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Year 6 > Cardiovascular examination > Flashcards

Cardiovascular examination Flashcards

1
Q

What are xanthomata?

A

Yellow cholesterol-rich deposits

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2
Q

Where are xanthomata found?

A

Palm
Tendons of the wrist
Tendons of the elbow

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3
Q

What are xanthomata associated with?

A

Hyperlipidaemia (typically familial hyperlipidaemia)
Coronary artery disease
HTN

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4
Q

What heart defects is Marfan’s associated with?

A

Aortic dissection
Mitral valve prolapse
Aortic valve prolapse

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5
Q

What are the cardiac causes of clubbing?

A

Congenital cyanotic heart disease
Infective endocarditis
Atrial myxoma

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6
Q

What are causes of splinter haemorrhages?

A 
Infeective endocarditis
Local trauma 
Sepsis 
Vasculitis 
Psoriatic nail disease
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7
Q

Where do janeway lesions typically occur?

A

Thenar and Hypothenar eminences of the palms

Also the soles

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8
Q

Where are Osler’s nodes found?

A

Fingers or toes

Colour = red-purple

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9
Q

Which are painful- Osler’s nodes or janeway lesions?

A

Osler’s nodes

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10
Q

What might cool hands in a cardio exam suggest?

A

Poor peripheral perfusion caused by:

  1. Congestive cardiac failure
  2. Acute coronary syndrome
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11
Q

If you detect an irregular radial pulse, how long do you count for?

A

60 seconds

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12
Q

What are causes of an irregular rhythm in the pulse?

A

AF
Ectopic beats
AV blocks

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13
Q

What are causes of radio-radial delay?

A
  1. Subclavian artery stenosis (e.g. by compression by a cervical rib)
  2. Aortic dissection
  3. Aortic coarctation
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14
Q

What is another name for Collapsing pulse?

A

Water hammer pulse

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15
Q

What are causes of a collapsing pulse?

A
  1. Normal physiological states: fever, pregnancy
  2. Cardiac lesions: Aortic regurgitation, patent ductus arteriosus
  3. High output states: anaemia, arteriovenous fistula, thyrotoxicosis
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16
Q

What causes a slow rising pulse?

A

Aortic stenosis

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17
Q

What causes a bounding pulse?

A

Aortic regurgitation

CO2 retention

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18
Q

What causes a thready pulse?

A

Intravascular hypovolaemia e.g. in sepsis

19
Q

What does narrow pulse pressure mean?

A

<25mmHg between SBP and DBP

20
Q

What does wide pulse pressure mean?

A

> 100mmHg between SBP and DBP

21
Q

What is a significant difference in BP between the left and the right arm?

A

> 20mmHg

22
Q

What causes a narrow pulse pressure (3)

A

Aortic stenosis
Congestive heart failure
Cardiac tamponade

23
Q

What causes a wide pulse pressure? (2)

A

Aortic regurgitation

Aortic dissection

24
Q

What causes a difference in BP between the arms?

A

Aortic dissection

25
Q

Where does the internal jugular vein connect to?

A

The Right atrium (via the superior vena cava) - there are no valves

26
Q

What are the causes of a raised JVP?

A

Venous HTN - can be caused by the following:

  1. Right sided HF
  2. Tricuspid regurgitation
  3. Constrictive pericarditis
27
Q

What are causes of RHF

A
  1. LHF

2. Pulmonary HTN (due to COPD or interstitial lung disease)

28
Q

What are the causes of tricuspid regurgitation?

A

Infective endocarditis

29
Q

What are the causes of Constrictive pericarditis?

A

Idiopathic
Rheumatoid arthritis
TB

30
Q

What is a positive hepatojugular reflux result?

A

a rise in JVP which is sustained and =/> 4cm

31
Q

What does a positive hepatojugular reflux result mean?

A

The RV is unable to accomodate an increased venous return

32
Q

What are the causes of a positive hepatojugular relfux?

A

Constrictive pericarditis
RHF
LHF
Restrictive cardiomyopathy

33
Q

At what age is corneal arcus normal?

A

> 60 yo

34
Q

If corneal arcus is detected in 50 what can it suggest?

A

hypercholesterolaemia

35
Q

What are xanthelasma

A

cholesterol-rich deposits around the eye

36
Q

What may angular stomatitis suggest?

A

Iron deficiency

37
Q

What are the 4 scars in cardio exam? and state what the procedures occur there

A

Midline sternotomy (valve replacement surgery and CABG)
Anterolateral thoracotomy scar (minimally invasive cardiac valve sugery)
Infraclavicular scar (pacemaker insertion)
Left mid-axiallary scar (ICD insertion)

38
Q

Where do you feel for a parasternal heave?

A

left sternal edge

39
Q

What causes a parasternal heave?

A

RV hypertrophy

40
Q

What are the steps for the auscultations process?

A
  1. Palpate the carotid
  2. Listen with diaphragm (4 valves)
  3. Listen with the bell (4 valves)
  4. Accentuation manoeuvres
41
Q

What are the steps for accentuation manoeuvres?

A
  1. Ausculatate the carotid (pt holds breath)
  2. Sit the pt forwards + listen over aortic area using the diaphragm - on EXPIRATION
  3. Roll the patient to the left side - listen over mitral area during EXPIRATION - mitral regurg
  4. continue to listen into the axilla - mitral regurg radiation
  5. With the pt still on theit left - listen over the mitral area with bell during EXPIRATION - mitral stenosis
42
Q

What scar is it important to check for in the legs?

A

Saphenous vein harvesting

43
Q

How do you complete a cardiovascular exam?

A 
Peripheral vascular exam 
12-lead ECG 
Dipstick urine 
Bedside capillary glucose 
Fundoscopy

Year 6 (18 decks)

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