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!VIVA/PACES/PSA > Examination findings > Flashcards

Examination findings Flashcards

1
Q

Coarse crackles

A

Cystic fibrosis

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2
Q

Elevated JVP

A

Fluid overload
Right sided heart failure
Pulmonary HTN

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3
Q

Pan-systolic murmur heard loudest at apex

A

Mitral regurgitation

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4
Q

Ejection systolic murmur heard loudest at right sternum

A

Aortic stenosis

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5
Q

Third heart sound

A

indicates rapid ventricular filling

dilated cardiomyopathy eg HF
constrictive pericarditis

severe mitral or tricuspid regurgitation

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6
Q

Fourth heart sound

A

Reduced compliance of left ventricle eg in conditions causing ventricular hypertrophy (sign of diastolic heart failure). Conditions include:

  • Long standing HTN
  • Severe aortic stenosis
  • Hypertrophic cardiomyopathy
  • Restrictive cardiomyopathy
  • Post-MI fibrosis
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7
Q

Opening snap

A

Mitral stenosis

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8
Q

Slow rising pulse

A

Aortic stenosis

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9
Q

Bounding pulse

A

Aortic stenosis or CO2 retention

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10
Q

Collapsing pulse

A

= water hammer or corrigans = aortic regurgitation

associated with widened pulse pressure

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11
Q

Loud S1

A

AF (due to delayed closure of AV valves, so can also occur in tachycardia)

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12
Q

Tapping apex

A

= palpable S1 = mitral stenosis

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13
Q

Cannon A waves in JVP

A

Occur when right atria contracts against closed tricuspid valve. Seen in

  • AVNRT
  • Complete heart block
  • VT
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14
Q

Low pitched rumbling mid-diastolic murmur

A

= Austin Flint Murmur = severe aortic regurgitation

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15
Q

Mid-systolic click

A

Mitral valve prolapse

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16
Q

Postural flapping tremor

A

Acute CO2 retention

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17
Q

Hyperexpanded chest

A

COPD

Chronic asthma

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18
Q

Stony dull percussion

A

Pleural effusion

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19
Q

Fine crepitations

A

Pulmonary oedema

Pulmonary fibrosis

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20
Q

Pleuritic chest pain

A

PE
Pneumonia
Pneumothorax

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21
Q

Stridor

A

Upper airway obstruction eg foreign body or croup

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22
Q

Coarse crackles

A

Aspiration
Pulmonary oedema
Chronic bronchitis
Pneumonia

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23
Q

Pleural rub

A

Pleurisy
Pleural effusion
Pneumothorax

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24
Q

Erythema nodosum

A 
Sarcoidosis 
Drugs: sulphonamides, COCP, Dapsone
Streptococcal infection 
IBD
BCG vaccination
Leptospirosis 
Mycobacterium eg TB, leprosy 
Yersinia, other viruses, fungi
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25
Q

ECG finding for PE

A

S1Q3T3 (S waves in lead 1, q waves in 3, T wave inversion in lead 3)

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26
Q

Findings for HOCM O/E

A

jerky pulse, double apex beat

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27
Q

Tapping apex

A

Mitral stenosis

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28
Q

Canon a waves in neck

A

3rd degree heart block

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29
Q

Early diastolic murmur at left sternal edge

A

Aortic regurgitation

30
Q

Cause of 3rd heart sound

A

Rapid ventricular filling, eg may be seen in

  • dilated cardiomyopathy
  • Constrictive pericarditis
  • mitral regurgitation
31
Q

Cause of 4th heart sound

A

Atria contracting against stiffened left ventricle (usually secondary to HTN, aortic stenosis or HOCM)

32
Q

Low pitched rumbling mid-diastolic murmur

A

Mitral stenosis

33
Q

Austin flint murmur

A

Pseudo mitral stenosis murmur

= Aortic regurgitation makes mitral valve leaflet close

34
Q

Graham steell murmur

A

High pitched early diastolic murmur due to pulmonary regurgitation -> loudest on inspiration

35
Q

Opening snap on auscultation

A

Mitral stenosis

36
Q

Loud S1 heart sound

A

Mitral stenosis

37
Q

Soft pan-systolic murmur

A

Tricuspid regurgitation

38
Q

Expiratory wheezing

A

Acute severe asthma

39
Q

Coarse crackles + purulent sputum

A

Bronchiectasis

40
Q

Fine crepitations at lung bases

A

Pulmonary oedema

Pulmonary fibrosis

41
Q

Pericardial rub

A

Acute pericarditis

Dressler’s syndrome

42
Q

Stridor indicates?

