Day 4 - CV2 Quiz

Question 1

CXR pericardial effusion

Answer 1

Globular/watterbottle shaped heart (similar to DCM)

Question 2

PE pericardial effusion

Answer 2

Diminished heart sounds, difficult to palpate apical impulses

Question 3

Kussmaul sign

Answer 3

Increased JVD w/ inpsiration; Most commonly constrictive pericarditis; Restrictive CM, Right ventricular infarct, Massive PE; Rarely, with cardiac tamponade

Question 4

Signs of HF, DM, elevated LFTs

Answer 4

Triad = Hemochromatosis (restrictive CM); Bronze diabetes

Question 5

Restrictive CM etiology, reversed w/ phlebotomy

Answer 5

Hemochromatosis

Question 6

Next step in w/u low grade systolic murmur in healthy, asymptomatic pt

Answer 6

Usually benign, so Observation; If symptomatic or sx of valvular disease - Echo

Question 7

Next step in w/u diastolic murmur in healthy, asymptomatic pt

Answer 7

Echo

Question 8

Short systolic murmur at cardiac apex, decrease w/ squatting, sometimes assoc w/ benign chest pain last a few seconds

Answer 8

MVP (also may have mid-systolic click); Also assoc. w/ anxiety

Question 9

Valve disorder from heumatic disease may become sx/pronounced when

Answer 9

Volume overload state (e.g., pregnancy)

Question 10

HF in young patients

Answer 10

Myocarditis (e.g., coxsackievirus, echovirus)

Question 11

Beck’s triad

Answer 11

Hypotension, distended neck veins, muffled heart sounds; Cardiac tamponande

Question 12

CHF Drugs

Answer 12

ACEi/ARB; Beta blocker; Loop diuretic; Spironolactone/Eplerenon; Maybe digoxin; ASA

Question 13

Acute HF

Answer 13

LMNOP = Lasix, Morphine, Nitrates (sometimes, Nesiratide), Oxygen, Positioning/Pressors (e.g., Dobutamine)

Question 14

Diastolic murmur heard best at LL sternum, increases w/ inspiration

Answer 14

Tricuspid stenosis

Question 15

Late diastolic murmur w/ opening snap, No change w/ inspiration

Answer 15

Mitral stenosis

Question 16

Systolic murmur heard best in 2nd right intercostal space

Answer 16

Aortic stenosis

Question 17

Systolic murmur heard best in 2nd left interspace

Answer 17

Pulmonic stenosis

Question 18

Late diastolic murmur heard best at apex

Answer 18

MVP

Question 19

Diastolic murmur w/ widened pulse pressure

Answer 19

AR

Question 20

Holosystolic murmur loudest w/ inspiration heard at LLS

Answer 20

Tricuspid regurgitation

Question 21

Holosytolic murmur heard best at apex and radiates to axilla

Answer 21

Mitral regurgitation