Exam - Cardio

Question 1

Jugular Venous Pressure (6) differences from Carotid Pulse

Answer 1

1. Double impulse (if in sinus rhythm)
2. Falls with inspiration, rises with expiration
3. Not palpable
4. Can be occluded by gentle finger pressure
5. Varies with sitting up or lying down
6. Increases with hepato-jugular reflux

6 features:
2 to see: (1 & 2)
2 to feel: (3 & 4)
2 to do: (5 & 6)

Question 2

What should you suspect in fever + murmur?

Answer 2

Infective endocarditis

Question 3

Common causes of “regularly irregular” pulse

Answer 3

Premature beats

Question 4

What does high JVP indicate?

Answer 4

High RA Pressure

due to Cardiac Failure, Fluid Overload

Question 5

When do you see single wave of JVP?

Answer 5

Atrial Fibrillation

Question 6

What is Kussmaul’s Sign?

Answer 6

JVP Rising with inspiration e.g. in constrictive pericarditis

Question 7

When do you get a large a wave of JVP?

Answer 7

Stiff RV

Question 8

When do you get a large v wave of JVP?

Answer 8

Tricuspid Regurgitation

Question 9

Character of carotid pulse in aortic stenosis

Answer 9

Small volume, late rise

specific but not sensitive

Question 10

Character of carotid pulse in aortic regurgitation

Answer 10

High volume, rapid fall (collapsing)

sensitive but not specific

Question 11

What can a carotid bruit tell you?

Answer 11

–Represents carotid narrowing

–But not sensitive or specific and poor predictor of TIA & stroke

Question 12

When do you hear S3?

Answer 12

–Turbulence during early filling of the ventricle
–May be normal
–Dilated left ventricle
•Dilated Cardiomyopathy
•Volume overload: Mitral or Aortic Regurgitation

Question 13

When do you hear S4?

Answer 13

–Turbulence during atrial contraction
–In stiff ventricle
•Hypertension
•Aortic Stenosis
•Hypertrophic Cardiomyopathy