Cardiovascular System

Question 1

What is the initial treatment plan for a patient with atrial fibrillation?

Answer 1

1. High flow O2 (always for acutely unwell patients)
2. 250ml IV fluids & review their BP & HR
3. Digoxin (antiarrhythmic) for rate control
4. Cardioversion

Question 2

What are the other possible drugs you could prescribe to treat atrial fibrillation?

Answer 2

1. B-blockers (antiarrhythmic)

2. Amiodarone (antiarrhythmic)

Question 3

What sign might you encounter in pulmonary oedema?

Answer 3

Paroxysmal nocturnal dyspnoea (PND)

Question 4

What are 2 cardiovascular causes of syncope?

Answer 4

1. Heart block

2. Paroxysmal arrhythmias

Question 5

What are 3 possible cardiovascular causes of fatigue?

Answer 5

1. Heart failure
2. Arrhythmias
3. Drugs

Question 6

What may leg pain on walking indicate?

Answer 6

Claudication secondary to peripheral vascular disease

Question 7

What does a sternotomy scar possible indicate?

Answer 7

• CABG

- Valve replacement

Question 8

What 3 cases would you see peripheral cyanosis?

Answer 8

1. Vasoconstriction
2. Shock
3. Heart failure

Question 9

What are the clinical signs of infective endocarditis?

Answer 9

• Splinter haemorrhages
• Janeway lesions
• Olser’s nodes
• Splenomegaly

Question 10

What is collapsing pulse a sign of?

Answer 10

Aortic regurgitation

Question 11

What are the 2 clinical signs of hyperlipidaemia?

Answer 11

1. Xanthelasma

2. Corneal arcus

Question 12

What is malar flush a sign of?

Answer 12

Mitral valve disease

Question 13

What are the 3 possible causes of an un-palpable apex beat?

Answer 13

1. Obesity
2. Hyperinflation
3. Pleural effusion

Question 14

What are the 3 possible causes of a displaced apex beat?

Answer 14

1. Cardiomegaly
2. Dilated cardiomyopathy
3. Pneumothorax

Question 15

What is tapping a sign of in the cardiovascular examination?

Answer 15

Mitral stenosis

Question 16

What is heaving a sign of in the cardiovascular examination?

Answer 16

• Hypertension

- Aortic stenosis

Question 17

What is a positive parasternal heave a sign of in the cardiovascular examination?

Answer 17

Right ventricular hypertrophy

Question 18

What does a loud 1st heart sound sometimes suggest?

Answer 18

AV stenosis

Question 19

What does a quiet 1st heart sound sometimes suggest?

Answer 19

• Mitral regurgitation

- Heart failure

Question 20

What valves closing make up the 1st heart sound?

Answer 20

Mitral & Tricuspid

Question 21

What valves closing make up the 2nd heart sound?

Answer 21

Aortic & Pulmonary

Question 22

What are 3 possible causes of non-benign murmurs?

Answer 22

1. Valve defects
2. Hyperdynamic circulation
3. Atrial/ventricular septal defects

Question 23

What do ascites suggest?

Answer 23

• Increased central venous pressure

- Heart failure

Question 24

What 2 things can cause a radio-femoral delay?

Answer 24

1. Atherosclerosis

2. Aortic stenosis

Question 25

What 3 things can a thready carotid pulse suggest?

Answer 25

1. Heart failure
2. Shock
3. Valve disease

Question 26

What does a slow rising carotid pulse suggest?

Answer 26

Aortic stenosis

Question 27

What is JVP a measure of?

Answer 27

Indirect measure of right atrial pressure

Question 28

What 2 things can a decrease in central venous pressure suggest?

Answer 28

1. Hypovolaemic shock

2. Dehydration

Question 29

What can an increase in central venous pressure suggest?

Answer 29

Right heart failure

Question 30

What does SPECT (single photon emission computed tomography) do?

Answer 30

Shows the perfusion of the heart

Question 31

Why can MRI be helpful for the cardiovascular system?

Answer 31

• Locating masses

- Malformations including aneurysms

Question 32

Why can Angiography be helpful?

Answer 32

• Cardiac pumping function

- Locate blockages (emboli)

Question 33

Why can Echocardiography be helpful?

Answer 33

• Enlarged heart

- Abnormal cardiac movements