardiac constriction

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6
Q

What conditions cause a steep descent of y wave in JVP waveform?

A

Cardiac constriction
Tricuspid stenosis

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7
Q

What is Kussmaul’s sign?

A

Raised JVP upon inspiration and drops with expiration (opposite of health).
Implies R heart chambers cannot increase in size to accommodate increased venous return - pericardial disease/effusion/tamponade.

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8
Q

What are the causes ion raised JVP with normal waveform?

A

Heart failure
Fluid overload
Severe bradycardia

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9
Q

What are some causes of an absent radial pulse?

A

Iatrogenic - post catheter/art line
Blalock-Taussig shunt for congenital heart disease
Aortic dissection with subclavian involvement
Trauma
Takayasu’s arteritis
Peripheral arterial embolus

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10
Q

Collapsing arterial pulse can be a sign of?

A

Aortic regurgitation
Arteriovenous fistula
PDA
Extracardiac shunt

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11
Q

A slow rising pulse is a sign of which condition?

A

Aortic stenosis

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12
Q

What is Bisferiens pulse (double shudder) is a sign of?

A

Mixed aortic valve disease with significant regurgitation.

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13
Q

A jerky pulse is a sign of?

A

Hypertrophic obstructive cardiomyopathy

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14
Q

When does an alternates pulse occur?

A

Severe left ventricular dysfunction.

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15
Q

When can pulses paradoxus (excessive reduction in pulse with inspiration) occur?

A

Ventricular compression
Tamponade
Constrictive pericarditis
Severe asthma

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16
Q

A heaving apex beat may indicate?

A

Left ventricular hypertrophy

17
Q

Thrusting/hyperdynamic apex beat indicates?

A

High left ventricular volume:
Mitral regurgitation
Aortic regurgitation
PDA
Ventricular septal defect

18
Q

A tapping apex beat indicates?

A

Palpable first heart sound in mitral stenosis

19
Q

A displaced/dyskinetic apex beat indicates?

A

Left ventricular impairment and dilatation.

20
Q

A double impulse apex beat indicates?

A

Left ventricular aneurysm (with dyskinesia)
Hypertrophic cardiomyopathy (without dyskinesia)

21
Q

A pericardial knock indicates?

A

Constrictive pericarditis

22
Q

A parasternal heave indicates?

A

Right ventricular hypertrophy:
- ASD
- pulmonary hypertension
- COPD
-pulmonary stenosis

23
Q

A palpable third heart sound indicates?

A

Heart failure
Severe mitral regurgitation

24
Q

What valves close during the first heart sound?

A

Mitral and tricuspid

25
Q

What are causes of a loud first heart sound?

A

Mobile mitral stenosis
Hyperdynamic states
Tachycardia
Left to right shunts
Short PR interval

26
Q

What are causes of a soft first heart sound?

A

Immobile mitral stenosis
Hypodynamic states
Mitral regurgitation
Poor ventricular function
Long PR interval

27
Q

What causes a spilt first heart sound?

A

RBBB
LBBB
VT
Inspiration
Ebstein’s anomaly

28
Q

What causes a variable first heart sound?

A

Atrial fibrillation
Complete heart block

29
Q

What valves close during the second heart sound?

A

Aortic then pulmonary

30
Q

What causes a loud second heart sound?

A

Systemic hypertension
Pulmonary hypertension
Tachycardia
ASD

31
Q

What causes a soft or absent second heart sound?

A

Severe aortic stenosis

32
Q

What causes a fixed splitting of the second heart sound?

A

ASD

33
Q

What causes a widely split second heart sound?

A

RBBB
Pulmonary stenosis
Deep inspiration
Mitral regurgitation

34
Q

What causes a third heart sound?

A

Passive filling of ventricles on opening of AV valves.

35
Q

What are pathological causes of a third heart sound?

A

Rapid ventricular filling:
Mitral regurgitation
VSD
Congestive cardiac failure
Constrictive pericarditis

36
Q

What causes a fourth heart sound?

A

Atrial contraction that fills a stiff left ventricle

37
Q

What are some causes of a 4th heart sound?

A

LVH
Amyloid
HCM
Left ventricular ischaemia

38
Q
A

MRCP (3 decks)

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