A

Upper respiratory tract obstruction eg trachea, epiglottis or larynx = just in inspiratory phase

If biphasic then indicates glottis or sub glottis problem

43
Q

What is a wheeze and what can cause it?

A

Indicates lower respiratory tract obstruction

Inspiratory wheeze = extrathoracic cause. Wheezing in inspiratory phase = sign of stenosis/tumour/foreign body

Expiratory wheeze = intrathroracic cause, eg asthma or anaphylaxis

44
Q

Fine crepitations at lung bases suggests?

A

Pulmonary oedema

Pulmonary fibrosis

45
Q

Causes of intention tremor

A

Cerebellar disease or lesion

46
Q

Darkened red reflex on fundoscopy may suggest?

A

Cataracts
Corneal abrasion
Vitreous haemorrhage

47
Q

White eye with no red reflex in child on fundoscopy?

A

Retinoblastoma

48
Q

Features of CNIII palsy and causes

A

Down and out eye, fixed dilated pupil, ptosis
Medical: DM, MS, infarction
Surgical: PCA aneurysm, cavernous sinus thrombosis

49
Q

Features of CNIV palsy and causes

A

Diplopia going downstairs
Central causes: MS, SOL, Vascular
Peripheral: DM, Trauma, Compression

50
Q

Features of CNVI palsy

A

Diplopia horizontally
Central causes: MS, SOL, Vascular
Peripheral: DM, Trauma, Compression

51
Q

Causes of floaters in eye

A

Retinal dettachement
Vitreous haemorrhage
DM/HTN retinopathy

52
Q

Causes of haloes in eye

A

Acute glaucoma (if + pain)
Cataract
Corneal oedema

53
Q

Green-brown rings in the periphery of the iris - name and cause?

A

Kaiser-Fleisher rings

Wilson’s disease

54
Q

A CT scan was performed which shows a biconvex mass after a head injury - diagnosis?

A

Extradural haemorrhage

55
Q

A CT scan was performed which shows a crescent shaped mass after a head injury - diagnosis?

A

Subdural haemorrhage

56
Q

ECG changes…, position and vessel?

V1-V4

A

Anteroseptal

LAD

57
Q

ECG changes…, position and vessel?

I, aVL, V5/V6

A

Lateral

Left circumflex

58
Q

ECG changes…, position and vessel?

II, III, aVF

A

Inferior

RCA

59
Q

ECG changes…, position and vessel?

V4-V6, I, aVL

A

Anterolateral

LAD or LCA

60
Q

ECG changes…, position and vessel?

V1-V3 ST depression or upright T waves

A

Posterior?

LCA or RCA

61
Q

Subungal fibromas O/E - what condition?

A

Tuberous sclerosis

62
Q

Patient presents with

  • raised JVP
  • pulsus paraxodus
  • diminished heart sounds

what’s cause?

A

cardiac tampondade eg could be post MI

63
Q

Dull percussion, absent vocal resonance, reduced expansion - diagnosis?

A

Empyema

64
Q

Dull percussion, increased vocal resonance, reduced expansion - diagnosis?

A

Consolidation

65
Q

Soft S1

A

Prolonged PR interval
Severe Mitral stenosis
Mitral regurgitation

66
Q

Inability to flex the 1st, 2nd and 3rd digits of the hand - name of sign and nerve damaged?

A

Benediction sign

- Median nerve

67
Q

Inability to extend the 4th and 5th digits of the hand - name of sign and nerve damaged?

A

Ulnar claw hand

68
Q

Loss of sensation on the dorsum of the hand over the thumb and index finger - nerve damaged?

A

Radial nerve

69
Q

Signs of fluid overload

A

Tachypnoea
Ascites
Pulmonary oedema
Raised JVP

70
Q

Signs of fluid underload

A

Tachycardia
Hypotension
Oliguria
Sunken eyes and reduced skin turgor

71
Q

Fine end inspiratory crepitations on auscultation - cause?

A

Pulmonary fibrosis

72
Q

Causes of pulmonary fibrosis

A 
Upper: BREAST
Berrylosis
Radiotherapy 
EAA
Ank Spondylosis 
Sarcoidosis 
TB

Zone: CARDS
Cryptogenic fibrosing alveolitis (idiopathic)
Asbestos
RA and other CTDs
Drugs : B-DAMN (bleomycin, Da agonists, amiodarome, methotrexate, nitrofurantoin)
Scleroderma

!VIVA/PACES/PSA (5 decks)

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