CVS clinical skills

Question 1

What is malar flush

Answer 1

pinky purple high cheeks
mitral stenosis
Co2 retention

Question 2

what should you look for in eyes when examining CVS

Answer 2

pallor of conjunctivae
xanthelasma
corneal arcus

Question 3

corneal arcus in under 40

Answer 3

familial hyperlipidemia/hypercholesterolemia
dodgy
heart disease

Question 4

hands in CVS exam

Answer 4

splinter haemorrhages
clubbing
janeway#’s lesions
Osler’s nodes
tar
tendon xanthomata
temp and perfusion

Question 5

splinter haemhorrages

Answer 5

normally trauma but can be eg trichonosis or sub-acute bacterial endocarditis

Question 6

Janeway lesions

Answer 6

BAD
Janeway lesions are irregular, nontender hemorrhagic macules located on the palms, soles, thenar and hypothenar eminences of the hands, and plantar surfaces of the toes. They typically last for days to weeks. They are usually seen with the acute form of bacterial endocarditis.

Question 7

Oslers nodes. Condition?

Answer 7

Tender regular shaped nodes
sub-acute endocarditis

Question 8

tendon xanthomata

Answer 8

cholesterol depostits on tendons
hypercholesterolaemia

Question 9

how do you observe nutrition status

Answer 9

“body habitus is consistent with…”

Question 10

exposure

Answer 10

shirt off and shoes and socks off

Question 11

Observe Marfan, Turner syndrome

Answer 11

aortic dissection

Question 12

poor dental hygiene can lead to

Answer 12

bacterial endocarditis

Question 13

Osler nodes painful?

Answer 13

yes

Question 14

Janeway lesions painful?

Answer 14

no

Question 15

clubbing sign name

Answer 15

Schamroth’s window

Question 16

heave

Answer 16

left ventricle thud against the wall

Question 17

thrill

Answer 17

murmur (regurgitation)

Question 18

What sounds with what valvulopathies

Answer 18

Mr. Ass
Ms. Ard

Mitral regurgitation, aortic stenosis systole
Mitral stenosis, aortic regurgitation diastole

Question 19

how do you conclude?

Answer 19

this is a …patient…presented with…. on examination I found…
remember walkin aids, GTN spray
conclude succinctly but thoroughly in the same order you examined

Question 20

what hands/wrists findings in resp exam

Answer 20

Nails – tar, yellow nails, clubbing
Joints – hypertrophic pulmonary osteopathy (HPOA) – ‘painful swelling’ of wrists/ankles
Palms – cyanosis, muscle wasting
Wrist – HPOA, ‘CO2 tremor’ ‘salbutamol tremor’

Question 21

what are the 4 pillars of wellness

Answer 21

temp
pulse
O2 levels
BP

Question 22

what tremor in low CO2

Answer 22

wrist flapping tremor

Question 23

neck in resp exam

Answer 23

JVP tracheal deviation lymph nodes

Question 24

mouth in resp exam

Answer 24

cyanosis

Question 25

whilst you are at the back, looking for scars check…

Answer 25

lymph nodes

Question 26

lymph nodes associated with (2)

Answer 26

cancer
infections

Question 27

palpate thorax for (3) resp exam

Answer 27

apex beat
Hoover’s sign
expansion

Question 28

pleural effusion sounds like on percussino

Answer 28

stony dullness

Question 29

where do you percuss the lungs

Answer 29

intercostal spaces, not ribs

Question 30

other tests resp examq

Answer 30

Temperature and peripheral oxygen saturations
Peak flow
Spirometry
Sputum culture
Chest radiograph
Chest CT scan

Question 31

what is a rub?

Answer 31

The pleural rub sound results from the movement of inflamed and roughened pleural surfaces against one another during movement of the chest wall. [1] This sound is non-musical and described as “grating,” “creaky,” or “the sound made by walking on fresh snow.”[2] It is often heard in the upper lung fields.

Question 32

why do chemo pts have tb test

Answer 32

chemo agents can reactivate it

Question 33

pectus carinatum is

Answer 33

out-pointing chest

Question 34

pectus excavatum is

Answer 34

in pointing chest

Question 35

which bit of stethoscope to auscultate apex of lungs

Answer 35

small one

Question 36

which breathing signs might you see from bottom of the bed

Answer 36

accessory muscles
stridor/cough
pursed lip breathing

Question 37

proper name for normal breath sounds

Answer 37

vesicular breathing