Dr. John's Week 4 Flashcards

1
Q

Mitral Stenosis: high or low pitch?

A

low pitch

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2
Q

Where is mitral stenosis heard best?

A

lying on left side; at apex

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3
Q

Cause of mitral stenosis?

A

rheumatic, rarely congenital

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4
Q

Aortic Stenosis heard when and where?

A

early to mid-systolic best over the base

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5
Q

Where is diastolic mitral stenosis best heard?

A

diastolic murmur heard best at apex with patient in left lateral recumbent position

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6
Q

What is the sound of aortic insufficiency?

A

high pitched diastolic murmur heard best at base

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7
Q

Cause of aortic insufficiency?

A

two thirds are rheumatic endocarditis, trauma, congenital

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8
Q

Describe an aortic insufficiency murmur

A

louder and longer with increasing severity, ‘water hammer’ pulse, increased pulse pressure; best heard at base

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9
Q

What is the pathophysiology of aortic insufficiency?

A

increased stroke volume

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10
Q

Deterioration of what in aortic insufficiency precedes symptoms?

A

left ventricular function

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11
Q

Symptoms of aortic insufficiency?

A

uncomfortable awareness of heartbeat when lying down, exertional dyspenea first symptom followed followed by orthopnea and PND, angina, CHF

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12
Q

When do you hear Mitral Valve Prolapse?

A

mid or late systolic

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13
Q

What is the old name for Mitral Valve Prolapse? Where is it hear?

A

click-murmur syndrome; heard best at the apex

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14
Q

What may follow a mitral valve prolapse murmur?

A

a high pitched late systolic murmur

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15
Q

What is the cause of mitral valve prolapse?

A

congenital or genetic, very common, females between ages 14 and 30

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16
Q

What is the pathophysiology of mitral valve prolapse?

A

myxomatous degeneration of posterior leaflet

17
Q

Are mitral valve prolapse benign or a trigger?

A

benign but may trigger arrhythmias

18
Q

What is the tx for mitral valve prolapse?

A

reassurance

19
Q

What are the two right sided murmurs?

A

tricuspid stenosis and tricuspid regurgitation

20
Q

Where do you see tricuspid stenosis?

A

rare in developed countries; rheumatic

21
Q

What is tricuspid stenosis associated with?

A

mitral stenosis

22
Q

dyspnea

A

abnormally uncomfortable awareness of breathing; can relate to exertion of not

23
Q

Differential Dyspnea on Exertion

A

CHF, angina (anginal equivalent), obstructive airway ds, anemia, hypothyroid, metabolic acidosis (DKA), anxiety and hyperventilation

24
Q

Dyspnea causes not related to exertion?

A

sudden episodes at rest: PE, pneumothorax, anxiety

25
Q

Orthopnea

A

dyspnea when supine

26
Q

Orthopnea causes

A

CHF, asthma, COPD

27
Q

Paroxysmal Nocturnal Dyspnea (PND)

A

waking at night short of breath

28
Q

Cause of PND

A

CHF, COPD

29
Q

Causes of Leg Edema: Mechanisms

A

increased capillary pressure, reduced lymphatic clearance, decreased capillary oncotic pressure, increased capillary permeability

30
Q

Causes of Leg Edema: Subset

A

vena cava obstruction, deep venous obstruction, right atrial HTN, lymphatic obstruction, malnutrition, liver, renal, GI ds, Ca channel blockers, idiopathic cyclic edema