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1 Medicine > Cardiovascular Examination > Flashcards

Cardiovascular Examination Flashcards

1
Q

what should be looked for in general inspection in CV exam?

A

patient: well/unwell, comfortable, alert, breathless, pallor, cyanosis
around bed: oxygen, medication, IV infusions

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2
Q

what should be checked for on the hands?

A

perfusion: temperature, CRT, peripheral cyanosis
nails: clubbing, splinter haemorrhages, Quincke’s sign
dorsum: extensor tendon xanthomata
palms: osler nodes, janeway lesions

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3
Q

what should be checked on the arms

A

inspect for bruising
radial pulse (rate, rhythm, radio-radial delay)
collapsing pulse

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4
Q

what should be check on head and neck?

A

face
eyes
mouth
neck

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5
Q

what may be seen in the face?

A

malar flush

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6
Q

what may be seen in the eyes?

A

conjunctival pallor/haemorrhages
corneal arcus
xanthelasma

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7
Q

what may be seen in the mouth?

A

central cyanosis under tongue
petechial haemorrhages
poor dental hygiene
high arches palate

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8
Q

what may be seen in the neck?

A

JVP
hepatojugular reflex test
carotid pulse

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9
Q

what disease is associated with Mitral regurgitation, aortic regurgitation and mitral prolapse?

A

marfan’s syndrome

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10
Q

what disease is associated with aortic stenosis?

A

turner’s syndrome

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11
Q

what disease is associated with congential heart disease?

A

Down’s syndrome

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12
Q

what does a CRT >2s indicated

A

hypoperfusion

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13
Q

what disease may cause clubbing

A

cyanotic congential heart disese

infective endocarditis

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14
Q

what disease may cause splinter haemorrhages?

A

infective endocarditis

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15
Q

what is Quincke’s sign?

A

visible pulsations in the nails

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16
Q

what disease may cause Quincke’s sign?

A

aortic regurgitation

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17
Q

what is extensor tendon xanthomata

A

irregular nodules overlying tendons

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18
Q

what may cause extensor tendon xanothomata?

A

hyperlipidemia

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19
Q

what are Osler’s nodes

A

painful purple papules on pulps

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20
Q

what may cause Osler’s nodes?

A

infective endocarditis

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21
Q

what are Janeway lesions?

A

erythematous macules on palms

22
Q

what may cause Janeway lesions?

A

infective endocarditis

23
Q

what does bruising on arms suggest?

A

anticoagulation

24
Q

what does a radio-radial delay in pulse suggest?

A

aortic dissection/ aneurysm

or proximal coarctation

25
Q

how do you measure a collapsing pulse?

A

while feeling the radial pulse
quickly lift their arm up
check for shoulder pain first
a strong tapping is felt when arm elevated

26
Q

what are the causes of a collapsing pulse?

A

classically aortic regurgitation
patient ductus arteriosus
high output states (anaemia, thyrotoxicosis)
physiological states (pregnancy, fever)

27
Q

what does a wide pulse pressure in BP suggest?

A

aortic regurgitation

28
Q

what does a narrow pulse pressure in BP suggest?

A

aortic stenosis

29
Q

what disease may cause malar flush?

A

mitral stenosis

30
Q

what may cause conjunctival pallor?

A

anaemia

31
Q

what may cause conjuntival haemorrhages?

A

infective endocarditis

32
Q

what may cause xanthelasma?

A

hyperlipidaemia

33
Q

what is xanthelasma?

A

periorbital yellow plaques

34
Q

what is central cyanosis under tongue a sign of?

A

hypoxia

35
Q

what cause petecial haemorrhages?

A

infective enodcarditis

36
Q

what is poor dental hygiene a risk for?

A

infective endocarditis

37
Q

what disease does a high arched palate suggest?

A

marfan’s syndrome

38
Q

how do you meausre JVP?

A

turn head slightly and look for double pulsation of internal jugular vein
up to 3cm above sternal angle is normal

39
Q

what are some causes of a raised JVP?

A 
PQRST
pulmonary hypertension/ Pulmonary emolism/ pulmonary stenosis/pericardial effusion 
quantity of fluid i.e overload 
right ventricular failure 
SVC obstruction 
tamponade/ tricuspid regurgitation
40
Q

how do you carry out the hepatojugular reflex test?

A

apply pressure over RUQ while observing JVP

transient rise= normal

41
Q

what does a sustained rise in JVP with hepatojugular reflex test suggest?

A

right ventricular failure

42
Q

what does a slow rising low volume carotid pulse suggest?

A

aortic stenosis

43
Q

what does a bounding/ collapsing carotid pulse suggest?

A

aortic regurgitation or patent ductus arteriosus

44
Q

what is Corrigan’s sign?

A

visible carotid pulsation

45
Q

what is Corrigan’s sign a sign of?

A

aortic regurgitation

46
Q

what is Musset’s sign?

A

head bobbing in time with pulse

47
Q

what is Musset’s sign a sign of?

A

aortic regurgitation

48
Q

what may cause an impalpable apex beat?

A 
DOPE
dextrocardia
obese
pericaridal effusion
emphysema
49
Q

what may cause a displaced apex beat?

A

LV dilation
cardiomegaly
mediastinal shift

50
Q

what may cause parasternal heave and thrills?

A

pulmonary hypertension

51
Q

how do you auscultate the aortic valve?

A

2nd ICS

right sternal edge

1 Medicine (10 decks)

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