CVS

Question 1

What is S1 and S2 due to?

Answer 1

• S1
  
  • Closing of mitral and tricuspid valves, start of systole
• S2
  
  • Closing of aortic and pulmonary valves, start of diastole

Question 2

What can cause heart murmur?

Answer 2

• Abnormal valve
• Increased volume or velocity of blood
• Abnormal openings between chambers, usually congenital

Question 3

Where are the 4 valves listened for?

Answer 3

• Aortic
  
  • 2nd right intercostal
• Pulmonary
  
  • 2nd left intercostal
• Tricuspid
  
  • 4th left intercostal
• Mitral
  
  • Apex (5th left mid-clavicular line)

Question 4

What are causes of added heart sounds

Answer 4

• S3
  
  • Heard in diastole
  • Below 40 physiological, over 40 left ventricular failure and mitral regurgitation
• S4
  
  • Just before S1
  • Left ventricular hypertrophy
• Snaps
  
  • Mechanical valves
• Pericardial rub

Question 5

What do you comment on for radial pulse

Answer 5

• Rate
• Rhythm
  
  • Regular, regularly irregular, irregularly irregular
• Volume
  
  • Normal, bounding, full, thready, low
• Character
  
  • Normal, slow rising, collapsing

Question 6

Angular stomatitis and sore red tongue

Answer 6

Iron deficiency anaemia

Question 7

Xanthelasmata and corneal arcus?

Answer 7

Hypercholesteraemia

Question 8

How long do you hold checking for oedema

Answer 8

15 seconds

Question 9

What is normal JVP

Answer 9

<4cm

Question 10

Heaves

Answer 10

Left ventricular hypertrophy

Question 11

Thrills

Answer 11

Palpable murmur, usually systolic

Question 12

What do you commen on in auscultation?

Answer 12

Heart sounds S1 and S2

Added sounds (S3, S4)

Murmurs

Question 13

What are systolic murmurs?

Answer 13

Aortic stenosis

Mitral regurgitation

Question 14

What are diastolic murmurs?

Answer 14

Aortic regurgitation

Mitral stenosis

Question 15

For BP how far above estimate do you go

Answer 15

30mmHg

Question 16

What is normal BP, stage 1 and stage 2 hypertension?

Answer 16

• Normal
  
  • 120/80
• Stage 1
  
  • 140/90
• Stage 2
  
  • 160/100

Question 17

How do you analyse ECG?

Answer 17

• ARIBAR
• A
  
  • Activity?
• R
  
  • Rhythym (count 30 big squares and multiple by 10)
• I
  
  • Irregular or regular
• B
  
  • Broad or narrow QRS complex (should be <0.12s) from start of Q to end of S
• A
  
  • Is atrial activity present
• R
  
  • Relationship between atrial and ventricular activity
  • Is P followed by QRS, is QRS preceeded by P
  • PR interval should be 0.12-0.2s)

Question 18

Where do ECG limb leads to?

Answer 18

• Red
  
  • Right arm
• Yellow
  
  • Left arm
• Green
  
  • Left leg
• Black
  
  • Right leg

Question 19

Where do ECG chest leads to?

Answer 19

• V1
  
  • 4th left intercostal
• V2
  
  • 4th right intercostal
• V3
  
  • Between V2 and 4
• V4
  
  • Apex beat
• V5
  
  • Between V4 and 6
• V6
  
  • Horizontally aligned with apex beat on mid axilla line