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examinations > CVS examination > Flashcards

CVS examination Flashcards

1
Q

CVS causes of clubbing are (3)

A 
Infective endocarditis
Cyanotic congenital heart disease
Atrial Myxoma (benign tumour)
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2
Q

What are the 4 causes of Radio-radio (femoral) delay

A

Aortic coarctation
Aortic dissection
Aortic embolism
Cervical rib (just R-R)

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3
Q

When assessing character of pulse, a … is indicative of aortic stenosis

A

slow rising

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4
Q

When assessing character of pulse, a bisferious pulse feels like what

A

A double peak per cardiac cycle (translates as ‘striking twice’)

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5
Q

What does a Bisferious pulse character indicate

A

Mixed AR and AS

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6
Q

A … pulse pressure indicates AR

A

wide

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7
Q

A … pulse pressure indicates AS

A

Narrow

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8
Q

… can present with … and looks like flushing of cheeks with labial sparing

A

Mitral Stenosis … Malar flush

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9
Q

What does corrigans sign look like

A

Ear movement or head nodding as a result of powerful carotid pulsation

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10
Q

Corrigans sign is caused by …

A

Aortic regurgitation

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11
Q

How can you exacerbate JVP

A

Hepatojugualr reflex (ask if in pain)

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12
Q

Persistent elevation of JVP after pressing in RUQ indicates ….

A

RHF

Volume overload

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13
Q

…. and …. surgery will be visible as midline sternotomy scars

A

CABG

Valve replacement

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14
Q

A left submammary scar would indicate

A

Mitral valve replacement

Pericardial window

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15
Q

When is a pericardial window done

A

Pericardial effusion, fluid drains into pleural cavity where it is not dangerous.

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16
Q

What 3 types of character can you assess for when feeling the apex beat?

A

Thrusting
Heaving
Tapping

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17
Q

A thrusting apex beat indicates (3)

A

AR
MR
LVF

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18
Q

A heaving apex beat = LVH, which indicates what (4)

A

HOCM (hypertrophic cardiomyopathy)
Aortic stenosis
Hypertension
Aortic coarctation

19
Q

A Tapping apex beat indicates what one thing

A

MS

20
Q

What minimum grade of murmur can be found as a thrill

A

grade 4 and above

21
Q

What would a left parasternal heave indicate

A

RVH

22
Q

Lung crepitations would indicate … sided heart failure

A

Left

23
Q

When auscultating where MUST your left hand be?

A

palpating carotid pulse

24
Q

… radiates to axilla

A

MR

25
Q

All RIGHT sided murmurs can be made louder by

A

inspiration (lower intrathoracic pressure increases venous return)

26
Q

Mitral and Aortic murmurs can be made louder by asking the patient to …

A

hold their breath on expiration (increased pressure)

27
Q

To increase the volume of the MS diastolic murmur you would ask the patient to move … and hold their breath on …. whilst listening with the … of stethoscope

A

Roll onto LHS
expiration
bell

28
Q

How would you amplify AS (2)

A

sit forward

Hold breath on expiration

29
Q

How would you better differentiate between a CABG and valve replacement scar.

A

Is there an accompanying leg scar

30
Q

Central cyanosis will present with … feeling hands (unless severe) and blue lips/tongue.

A

warm

31
Q

What 3 things might causes central cyanosis

A

Hypoxic lung disease
R-L cardiac shunt
Methaemoglobinaemia

32
Q

What are the 2 causes of R-L cardiac shunt

A

Cyanotic congenital heart disease

Eisenmengers syndrome

33
Q

∆∆ for atrial fibrillation (3)

A

AF
VEBs (ventricular ectopic beats - disappear on exercise)
Complete heart block + ventricular escape

34
Q

The 6 important causes of atrial fibrillation are remembered by the mneumonic PPARTI . What are the first 3

A

PE
Pneumonia
Alcohol

35
Q

The 6 important causes of atrial fibrillation are remembered by the mneumonic PPART. What are the last 3

A

Rheumatic heart disease
Thyrotoxicosis
Ischaemic heart disease

36
Q

An abnormally large decrease in pulse wave amplitude and BP during inspiration despite the heart being heard on auscultation is called a …

A

Pulsus paradoxus

37
Q

In pulsus paradoxus key thing to remember is that it is due to a decreased ability of the heart to contract when pressure increases e.g. during inspiration. Knowing this, what are the 4 main causes (4)

A

Severe obstructive lung disease
Tamponade
Restrictive cardiomyopathy
Constrictitive pericarditis

same as Kussmauls except for SOLD

38
Q

Describe Kussmauls signs

A

Increased JVP on inspiration

39
Q

What is physiologically causes Kussmauls sign

A

impaired RV filling

40
Q

What are the causes of Kussmauls sign

A

Tamponade
Constrictive pericarditis
Restricitve cardiomyopathy
same as pulsus paradoxus

41
Q

there are 5 logical causes of an impalpable apex beat

A 
Fat 
Fluid (pericardal/pulm. effusion) 
Air (pneumothorax)
Displaced (LHF)
Dextrocardia
42
Q

An elevated JVP can be caused by (4)

A

Constrictive pericarditis
PE
RHF
Volume overload

43
Q

Continued elevated JVP can only be caused by one thing

A

SVC obstruction

44
Q

A decreased BP with an increased JVP can be caused by 3 things

A

Massive PE
Tamponade
T pneumothorax

examinations (9 decks)

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