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PD Block 1 > CVS PhExam > Flashcards

CVS PhExam Flashcards

1
Q

Jane way lesion - non tender red macular
osler nodes - painful red raised
splinter hemorrhages - red brown lines in nail bed

A

all signs seen in infective endocarditis

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2
Q

pressure applied to nail bed until it turns white

prolonged: dehydration, shock, PVS, hypothermia

A

capillary refill

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3
Q

JVP best assessed where

A

right internal jugular vein

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4
Q

atrium contracting tricuspid valve open

A

A wave on JVP

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5
Q

atrium relaxing then filling, tricuspid closed

A

x descent on JVP

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6
Q

atrium tense, full; tricuspid closed

A

v wave on JVP

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7
Q

atrium emptying, tricuspid open

A

y wave on JVP

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8
Q

resistance to RA emptying at or beyond TV
open tricuspid
causes - pulmonary HTN, tricuspid stenosis

A

elevated a wave

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9
Q

occurs when RA contracts against a closed TV during AV dissociation
cause - PAC; ventricular beats, complete AV block, ventricular tachycardia
closed tricuspid valve

A

cannon a wave

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10
Q

no atrial contraction

cause A fib

A

absent a wave

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11
Q

increased atrial filling during systole

cause - tricuspid regurgitation (lancisi sign)

A

elevated v wave

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12
Q

normal JVP

A

3-4 cm above sternal angle

8-9 cm from right atrium

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13
Q

increased JVP

A

1) RHF
2) pericardial dz
3) tricuspid stenosis
4) chronic pulmonary HTN
5) SVC obstruction

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14
Q

decreased JVP

A

hypovolemia

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15
Q

with px breathing normally, place right hand on RUQ of abdomen and press firmly upward under costal margin for 10-15 sec
+ sign: JVP rises and persists as long as abdominal pressure continues
RHF

A

hepatojugular reflex

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16
Q

+ sign: failure of the jugular venous column to collapse during inspiration
constrictive pericarditis

A

kussmaul sign

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17
Q

correlates well with pulse pressure

A

amplitude

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18
Q

speed of upstroke - brisk or high pitched, murmur like sound
smooth, rounded, midsystolic - contour

A

contour

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19
Q

high pitched, murmur like sound

A

bruit or thrill

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20
Q

small thready pulse amplitude

A

cardiogenic shock

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21
Q

bounding amplitude

A

AR

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22
Q

delayed upstroke contour

A

AS

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23
Q

pulsus alternans contour

A

beat to beat variability

24
Q

bigeminal pulse contour

A

normal heart alternating with PVC

25
Q

biferiens pulse contour

A

double systolic peak

26
Q

carotid sinus
tortuous carotid artery
hypervascularity of hyperthyroidism
external compression from TOS

A

examples of bruits and thrills

27
Q 
rarely palpable 
soft, biphasic, undulating quality
eliminated on light pressure
height of pulsations changes 
on inspiration usually falls
A

JVP

28
Q 
palpable
brisk, single pulse
does not disappear on light tough
no change with position change
no effect on inspirations
A

carotid pulse

29
Q

point of maximal impulses

A

5th ICS, LMCL

single outward pulse

30
Q

double pulse (2 peaks)

A

hypertrophic cardiomyopathy

31
Q

fast impulse with large amplitude, terminates quickly
increase volume work
MR and AR, exercise, hyper metabolic state

A

forceful and hyper dynamic amplitude

32
Q

impulse is sustained throughout systole
increase pressure work
AS, LVH, systemic HTN

A

forceful and sustained amplitude

33
Q

anemia
hyperthyroidism
high cardiac output

A

hyper metabolic state

34
Q 
closure of mitral and tricuspid 
mitral closes first
transition from diastole to systole
listen with diaphragm 
loudest at apex
identify just before the carotid upstroke
A

S1 sound

35
Q

short PR interval
mild mitral stenosis
hyperdynamic states

A

loud S1

36
Q 
Long PR interval 
severe mitral stenosis
LBBB
COPD
obesity
pericardial effusion
A

soft S1

37
Q

AV dissociation
atrial fibrillation
large pericardial effusion
severe LV dysfunction

A

variable S1

38
Q 
closure of AV and PV
AV closes first 
identify just after upstroke 
listen to it with diaphragm 
during expiration single
during inspiration split
loudest at base - 2 ICS
A

S2 sound

39
Q

presence if splitting during expiration, wider during inspiration

RBBB, pulmonic stenosis, MR

A

wide split

40
Q

splitting at both expiratory and inspiratory phases but dies not lengthen with inspiration

ASD, RV failure, pulmonary HTN

A

fixed splitting

41
Q

reverse of normal physiology; splitting of S2 during expiration, singular during inspiration

pulmonary before aortic

LBBB, AS

A

paradoxical split

42
Q

single S2

A

severe AS or AR

43
Q

listen with the bell
ventricular gallop rhythm (Kentucky)
apex, left lateral decubitus position
early diastole: rapid ventricular filling

physiological: child, pregnant, athletes
pathological: abrupt deceleration (LVF, volume overload, decreased myocardial contraction)

A

S3

44
Q 
listen with bell 
atrial gallop (Tennessee)
apex, left lateral decubitus position
late diastole
pathologic: stiff and non complaint ventricle
A

S4

45
Q

heard at right 2 ICS
at early systole
causes: dilated aorta, AS

A

aortic ejection sound

46
Q

heard left 2 ICS and 3 ICS
at early systole

cause: dilated pulmonary artery, pulmonic stenosis, pulmonary HTN

A

pulmonic ejection sound

47
Q

heard at apex
at mid systole

cause: ballooning of part of MV into the atrium

A

MVP click

48
Q

vibration felt through chest wall

A

thrills

49
Q

murmur intensities

A

grade 1 - barely audible
grade 2 - soft but easily heard
grade 3 - loud
grade 4 - loud + palpable thrill
grade 5 - loud with minimal contact between stethoscope and chest + thrill
grade 6 - loud with no contact between stethoscope and chest + thrill

50
Q

heard at erbs point - left 3 ICS

A

AR

51
Q 
scratchy, scraping sound
left 3 ICS
seen in pericarditis 
px leans forward, exhales and holds breath 
triphasic in 50% of px
A

pericardial friction rub

52
Q

systemic HTN

dilated aortic root

A

loud A2

53
Q

calcified aortic stenosis

A

soft or absent A2

54
Q

pulmonary HTN

ASD

A

loud P2

55
Q

pulmonic stenosis
COPD
aging

A

soft or absent P2

PD Block 1 (4 decks)

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