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PCM III exam I > CV exam > Flashcards

CV exam Flashcards

1
Q

stills murmur

A

benign, midsystolic, louder supine

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2
Q

split S1

A

normal if heard LSB

if RSB then prob RBBB

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3
Q

split S2

A

normal- gets wider w/inhalation and dcreases w/exhalation

abnormal if fixed, RBBB or PS

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4
Q

S3

A 
early diastolic
best at apex 
normal up to age 30
noncompliant ventricle
LV path (mitral regurg or dilated cardiomyopathy)
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5
Q

S4

A

late diastole just after atrial contraction
best at apex in left lat decubitus
caused by virbration from atrial kick
low pitched, quiet, bell

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6
Q

S4 etiology

A 
thickening and stiffening of ventricular walls 
HTN
AS
PS
hypertrophic cardiomyopathy
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7
Q

gallop rhythm

A

all 4 sounds technically

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8
Q

ejection cilck

A

sound occurring at moment of maximal pressure w/sudden tensing of valve root

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9
Q

aortic ejection click

A 
early systolic at onset of LV ejection aortic root stretches
dilated aneurysm of aorta
COA
HTN
AS/AR
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10
Q

Aortic stenosis

A

systolic crescendo-decresceno
medium pitched
typically hard
transmits sound to carotid aa

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11
Q

pathology of AS

A

rheumatic disease
congenital bicuspid valve
calcification

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12
Q

symptoms of AS

A

dyspnea on exertion
angina
syncope
S4

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13
Q

AR

A

austin flint murmur
early diastolic high pitched blowing decrescendo
dilates LV -> S3

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14
Q

AR pathology

A

rheumatic disease
congenital bicuspid valve
endocarditis

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15
Q

pulmonary ejection click

A

sudden root tensing

very early systole

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16
Q

pulmonary ejection click pathology

A

PHTN
aneurysm dilating root
PS/PR

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17
Q

PS

A

systolic crescendo-decrescendo murmur

most asymptomatic and do not progress

18
Q

severe PS symptoms

A 
exertional dyspnea 
chest pain
syncope
dilated RV
S4
19
Q

PS etiology

A

congenital
carcinoid tumor
PHTN

20
Q

PR

A

graham steel murmur

softer diastolic decrescendo

21
Q

PR path

A 
PHTN
MS
LV failure
obstructive sleep apnea
emphysema
22
Q

tricuspid stenosis

A

diastolic low pitched rumble, bell
opening snap
accentuated by inspiration
increases CVP

23
Q

tricuspid pathology

A

RD
congenital HD
carcinoid tumor

24
Q

TR

A

early pansystolic
diaphragm
will not radiate to left axilla
inspirational accentuation

25
Q

TR path

A

ebstein congenital anomaly

26
Q

mitral valve opening snap

A

stenotic mitral leaflets are tethered at orifice, but still mobile

27
Q

MS

A

diastolic
can be w/opening snap
can cause PHTN, elevated JVP, RV hypertrophy

28
Q

MS path

A

almost always from RD

29
Q

MP

A

mid to late systolic click at apex that may or may not be followed by a murmur
high pitched short murmur

30
Q

MR

A

holosystolic
loud high pitched
can radiate to left axilla

31
Q

MR etiology

A

endocarditis
RD
post MI pap mm rupture

32
Q

squatting

A

increases preload
decreases MP and hypertrophic cardiomyopathy murmur
increases AD

33
Q

standing

A

decreases preload
increases MP and hypertrophic cardiomyopathy murmur
decreases AS

34
Q

IHSS

A

idiopathic hypertrophic subaortic stenosis

symptoms same as AS- exertional dypsnea, angina, syncope

35
Q

IHSS murmur

A

systolic ejection murmur along left sternal border and apex, often accentuated PMI

36
Q

PDA

A

murmur through systole and diastole
best at pulmonic
may have thrill

37
Q

constrictive pericarditis

A

pericardial knock

38
Q

inflamed pericarditis

A

rub
more in systole
leaning forward accentuates

39
Q

4 main risk factors of vascular disease

A

smoking
DM
HTN
hyperlipidemia

40
Q

mitral valve prolapse

A

often present w/complaint of symptom of palpitations
young women
at risk for arrhythmia if there is also dilated LA

41
Q

carotid bruit

A

can be atherosclerosis, primary stenosis at carotid or a radiating aortic stenosis
at risk for stroke

PCM III exam I (5 decks)

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