Cardiology 2

Question 1

mid-late diastolic murmur loudest on expiration
Loud S1 with opening snap

Diagnose

Answer 1

Mitral stenosis

Question 2

L subclavicular thrill
Machinery murmur
large volume, bounding, collapsing pulse
wide pressure pulse

Diagnose

Answer 2

PDA

Question 3

Wide pulse pressure
Cannon waves on JVP
Variable intensity S1

Diagnose

Answer 3

CHB

Question 4

How do thiazide diuretics work

Answer 4

inhibit sodium reabsorption at the beginning of the DCT by blocking the thiazide-sensitive Na+-Cl− symporter

Question 5

SE of thiazide diuretics

Answer 5

Low K+
Low Na
High Ca
Impaired glucose tolerance
ED
Gout

Question 6

If pulses paradoxus is present what could that indicate

Answer 6

severe asthma
tamponade

Question 7

slow rising pulse

Answer 7

AS

Question 8

collapsing pulse

Answer 8

Aortic Regurg
PDA
hyperkinetic states (anaemia, thyrotoxic, fever, exercise/pregnancy)

Question 9

pulse alternans

Answer 9

severe LVF

Question 10

bisferiens pulse

Answer 10

mixed aortic valve disease

Question 11

jerky pulse

Answer 11

HOCM

Question 12

40 yo female
SOB, CP on exertion, cyanosis, HTN
OE JVP with a waves

Diagnosis and management

Answer 12

Pulmonary Artery Hypertension
Acute vasodilator testing
-ve: prostatglandin analogues
endothelial receptor antag
+ve: CCB

Question 13

Endocarditis following dental procedure organism

Answer 13

Streptococcus viridans

Question 14

Endocarditis following operation (non dental) organism

Answer 14

Staphylococcus epidermidis

Question 15

Endocarditis in patient with colorectal cancer, organism

Answer 15

Streptococcus bovis
- subtype Streptococcus gallolyticus

Question 16

Large A wave

Answer 16

Tricuspid Stenosis/Pulmonary Stenosis
pulmonary HTN

Question 17

Absent A wave

Answer 17

AF

Question 18

What does A wave on JVP show

Answer 18

Atrial contraction

Question 19

What does cannon A wave represent

Answer 19

Atrial contraction against closed valve

Question 20

What causes cannon A wave

Answer 20

reg: VT AVNRT
ireg: CHB

Question 21

What does c wave show

Answer 21

Closure tricuspid
not normally visable

Question 22

What does v wave show

Answer 22

filling of blood into the atrium against a closed tricuspid valve

Question 23

Giant V wave

Answer 23

Triscuspid regurg

Question 24

What does y wave show

Answer 24

tricuspid opening

Question 25

What does rise in JVP during insp indicate?

Answer 25

Kussmals sign
constrictive pericarditis

Question 26

Loud S1

Answer 26

Mitral stenosis

Question 27

Soft S1

Answer 27

long PR or mitral regurgitation

Question 28

Soft S2

Answer 28

aortic stenosis

Question 29

When would S3 be considered normal?

Answer 29

< 30 years old (may persist in women up to 50 years old)

Question 30

S3 >50yo

Answer 30

LVH
MR
Constrictive pericarditis

Question 31

S4

Answer 31

Aortic stenosis, HOCM, HTN

Question 32

67 year old admitted SOB
PHx: COPD
ECG: narrow complex tachy, 3 P wave morphologies
Diagnosis and management

Answer 32

Multifocal atrial tachycardia
CCB

Question 33

48h post MI
CP worse on lying flat
diagnosis

Answer 33

pericarditis

Question 34

1 week post MI
SOB, raised JVP, quiet heart sounds
diagnosis

Answer 34

LV free wall rupture

Question 35

1 week post MI
acute MR and pansytolic mumur
diagnosis

Answer 35

Ventricular septal defect

Question 36

Post MI persistent ST elevation with no CP

Answer 36

LV aneurysm

Question 37

4 weeks post MI
fever, pleuritic pain and effusion
Diagnosis and management

Answer 37

Dresslers
NSAIDS

Question 38

Post MI
hypotension, pulm oedema, early mid diastolic murmur

Answer 38

acute MR due to papillary muscle ischaemia/rupture

Question 39

Patient with Turners
Soft ES murmur

Answer 39

bicuspid aortic valve

Question 40

Resp depression following IV Mg
management

Answer 40

Calcium Gluconate

Question 41

Which med is CI in VT

Answer 41

verapamil

Question 42

Which med is CI in HOCM

Answer 42

ACE-I