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OSCE - examinations > Cardiovascular exam > Flashcards

Cardiovascular exam Flashcards

1
Q

What would you investigate the hands for in a cardiovascular examination?

A
  1. CRT and cyanosis
  2. Temperature
  3. Tendon xanthomata
  4. Osler’s nodes and Janeway lesions
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2
Q

What is peripheral cyanosis a sign of?

A

PVD
Raynaud’s
CCF

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3
Q

How would you describe temp and CRT?

A

Warm and well perfused

Peripherally shut down

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4
Q

How would you identify Osler’s nodes?

A

On the pulp of hands and feet
Pinhead size to pea size
Pink to purple
Painfful

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5
Q

How would you identify Janeway lesions?

A

Flat, painless, red-blue spots on the palms of the hands and sole of feet

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6
Q

What are all the signs of acute bacterial infective endocarditis?

A

Janeway lesions
Osler’s nodes
Splinter haemorrhages
Roth spots

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7
Q

What would you investigate the nails for in a cardiovascular examination?

A

Clubbing
Koilonychia
Splinter haemorrhages
Nailfold infarcts

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8
Q

What are cardiac causes of clubbing?

A

IE
Cyanotic congestive heart disease
Atrial myxoma

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9
Q

What causes splinter haemorrhages?

A

IE

Trauma (gardening)

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10
Q

What causes nailfold infarcts?

A

Vasculitis

SLE

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11
Q

What would you look for in the wrist in a cardiovascular exam?

A

Radial pulse (rate, rhythm, volume, character)

Radial-radial delay

Radial-femoral delay

Collapsing pulse

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12
Q

How would you describe the radial pulse?

A

Rate: tachycardia/bradycardia

Rhythm: regular, irregular, regularly irregular

Volume: bounding, normal, thready

CharacterL bisferiens (AR/AS), slow-rising

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13
Q

What is a collapsing pulse a sign of?

A

AR

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14
Q

What is R-R delay a sign of?

A

Cervical rib, aortic coarctation or dissection, embolism

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15
Q

What is R-F delay a sign of?

A

Aortic coarctation or dissection, embolism

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16
Q

When is the pulse pressure wide?

A

AR

17
Q

When is the pulse pressure narrow?

A

AS

18
Q

What would you look for in the face in a cardiovascular exam?

A

Malar flush, sign of MS

19
Q

What would you look for in the eyes in a cardiovascular exam?

A

Corneal arcus and xanthelasma

Conjunctival pallor

20
Q

What would you look for in the mouth in a cardiovascular exam?

A

Dentition

Central cyanosis

21
Q

What are some causes of central cyanosis

A

Lung disease
Cardiac shunt
Abnormal Hb

22
Q

What would you look for in the neck in a cardiovascular exam?

A

Carotid pulse (briefly palpate)

JVP

23
Q

What is Corrigan’s sign?

A

Exaggerated pulsation: AR

24
Q

What are causes of an elevated JVP?

A

RHF
Volume overload
Constrictive pericarditis

25
Q

What are causes of an elevated JVP with a low BP?

A

Tension pneumothorax
Cardiac tamponade
Massive PE
Severe asthma

26
Q

What would you inspect in the precordium?

A
  1. Scars: pacemaker, middling sternotomy, left submammary

2. Visible heave

27
Q

How would you palpate the precordium?

A

Locate apex beat

Left parasternal heave (right ventricular hypertrophy)

Thrills

28
Q

What are the different characters of the apex beat?

A

Heaving: LVH
Tapping: MS
Thrusting: MR/AR

29
Q

How would you auscultate the precordium?

A
  1. The valves

2. Areas of murmur: axilla and carotid (breath on expiration)

30
Q

What murmur radiates to the axilla?

A

MS

31
Q

What murmur radiates to the carotids?

A

AS

32
Q

What manoeuvres would you do to amplify murmurs?

A

Apex, pt on LHS, breath on expiration (B): MS

LLSE, pt sitting forward, breath on expiration (D): AR

33
Q

What would you look for in the ankles and back in a cardiovascular exam?

A

Peripheral oedema: RHF

Sacral oedema: RHF

Crepitations: LHF

34
Q

What investigations would you suggest after a cardiovascular examination?

A 
ECG
CXR
Echocaridogram 
Urinalysis 
Abdo exam
Peripheral pulses
35
Q

What are 6 causes of AF?

A 
Ischaemic heart disease
Rheumatic heart disease
Thyrotoxicosis 
Pneumonia 
PE
Alcohol
36
Q

What are features of JVP versus carotid?

A
  1. Double pulsation
  2. Rises with hepatojugular reflex
  3. Non palpable
  4. Obliterated when pressure applied at the base of the neck
  5. Height changes with respiration
  6. Height changes with angle of patient
37
Q

When does the JVP normally rise?

A

On expiration

OSCE - examinations (13 decks)

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