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1MB - Clinical Signs > Cardiovascular Examination > Flashcards

Cardiovascular Examination Flashcards

1
Q

risk factors for peripheral arterial disease

A

body habitus, age, smoking, etc

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2
Q

inspection of the upper arms may reveal?

A 
skin colour changes (pink, pale, matted)
ischaemic changes (gangrene)
tar stains in fingers
tendon xanthomata
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3
Q

what does palpation involves of the upper limbs

A

check temperature, capillary refill, pulses

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4
Q

what is required in upper limb pulse checks?

A 
radial pulse (including radio-radial delay and radio-femoral delay)
brachial pulse
blood pressure (>10 mmHg difference is significant)
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5
Q

inspection of face may reveal

A

eyes: corneal arcus, xantholasma
mouth: central cyanosis
check carotid pulse character and bruits

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6
Q

abdomen inspection is required - true or false?

A

true. check body habitus, scars, aortic pulse and femoral pulse

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7
Q

is it imporant to check for aortic pulse even in a focused exam of the legs?

A

yes. (will reveal if issues may be caused by a AAA)

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8
Q

what skin colour changes may be present on a lower limb inspection?

A

pink, pale, matted

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9
Q

true or flase, check for ischaemic changes between toes and at heels?

A

true

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10
Q

give examples of trophic changes

A

shiny skin, hair loss, thin skin, ulcers

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11
Q

why might scars be present on the lower leg?

A

previous surgeries - CABG venous grafting, femoral-popliteal bypass

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12
Q

palpation of lower limbs requires checking temperature, capillary refill and pulses?

A

yes

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13
Q

name the lower limb pulses and their anatomical location

A

dorsalis pedis - lateral to the extensor hallucis longus tendon
posterior tibial - halfway between the posterior border of the medial malleolus and the achilles tendon
popliteal - within the popliteal fossa

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14
Q

tenderness of calves may indicate critical ischaemia - true or false

A

true

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15
Q

describe Buerger’s triangle

A

with the pateint lying supine, lift their leg until heel becomes pale and hold for 30s (if it does not become pale the test is normal; if it becomes pale, this is Buerger’s angle)

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16
Q

pallor followed by reactive hyperaemia on dependancy is a positive test and implies significant peripheral aterial disease - true or false?

A

true

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17
Q

what is the ABPI of intermittent claudication?

A

ABPI <0.9

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18
Q

what is the ABPI of acute ischaemic limb? any other characteristics?

A

ABPI <0.6

6P’s - pale, pulseless, parasthesia, paralysis, pain, perishingly cold

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19
Q

what is the equation for critical ischaemia?

A

= tissue loss + rest pain + ABPI <0.3

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20
Q

clubbing of the fingernails could be suggestive of what diseases?

A

cyanotic congenital heart disease

infective endocarditis

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21
Q

splinter haemorrhages could indicate what infection?

A

infective endocarditis

22
Q

define Quincke’s sign

A

visible pulsation of capillary bed

aortic regurgitation

23
Q

extensor tendon xanthomata is due to hypolipidaemia - true or false?

A

false - indicative of hyperlipidaemia

24
Q

Osler’s nodes and Janeway lesions could indicate infective endocarditis. what are they?

A

O - painfull red lesions on palms and soles

J - nodular haemorrhaic lesions on palms and soles

25
Q

anticoagulation issue could present as ___ on the skin

A

bruising

26
Q

tachycardia is defined as a pulse rate <60 bpm, and bradycardia is defined as a pulse rate <100 bpm. true or false?

A

false

tachycardia is defined as a pulse rate >100 bpm, bradycardia is defined as a rate <60 bpm.

27
Q

irregularly irregular pulse could be suggestive of what?

A

atrial fibrillation and ventricular ectopics

28
Q

regularly irregular pulse could be suggestive of what?

A

2nd degree heart block

29
Q

the radio-radial delay and radio-femoral delay may indicate aortic dissecion/coarctation of the aorta/aortic arch aneurysm. true or false

A

true

30
Q

what conditions could a collapsing pulse indicate?

A

aortic regurgitation
patent ductus arteriosus
arteriovenous malformation

31
Q

large pulse pressure is a sign of aortic stenosis. true or false

A

false.

large pulse pressure would indicate aortic regurgitation. aortic stenosis has a narrow pulse pressure.

32
Q

name 4 facial signs which may be found on examination

A

pallor
malar flush
ruddy plethoric complexion
swollen cyanotic face

33
Q

name 4 signs you would look for in the eyes

A

conjunctiva pallor
haemorrhages
corneal arcus
xantholasma

34
Q

a high arched palate may be indicative of which condition?

A

Marfans

35
Q

what could cause a raised JVP (hint: PQRST)

A 
pulmonary hypertension/PE/PS/pericarditis/pericardial effusion
quality of fluid eg overload
right heart failure
SVC obstruction
tamponade/TR
36
Q

carotid pulse pressure and volume of aortic stenosis

A

slow rising low volume

37
Q

carotid pulse pressure and volume of aortic regurgitation

A

bounding/collapsing

same as patent ductus arteriosus

38
Q

define Corrigan’s sign

A

visible carotid pulsation (aortic regurgitation)

39
Q

define de Musset’s sign

A

heart bobbing in time with pulse (aortic regurgitation)

40
Q

define pectus excavatum

A

congenital deformity producing a ‘caved-in/hollowed’ chest appearance

41
Q

pigeon chest is an alternate name for pectus excavatum - true or false?

A

false. pectus carinatum may also be called pigeon chest

42
Q

an impalpable apex beat may be due to

A

obesity, muscular or hyperinflated chest

43
Q

a displaced apex beat may result from what conditions?

A

LV dilation eg from mitral/aortic regurgitation

44
Q

what causes a heaving apex?

A

high pressure pulsation in LVH eg aortic stenosis or systemic hypertension

45
Q

what causes a thrusting apex?

A

large area pulsation in volume overload eg MR or AR

46
Q

mitral stenosis produces a tapping apex - true or false

A

true

47
Q

what causes a parasternal heave?

A

RV hypertrophy in pulmonary hypertension

48
Q

what is a thrill?

A

a palpable murmur

49
Q

most common cause of a thrill

A

aortic stenosis

50
Q

why must the lung bases be auscultated?

A

check from pulmonary oedema in heart failure - heard as fine crackles

51
Q

peripheral oedema would indicate ___ and ___

A

hypoalbuminaemia and RVF

52
Q

true or false - auscultation of the heart valves is done with the diaphragm of the stethoscope

A

true. unless stated otherwise

1MB - Clinical Signs (4 decks)

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