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PPE OSCE > CVS Exam Signs > Flashcards

CVS Exam Signs Flashcards

1
Q

Give 2 cardiovascular causes of clubbing

A
  • Cyanotic congenital heart conditions

- Endocarditis

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2
Q

What are Janeway lesions and Osler’s nodes?

A

Microvascular infarctions caused by septic emnboli

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3
Q

Where would you see Janeway lesions? Are they painful?

A
  • On palms

- Painless

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4
Q

Where would you see Osler’s nodes?

Are they painful?

A
  • On pad of fingers

- Painful

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5
Q

Give 3 hand signs of infective endocarditis

A
  • Osler’s nodes
  • Janeway lesions
  • Splinter haemorrhages
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6
Q

What would be a cause of a regularly irregular pulse?

A

Heart block

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7
Q

What would be the rate and rhythm in AF?

A
  • Tachycardic

- Irregularly irregular

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8
Q

What is the character of the pulse in:

  • Aortic stenosis
  • Aortic regurg
A
  • Stenosis - slow rising

- Regurg - collapsing

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9
Q

What is JVP a measure of?

Which vein are you looking at?

A

Right atrial pressure

Internal jugular vein

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10
Q

What affects JVP apart from RA pressure (2 factors)?

A
  • Fluid status

- Contractility

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11
Q

How is JVP measured?

A

Height above sternal angle, plus 5cm, as RA is 5cm below sternal angle

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12
Q

What is normal JVP?

A

Less than 3cm (8cm in total)

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13
Q

Give 4 causes of a raised JVP

A
  • RV failure
  • Cardiac tamponade
  • SVC obstruction
  • Fluid overload
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14
Q

How would distinguish whether you were seeing the JVP or the carotid pulse?

A
  • Carotid - palpable

- JVP - non-palpable, obliterated by compression

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15
Q

What is hepatojugular reflux?

A

Phenomenon whereby firm pressure to RUQ causes transient rise in JVP
If persists - RV dysfunction

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16
Q

What is malar flush a sign of?

Why does it occur?

A

Mitral stenosis

CO2 retention results in vasodilatation

17
Q

What is a thrill?

A

A palpable murmur

18
Q

What is a heave?

What does it signify?

A

Sustained forceful pulsation

RV hypertrophy

19
Q

What is a murmur?

A

Extra/abnormal sound during the heartbeat cycle, caused by turbulent blood flow

20
Q

What are the two major causes of murmur?

A
  • Valvular stenosis

- Valvular incompetence resulting in regurgitation

21
Q

Describe the normal heart sounds in terms of character and what they signify

A

S1 - crescendo-decrescendo - A-V valves closing - beginning of systole
S2 - shorter duration, higher frequency - outflow valves closing - end of ventricular systole

22
Q

When timing a murmur with the carotids, what does the carotid pulse equate with?

A
  • Pulse = ventricular systole - S1
23
Q

Where would you best hear a murmur of mitral stenosis?

A
  • In apex, with bell, when patient rolled to left - held expiration
24
Q

Which murmur is best heard over the carotids?

A

Aortic stenosis

25
Q

Which murmur are you listening for if you lean the patient forward in held expiration, and listen over the 5th ICS, left sternal edge?

A

Aortic regurgitation

26
Q

How would you listen best for mitral regurgitation?

A

Over axilla

27
Q

You hear a murmur over the apex when the patient is rolled to the left.
What is the likely diagnosis?
When would you hear the murmur?

A

Mitral stenosis

Mid-diastolic

28
Q

You identify a pansystolic murmur. What is the likely diagnosis?
Where would you best hear it?

A

Mitral regurgitation

Over axilla

29
Q

Which condition causes an ejection systolic murmur?

A

Aortic stenosis

30
Q

When and where would you best hear a murmur of aortic regurgitation?

A
  • Early diastolic

- Leaning forward, 5th ICS, left sternal edge, held expiration

31
Q

What would cause a continuous murmur?

A

Patent ductus arteriosus

32
Q

If you identified basal lung crepitations but no peripheral oedema, which side is the heart failure?

A

Left

33
Q

Would you be more likely to get peripheral or pulmonary oedema in RHF?

A

Peripheral

34
Q

Where would you palpate for the dorsalis pedis pulse?

What about posterior tibial?

A
  • Dorsalis pedis - between flexor hallucis longus and flexor digitorum longus tendons
  • Posterior tibial - posterior to medial malleolus

PPE OSCE (8 decks)

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