CDV History

Question 0

Angina lasts for

Answer 0

2-20 minute

Question 1

Pain of angina is described as

Answer 1

Crushing tightening squeezing pressure like sensation

Question 2

Angina is of what origin

Answer 2

visceral origin, poorly localised, may radiate to neck jaw arm or shoulder

Question 3

angina is bought about by

Answer 3

exertion, emotional stress, heavy meals, cold air relieved by sublingual nitroglycerin

Question 4

Myocardial infarction location and radiation and quality of pain is the same as angina T or F

Answer 4

T

Question 5

Myocardial infarction comes at ____ and lasts for ____

Answer 5

comes at rest, lasts for more than half an hour

Question 6

Associated symptoms of Myocardial infarction

Answer 6

dyspnoea, sweating, anxiety, nausea, feeling of impending death

Question 7

Aortic Dissection

Speed of onset? Character? Location?

Answer 7

Abrupt onset, very severe, ripping tearing character, central to chest radiates to back, persists for hours, may be mistaken for MI

Question 8

Ischemic causes of chest pain x2

Answer 8

Angina pectoris

Myocardial Infarction

Question 9

Non ischemic cardiovascular causes of chest pain

Answer 9

Aortic dissection

Pericardial pain

Question 10

Pericardial pain

Character? Bought on by? Aggravated/relieved? caused?

Answer 10

Stabbing or burning
Not bought on by exertion
Aggravated by coughing, deep breathing and lying down
Relieved by leaning forward
Caused by mvmt of inflamed pericardial surfaces on one another

Question 11

Orthopnoea definition

Answer 11

Sensation of breathlessness when lying down, manifestation of heart failure. How many pillows do you sleep on? Has this changed?

Question 12

Paroxysmal nocturnal dyspnoea

Symptom of? Caused by? Relieved by?

Answer 12

LH failure
increased by pulmonary venous pressure from mobilization of interstitial fluid from infra-thoracic locations when lying flat, awakened suddenly with sensation of choking, air hunger, imminent death.
Relieved by sitting upright, may persist for >30min. Precedes orthopnoea.

Question 13

Palpitations can be provoked by:

Answer 13

increased intake of caffeine, chocolate, nicotine, sympathomimetic drugs

Question 14

Palpitations ask about:

Answer 14

Precipitants, rate, duration, degree of regularity (tap out), circumstances associated with onset and termination.,

Question 15

Intermittent Claudication:

Answer 15

Pain in lower limb assoc with walking, relieved by rest. 
Pain relieved (2-5min), reproduced at distance walked before symptoms begin.

Question 16

Causes of syncope - three over-riding themes.

What else do you ask about for syncope?

Answer 16

Cardiac - arrhythmias, valvular stenosis
Non cardiogenic - vasovagal, reduced blood volume in acute bleeding
Other - seizures, drugs, psychogenic

Precipating factors, aura (odd sensations immediately precede), AS, circumstances, position.

Question 17

Ankle Oedema seen:

Answer 17

In patients with RHF
side effect of Calcium channel blockers

Seen over the sacrum in bed-ridden patients.
Detected during day, diminishes during the night.

Question 18

Fatigue is a side effect of what two cardio drugs

Answer 18

Beta blockers, diuretics.

Also a symptom of congestive heart failure.

Question 19

History of rheumatic fever could be a risk for?

Answer 19

valvular heart disease

Question 20

History of valvular heart disease + dental work/ infection could be a risk factor for?

Answer 20

Infective endocarditis

Question 21

Trisomy 21 Down’s syndrome is associated with what congenital condition?

Answer 21

Ventricular septal defect

Question 22

Marfan’s syndrome is associated with?

Answer 22

Aortic dissection

Aortic regurgitation

Question 23

Turner’s syndrome is associated with:

Answer 23

Coarctation of aorta

Aortic stenosis

Question 24

Three signs of infective endocarditis

Answer 24

Osler’s nodes, Janeway lesions, Splinter haemorrhages

Distal, painful palm

Question 25

Radio-radial delay indicates

Answer 25

subclavian artery stenosis, dissection of thoracic aorta

Question 26

radio femoral delay

Answer 26

coarctation of aorta

Question 27

Difference in xanthomata and xantholesmata

Answer 27

Both hyperlipidaemia
Xanthomata - tendons on dorsum of hand.
Xantholesmata - near eyes, eyelids

Question 28

Mitral facies is indicative of

Answer 28

Mitral stenosis, pulmonary hypertension

Question 29

At the carotid pulse what two things are you feeling for?

Answer 29

VOLUME (small = H Failure, large = aortic regurgitation)
CHARACTER (waveform of pulse, normal, slow rising in AS, collapsing or water hamer in aortic regurgitation, bounding in CO2 retention)

Question 30

Thrills aka- ______ ______

Answer 30

Palpable murmurs

Question 31

JVP is an indication of :

Answer 31

Right ventricular filling pressure - right internal jugular vein is preferred. head turned slightly to left, 45 degree.
Vertical height above sternal angle should be < 4cm

Question 32

What four things do you check at the precordium

Answer 32

Inspection
Palpation
Percussion
Auscultation

Question 33

Inspect for:

Answer 33

Thoracic cage abnormalities 
Scars
Rashes
Pacemaker Boxes 
Apex beats

Question 34

Heaves are:

Answer 34

Palpable lifting sensation vs thrills - palpable vibrations from murmurs

Question 35

Bell of stethoscope:

Answer 35

Low pitched sounds - diaphragm for high pitched

Question 36

Order of auscultation

Answer 36

Mitral - 5th left IC space mid clav - start with bell then diaphragm
Tricuspid - 5th left IC space parasternal - diaphragm
Aortic- 2nd right IC space parasternal - diaphragm
Pulmonary- 2nd left IC space parasternal - diaphragm

Question 37

What is the acronym HAM in auscultation?

Answer 37

Heart sounds - S1 and S2 normal
Additional (clicks snaps) Abnormal sounds (S3,S4)
Murmurs (Systolic and diastolic )

Question 38

What are the peripheral lower limb pulses?

Answer 38

Femoral, popliteal, posterior tibial, dorsalis pedis