Cardiovascular

Question 1

Irregularly Irregular Pulse

Answer 1

Atrial Fibrillation

Question 2

Slow-rising pulse

Answer 2

Aortic Stenosis

Question 3

Collapsing Pulse

Answer 3

Aortic Regurgitation

Question 4

Bounding Pulse

Answer 4

Acute CO2 retention, Hepatic failure, sepsis

Question 5

Radiofemoral Delay

Answer 5

Coarction of aorta

Question 6

Jerky Pulse

Answer 6

Hypertrophic obstructive cardiomyopathy, Mitral Regurgitation

Question 7

Pulsus bisferiens

Answer 7

Mixed aortic valve disease, Hypertrophic obstructive cardiomyopathy

Question 8

Pulsus Paradoxus

Answer 8

Constrictive pericarditis, cardiac tamponade

Question 9

Raised, Fixed JVP

Answer 9

Superior vena cava obstruction

Question 10

JVP rising on inspiration

Answer 10

Cardiac Tamponade, Constrictive pericarditis

Question 11

Large v waves

Answer 11

Tricuspid regurgitation

Question 12

Absent a waves

Answer 12

atrial fibrillation

Question 13

Cannon a waves

Answer 13

Complete heart block, atrioventricular (AV) dissociation, ventricular arrhythmias

Question 14

Describe mitral stenosis

Answer 14

Tapping Apex Beat
Loud first heart sound
Rumbling mid-diastolic murmur at apex (louder in left lateral position on expiration)

Question 15

Describe Aortic Regurgitation

Answer 15

Wide pulse pressure
Displaced, volume overloaded apex beat
Early diastolic murmur at lower sternal edge (best heard in expiration leaning forward)

Question 16

Describe Mitral Regurgitation

Answer 16

Displaces, volume overloaded apex beat
Soft first heart sound
Pansystolic murmur at apex radiating to axilla (louder in expiration)

Question 17

Describe Tricuspid Regurgitation

Answer 17

Large systolic v waves

Pansystolic murmur lower left sternal edge (best heard un inspiration)

Question 18

Describe Aortic Stenosis

Answer 18

Narrow Pulse pressure
Heaving undisplaced apex beat
Soft second heart sound
Ejection systolic murmur heard in aortic area radiating to carotids and apex

Question 19

Describe Ventricular Septal Defect

Answer 19

Harsh pansystolic murmur lower left sternal edge

Left parasternal heave

Question 20

Malar (cheek) flush

Answer 20

Mitral stenosis

Question 21

Pulsatile hepatomegaly

Answer 21

Tricuspid regurgitation

Question 22

Carotid pulsation (corrigans sign)

Answer 22

Aortic regurgitation

Question 23

Head nodding (de musset’s sign)

Answer 23

Aortic regurgitation

Question 24

Capillary pulsations in nail bed (quincke’s sign)

Answer 24

Aortic regurgitation

Question 25

Pistol-shot heart over femora's (Traube's sign)

Answer 25

Aortic regurgitation

Question 26

Roth spots (boat-shaped retinal haemorrhages)

Answer 26

Infective endocarditis

Question 27

Osler's nodes (painful hard swellings on fingers/toes)

Answer 27

Infective endocarditis

Question 28

Janeway Lesions (painless erythematous blanching seen on palmar surface)

Answer 28

Infective endocarditis

Question 29

Describe atrial septal defect

Answer 29

Wide, fixed split second heart sound. | Ejection systolic murmur in second, third intercostal space

Question 30

Describe Ventricular septal defect

Answer 30

Harsh Pansystolic murmur left sternal edge

Question 31

Describe Coarction of aorta

Answer 31

Radiofemoral delay, hypertension

Question 32

Describe Patent ductus arteriosus

Answer 32

Continuous machinery murmur below left clavicle

Question 33

Describe transposition of great vessels

Answer 33

Cyanosis first day of life, Chest radiograph shows egg-shaped ventricles

Question 34

Describe Tetralogy of fallot

Answer 34

Cyanosis first month of life | Chest radiograph shows boot shaped heart

Question 35

Saw tooth pattern with normal complexes

Answer 35

atrial flutter

Question 36

absent P wave

Answer 36

Atrial fibrillation | Sinoatrial block

Question 37

Bifid P wave

Answer 37

Left atrial hypertrophy e.g. mitral stenosis

Question 38

Peaked P wave

Answer 38

Right atrial hypertrophy e.g. pulmonary hypertension, tricuspid stenosis

Question 39

ST depression

Answer 39

Myocardial ischaemia

Question 40

ST elevation

Answer 40

Acute MI | Left ventricular aneurysm

Question 41

Saddle shaped ST elevation

Answer 41

Acute constrictive pericarditis

Question 42

S I, Q III, T III pattern (deep S waves in I, Q waves in III, inverted T waves in III)

Answer 42

Acute constrictive pericarditis | Pulmonary embolus

Question 43

Tall tented ‘t’ waves, wide QRS | complex (sine wave)

Answer 43

Hyperkalaemia

Question 44

Flattened ‘t’ waves, prominent ‘U’ waves (muscle weakness, cramps, tetany)

Answer 44

Hypokalaemia

Question 45

Long ‘Q–T’ interval, tetany, | perioral paraesthesia, carpopedal spasm

Answer 45

Hypocalcaemia

Question 46

Hyperacute T waves (inverts later), ST elevation and then Q wave formation

Answer 46

Acute MI

Question 47

ECG changes): | II, III, aVF

Answer 47

Inferior infarct

Question 48

I, aVL, V2–V6

Answer 48

Anterolateral infarct

Question 49

V2-V5

Answer 49

Anterior infarct

Question 50

ST and T wave changes but no Q waves

Answer 50

Subendocardial infarct

Question 51

Reciprocal changes V1, V2 (tall R waves, ST depression, tall upright T waves)

Answer 51

Posterior infarct

Question 52

􏰂 blockers, e.g. propranolol

Answer 52

Impotence Shortness of breath Cold peripheries

Question 53

ACE (angiotensin-converting enzyme) inhibitor, e.g. captopril

Answer 53

Persistent dry cough

Question 54

Digoxin, spironolactone

Answer 54

Gynaecomastia

Question 55

Amiodarone

Answer 55

Hyper-/hypothyroidism Corneal microdeposits Lung/liver fibrosis

Question 56

Verapamil

Answer 56

Constipation

Question 57

Nifedipine

Answer 57

Flushing, headache, ankle oedema

Question 58

Thiazide diuretic, e.g. bendrofluazide

Answer 58

Gout (hyperuricaemia)

Question 59

Minoxidil

Answer 59

Increased hair growth

Question 60

Hydralazine

Answer 60

Drug-induced systemic lupus | erythematosus (SLE)