CV Examination

Question 1

Risk factors for CV disease: non modifiable risk factors include: 4 things

Answer 1

Age
Fam hx
Race
Gender

Question 2

Risk factors:
Men?
Women?

Answer 2

Men > 45

Women > 55

Question 3

Risk factors:

Fam Hx

Answer 3

Cardiac event in first degree male relative <55 or first degree female relative < 65 — 1.5-2x your risk

Question 4

Risk factors:

Race

Answer 4

African American

Question 5

Risk factors:

Gender

Answer 5

M>F (pre-menopause)

M=F (post-menopause)

Question 6

Reheat are the 7 modifiable risk factors

Answer 6

Cholesterol
Diabetes
Diet
Htn
Obesity
Physical inactivity
Tobacco

Question 7

Risk factors:
Goal for cholesterol?
Total?
LDL?
HDL?
Triglycerides

Answer 7

Total: <200
LDL: if low risk: <160, if intermediate risk: <130, If high risk, or have CD, or have DM: <100
HDL: >40 men, >50 women
Triglycerides: <150

Question 8

Risk factors:

Goal for DM

Answer 8

HgA1C: <7%

Question 9

Risk factors:

Goal for diet?

Answer 9

Low fat
Low salt
Balance of veggies, fruits, grains, and meats

Question 10

Risk factors:

Goal for Htn?

Answer 10

<120/<80

Question 11

Risk factors:
Goal for obesity
BMI?
Waist circumference?

Answer 11

BMI: 18.5-24.9 kg/m2

<40 in (men)
<35 in (female)

Question 12

Risk factors:

Goal for physical inactivity

Answer 12

At least 30 min exercise, 5-7 days per week

Question 13

Risk factors:

Goals for tobacco

Answer 13

Quit smoking

Question 14

Pulse is influenced by what 6 things?

Answer 14

Force of contraction
Volume and viscosity of blood
Diameter and elasticity of vessels
Emotions
Exercise
Blood temp
Hormones

Question 15

Palpate ___ seconds for regular pulse and ____ for irregular rhythm

Answer 15

30

1-2 minutes

Question 16

Apical pulse can be palpated where?

Answer 16

SUPINE

5th interspace, midclavicular vertical line

Question 17

What is the most common pulse monitoring site?

Answer 17

Radial pulse

Question 18

Carotid pulse is palpated where?

What do you want to watch out for?

Answer 18

Anterior neck btw SCM and trachea
HOB should be elevated

Assess one time at a time to reduce the risk of bradycardia through stimulation of baroreceptor (found in the aortic arch and carotid sinus) - this will produce a reflex drop in pulse rate or BP

Question 19

Brachial pulse is palpated where?

It is the best for what population?

Answer 19

Over brachial artery - medial aspect of antecubital fossa

Infants

Question 20

Femoral artery palpated where?

Answer 20

Femoral artery in inguinal region

Question 21

Popliteal Artery palpated where?

Answer 21

Popliteal artery behind the knee with knee SLIGHTLY FLEXED

Question 22

What is the grading scale for peripheral pulses?

Answer 22

0 = absent pulse, not palpable
1+ = diminished, barely perceptible
2+ = normal, easily palpable
3+ = full pulse, increased strength
4+ = bounding

Question 23

Pedal pulse: palpated where?

Answer 23

Over dorsalis pedis, dorsal medial aspect of foot

Question 24

Normal HR for adults and teens?

Answer 24

60-100 bpm

40-60 in aerobically trained

Question 25

Normal HR in children?

Answer 25

60-140 bpm

Question 26

Normal HR in newborn? What is the average?

Answer 26

90-164 | Average 127

Question 27

When is compensatory tachycardia seen?

Answer 27

Volume loss (surgery, dehydration)

Question 28

What is postural tachycardia syndrome?

Answer 28

Sustained HR greater than or equal to 30bpm within the first 10 min of standing > or = 40 bpm in teens

Question 29

Why might one have a weak thready pulse?

Answer 29

Low SV | Cardiogenic shock

Question 30

Why might one have a bounding full pulse?

Answer 30

Shortened ventricular systole Decreased peripheral pressure Aortic insufficiency

Question 31

Where can you locate the aortic valve for auscultation?

Answer 31

2nd right intercostal space at the sternal border

Question 32

Where can you locate the pulmonic valve for auscultation?

Answer 32

2nd left intercostal space at the sternal border

Question 33

Where can you locate the tricuspid valve for auscultation?

Answer 33

4th left intercostal space at the sternal border

Question 34

Where can you locate the mitral valve for auscultation?

Answer 34

5th left intercostal space at midclavicular area

Question 35

``` The S1 (lub) sound is normal closure of _____ and _____ valve This marks the beginning of ________ ``` It would be decreased in _____________

Answer 35

Tricuspid and bicuspid Systole First degree heart block

Question 36

``` The S2 (dub) sound is the normal closure of the ______ and ______ valves. This marks the end of ________ ``` Decreased in _________

Answer 36

Pulmonary and aortic Systole Aortic stenosis

Question 37

Systolic murmurs falls between ____ and _____. May indicate _____ _____ (_________) or may be normal

Answer 37

S1 and S2 Valvular disease (mitral valve prolapse)

Question 38

Diastolic murmurs occur between ____ and _____ | Usually indicates ________

Answer 38

S2 and S1 Valvular disease

Question 39

Grades of heart murmurs range from grade 1 (_____) to grade 6 (_____)

Answer 39

Grade 1: softest audible murmur Grade 6: audible with stethoscope OFF the chest

Question 40

Thrill: an abnormal _______ accompanying a _______ or _______ murmur Felt on palpation

Answer 40

Tremor | Vascular or cardiac

Question 41

Bruit: an ___________ sound or murmur ________ sound of arterial or venous origin Common in what two arteries? Indicative of what?

Answer 41

Adventitious Blowing Femoral and carotid Atherosclerosis

Question 42

A gallop rhythm is an abnormal heart rhythm with how many sound in each cycle? Includes ___ and ____

Answer 42

3 | S3 and S4

Question 43

S3 is associated with _________ ________ Occurs soon after ____ In older individuals, may be indicative of ______ ______ ______ (__)

Answer 43

Ventricular filling S2 CHF (left ventricle)

Question 44

S4 is associated with ______ ____ and _____ _____ Occurs just before ____ This is indicative of pathology including what 4 things?

Answer 44

Ventricular filling and Atrial contraction S1 Coronary heart disease, MI, aortic stenosis, chronic htn