CVS Exam : Dr Ghumans Tutorial

Question 1

Signs of Infective endocarditis ( 8 )

Answer 1

Janeway lesions
Oslers nodes
Splinter hemorrhages
Murmurs
-
-
-
-

Question 2

Signs of acute rheumatic fever in number and signs in cardiac failure (4)

Answer 2

Major
Carditis, erythrma, nodules, S chorea, joint pain

Minor
- raised Crp, Raised ESR, arthralgia, fever >38, prolonged PR interval, leukocytsis

What’s cardiac failure signs?
- hepatomegaly, bilateral pitting oedema, tachypnea, SOB, weight gain due to the oedema, poor feeding

Question 3

Feel all pulses

Answer 3

Carotid - volume and character
Brachial - volume character rate rhythm
Radial - volume character rate rhythm
Femoral
Dorsalis pedis
Posterior tibial
Popliteal

Question 4

Normal HR for newborn 1yr, 2yr and 3yr

Answer 4

Newborn : 120-160
1 year old: 110-140
2 years : 100-130
3 years : 90 - 120

??

Question 5

Causes of tachycardia (6)

Answer 5

Shock
Infection
Respiratory distress
Hyperthyroidism
Cardiac failure?
Anemia ?

Question 6

Bradycardia causes (4)

Answer 6

Raised icp ( part of cushings triad )

Question 7

Causes of irregularly irregular rate (2)

Answer 7

Atrial fibs and flutters

Question 8

Regularly irregular rate (3)

Answer 8

Sinus tachycardia
Sinus bradycardia
?

Question 9

Small VOL pulse (3) vs large (4)

Answer 9

Large volume
- acyanotic heart defects ( PDA )
-

Question 10

Pulsus deficit

Question 11

Water hammer v collapsing pulse

Question 12

Pulsus paradox and conditions that cause (3)

Question 13

Causes JVP ( 5)

Question 14

Palpable p2

Answer 14

Pulmonary hypertension
Compatible with a heave on the L parasternal boarder due to RVH ( more resistance therefore Rv compensates )

Question 15

Thrill in suprasternal notch means

Answer 15

Coarctation of the aorta
- murmur is heard in the back between the scapulae

Question 16

2 characters of apex beat means ?

Answer 16

Heaving - due to ventricular enlargement. Lightly pushes your hand upward from the chest wall. Occurs in pulmonary HT

Tapping - due to volume overload. Taps your fingers. Occurs in aortic stenosis????

Question 17

Cause RV hypertrophy (4)

Answer 17

• pulmonary stenosis
• pulmonary hypertension
• VSDs due to L to R shunting of blood. More vol in RV
• R heart failure ??

Question 18

Grading of murmurs (6)

Answer 18

Grade 1 : not significant
Grade 2 :
Grade 3 : significant physiological
Grade 4 : can hear with stethoscope on flattened on chest
Grade 5 : can hear with stethoscope near chest ( not flat )
Grade 6 : can hear without stethoscope