Clinical Signs

Question 1

What is pulsus alternans?

Answer 1

When the upstroke of the pulse alternates between strong and weak.
Indicating systolic dysfunction for example heart failure. Severe LVH.

Question 2

What is slow-rising pulse?

Answer 2

Pulse had a slow upstroke, seen in aortic stenosis (due to reduce flexibility of the valve the pressure rises slowly then plateaus)

Question 3

What is a collapsing pulse?

Answer 3

Has a forceful and rapid upstroke AND decent.
Seen in aortic regurgitation and patent ductus arteriosus (due the he blood follow changing direction).
Also seen in hyperkinetic states (anaemia, thyrotoxic, fever, pregnancy and exercise.

Question 4

What is bisferiens pulse?

Answer 4

Two systolic peaks , due to mixed aortic valve disease

Question 5

What is a jerky pulse?

Answer 5

Chatsgorised by a rapid forceful upstroke, seen in HOCM.

Question 6

What is pulsus paradoxes?

Answer 6

Fall in systolic blood pressure (>10mmhg) during inspiration. Seen in severe asthma or cardiac tamponade

Question 7

What’s needed to make a diagnosis of ARDS?

Answer 7

Underlying causes of ARDS
Bilateral pulmonary oedema
Persistent hypoxemia despite inspired oxygen >40%
Normal or near normal capillary wedge pressure (not cardiac failure)
Normal oncotic pressure (not hypoalbuminemia)
Poor lung compliance (endothelial damage)

Question 8

What is a tapping apex characteristically seen in?

Answer 8

Mitral stenosis