Clinical Findings

Question 1

what arrhythmia has an irregular irregular pulse?

Answer 1

atrial fibrillation

Question 2

what heart valve defect has a slow-rising pulse?

Answer 2

aortic stenosis

Question 3

what hear valve defect has a collapsing pulse?

Answer 3

aortic regurgitaiton

Question 4

what 3 major conditions give a bounding pulse?

Answer 4

acute CO2 retention, hepatic failure, sepsi

Question 5

what condition give a radial-femoral delay?

Answer 5

co-arction of the aorta

Question 6

what 2 conditions give a jerky pulse?

Answer 6

hypertrophic obstructive cardiomyopathy

mitral regurgitation

Question 7

what 2 conditions give pulsus bisferiens?

ie a bifid pulse

Answer 7

mixed aortic disease

hypertrophic obstructive cardiomyopathy

Question 8

what 2 conditions give pulsus paradoxus?

ie large decrease in pulse volume during inspiration

Answer 8

cardiac tamponade

constrictive pericarditis

Question 9

what condition gives a raised, fixed JVP?

Answer 9

superior vena cava, obstruction

Question 10

what condition gives a JVP rising on inspiration?

Answer 10

cardiac tamponade

constrictive pericarditis

Question 11

what gives large ‘v’ waves in the JVP?

Answer 11

tricuspid regurgitation

Question 12

what gives absent ‘a’ waves in the JVP?

Answer 12

atrial fibrillation

Question 13

what 3 major conditions give cannon ‘a’ waves in the JVP?

Answer 13

complete heart block
AV dissociation
ventricular arrhythmias (eg VT)

Question 14

what heart valve abnormality gives you a wide pulse pressure?

Answer 14

aortic regurgiation

Question 15

what heart valve abnormality gives you a narrow pulse pressure?

Answer 15

aortic stenosis

Question 16

what murmur is a rumbling mid-diastolic murmur heard best at the apex?

Answer 16

mitral stenosis

Question 17

what murmur is a pansystolic murmur at apex, radiating to carotids?

Answer 17

mitral regurgitation

Question 18

what murumur is a ejection systolic murmur heard best in the aortic area?

Answer 18

aortic stenosis

Question 19

what murmur is an early diastolic murmur heard best at the left lower sternal edge?
(best heard in expiration leaning froward)

Answer 19

aortic regurgitation

Question 20

what murmur is a harsh pansystolic murmur head best at the left sternal edge?

Answer 20

ventricular septal defect

Question 21

what murmur gives a tapping apex beat?

Answer 21

mitral stenosis

Question 22

what murmurs give a displace, volume overloaded, apex beat?

Answer 22

mitral regurgitation, aortic regurgitation

Question 23

what murmur gives a heaving undisplaced apex beat?

Answer 23

aortic stenosis

Question 24

what heart valve abnormality is associated with malar flush?

Answer 24

mitral stenosis

Question 25

what heart valve abnormality is associated with pulsatile hepatomegaly?

Answer 25

tricuspid regurgitation

Question 26

what heart valve abnormality is associated with carotid pulsation? (corrigans signs)

Answer 26

aortic regurgitation

Question 27

what heart valve abnormality is associated with head nodding? (de Mussets sign)

Answer 27

aortic regurgitation

Question 28

what heart valve abnormality is associated with capillary pulsations in nail bed? (quincke's sign)

Answer 28

aortic regurgitation

Question 29

what condition is associated with roth spots, janeway lesions and osler nodes?

Answer 29

infective endocarditis

Question 30

what congenital heart defect gives a continuous 'machinery' murmur best heard below left clavicle?

Answer 30

PDA

Question 31

when do patients with tranposition of the great vessels become cyanosed?

Answer 31

first day of life

Question 32

when do patients with tetralogy of fallot become cyanosed?

Answer 32

first month of life

Question 33

on an ECG, what does a 'saw-tooth' pattern with normal complexes suggest?

Answer 33

atrial flutter

Question 34

on an ECG what does absent 'p' waves suggest?

Answer 34

atrial fibrillation | or sino-atrial block

Question 35

on an ECG what does a bifid 'p' wave suggest?

Answer 35

left atrial hypertrophy | eg due to mitral stenosis

Question 36

on an ECG what does a peaked 'p' wave suggest?

Answer 36

right atrial hypertrophy (eg due to pulmonary hypertension, tricuspid stenosis)

Question 37

on an ECG what does ST depression show?

Answer 37

myocardial ischaemia

Question 38

on an ECG what does ST elevation show?

Answer 38

acute MI | or left ventricular aneurysm

Question 39

on an ECG, what does 'saddle'-shaped ST elevation show?

Answer 39

acute constrictive pericarditis

Question 40

on an ECG what does s1q3t3 pattern suggest? deep S waves lead 1 Q waves in lead 3 inverted T waves in lead 3

Answer 40

pulmonary embolism | but rare finding

Question 41

on an ECG, what does tall tented 't' waves and wide QRS complex suggest?

Answer 41

hyperkalaemia

Question 42

on an ECG, what does flattened 't' waves and prominent 'U' waves suggest?

Answer 42

hypokalaemia