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Boards 2 chiroessentials (1) > General diagnosis - Cardiovascular exam > Flashcards

General diagnosis - Cardiovascular exam Flashcards

1
Q

Aneurysm of the arch of the aorta

A

vascular surgeon referral

  • bovine cough and tracheal tug
  • dilation of the arch of the aorta
  • associated with: atherosclerosis, HTN, Marfan’s syndrome, tertiary syphilis
  • chest xray: widening of the S. mediastinum
  • CT confirms aneurysm
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2
Q

Aortic imcompetence

A

cardiologist referral

  • titubation, diastolic murmur (2nd right intercostal space near sternum)
  • valvular heart disease
  • associated w/: rheumatic fever,marfan’s syndrome, syphilitic aortitis
  • ECHOcardiography confirms Dx
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3
Q

Aortic stenosis

A

cardiologist referral

  • angina, systolic murmur (2nd right intercostal space parasternally)
  • valvular heart disease often caused rheumatic fever
  • ECHOcardiography confirms Dx
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4
Q

Bacterial endocardidtis

A

hospital referral

  • fatigue, fever, harsh murmur (tricuspid valve MC affected)
  • valvular heart disease seen with intravenous drug users (staphylococcus aureus)
  • blood cultures grow offending organism
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5
Q

Cardiac tamponade

A

hospital referral
Beck’s triad: distant heart sounds, high jugular venous pressure, hypotension
- compression of the heart by fluid/blood w/in pericardial sac (infection or traumatic)
- ECHOcardiography confirms Dx

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6
Q

Coarctation of the aorta

A

vascular surgeon referral

  • HTN in upper limbs and delayed radiofemoral pulse
  • congenital narrowing of the aorta beyond left subclavian aa.
  • CT confirms Dx
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7
Q

Fallot’s tetralogy

A

pediatric cardiologist referral

  • failure to thrive d/t poor feeding, cyanosis, clubbing of the fingers and loud pansystolic murmur herd (3rd left intercostal space parasternally)
  • MC cyanotic congenital heart disease (pulmonary stenosis, right ventricular hypertrophy, overriding aorta, ventricular septal defect)
  • chest xray: boot-shaped heart
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8
Q

Hyperthyroidism

A

Co-manage with enocrinologyist

  • goiter, tachycardia, diarrhea, BL exophthalmos (in graves disease), unblinking stare, fine physiological tremor of outstretched hands — older pts present with atrial fibrillation-irregularly irregular pulse.
  • overactive thyroid gland with excess production of thyroxin
  • elevated T3 and T4 with a low TSH in primary hyerthyroidism
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9
Q

Mitral incompetence

A

cardiologist referral

  • pansystolic murmur (5th left intercostal space, midclavicular line)
  • valvular heart disease often caused by rheumatic fever
  • ECHOcardiography confirms Dx
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10
Q

Mitral stenosis

A

cardiologist referral

  • malar flush, diastolic murmur with an opening snap (5th left intercostal space, midclavicular line)
  • valvular heart disease often caused by rheumatic fever
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11
Q

Mitral valve prolapse

A

cardiologist referral

  • atypical chest pain, mid-systolic click (5th left intercostal space, midclavicular line)
  • valvular heart disease (idiopathic), associated w/ marfan’s syndrome
  • echography confirms Dx and severity of prolapse
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12
Q

Pulmonary embolism

A

911
sudden onset of dyspnea, pleuritic chest pain, hemoptysis
- breakaway clot from DVT causing obstruction of pulmonary aa. or branch
- positive d-dimer
- lung perfusion scan or spiral CT of chest is diagnostic

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13
Q

Subacute bacterial endocarditis

A

hospital referral

  • fatigue, low grade fever, anemia, splinter hemorrhages, clubbing of the fingers and splenomegaly
  • disease caused by infection of previously damaged heart valves by streptocccus viridans
  • blood cultures grow causative organism associated with dental caries
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14
Q

Subclavian steal syndrome

A

cardiologist referral

  • syncope, especially with upper body exercise and radio-radial delay (>10 mm diff b/w BP in both arms)
  • congenital occlusion of subclavian aa w/ shunting of blood via vertebral aa
  • MRA confirms Dx
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15
Q

S. vena cava obstruction

A

cardiothoracic surgeon referral

  • edema of the face and distended neck and upper limb veins
  • obstruction fo the SVC by large mass in the S. mediastinum
  • seen in lymphoma
  • chest xray: widening of the S. mediastinum
  • CT scan will show the mass
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16
Q

Absence of Schamroths space or nail bed angle

A

clubbing of the fingers

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17
Q

Beau’s lines (transverse grooves in nails)

A

recent serious disease

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18
Q

carotid bruit (whooshing sound)

A

significantly narrowed artery

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19
Q

clubbing of fingers

A

bacterial endocarditis, Fallot’s tetralogy

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20
Q

cyanosis-central (blue lips, fingers, toes)

A

sever respiratory distress, Fallot’s tetralogy

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21
Q

cyanosis-peripheral (blue finger, toes)

A

cold temperature, raynaud’s disease

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22
Q

diagonal earlobe creases

A

increased risk of heart attack

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23
Q

dilated chest and arm veins

A

superior vena cava obstruction

24
Q

diastolic murmur in 2nd RICS

A

aortic regurgitation

25
Q

elevated jugular venous pressure

A

CHF, cardiac temponade

26
Q

diastolic murmur 5th LICS

A

mitral stenosis

27
Q

displaced apex beat outside of 5th LICS

A

left ventricular hypertrophy

28
Q

distended jugular veins

A

congestive heart failure

29
Q

erythema marginatum, cardiac murmur, joint pain

A

rheumatic fever

30
Q

hepatojugular reflex (increased JVP with RUQ pressure)

A

congestive heart failure

31
Q

koilonychia (spoon shaped nails)

A

severe iron deficiency anemia

32
Q

left parasternal heave

A

right ventricular hyperophy

33
Q

loss of hair on the dorsum of the foot and toes

A

peripheral vascular disease

34
Q

malar flush (red flushed cheeks)

A

mitral stenosis, carcinoid tumors

35
Q

midsystolic click in 5th LICS

A

mitral valve prolapse

36
Q

pale nail beds, mucosa or tongue

A

anemia

37
Q

pansystolic murmur in 5th LICS

A

mitral regurgitation

38
Q

peripheral edema BL

A

CHF, chronic bronchitis, cirrhosis, renal failure

39
Q

peripheral edema unilateral

A

DVT, cellulitis

40
Q

precodial thrill (palpable murmur)

A

pathological murmur

41
Q

pulses alternans (strong followed by weak)

A

left ventricular failure

42
Q

pulses bigeminus (double beats)

A

hypertrophic obstructive cardiomyopathy

43
Q

pules magnus (bounding pulse)

A

fever, anemia, hyperthyroidism

44
Q

pulses paradoxus (pule decreases in inspiration)

A

> 10 mm Hg : asthma, cardiac tamponade

45
Q

pulses parvus (low volume pulse0

A

shock, aortic stenosis

46
Q

Radio-femoral delay

A

coarctation of the aorta

47
Q

S3 heart sound

A

normal in healthy young adults, CHF

48
Q

S4 heart sound

A

HTN, cardiomyopahty

49
Q

split 1st heart sound varies with breathing

A

normal in health yound 30yo adults

50
Q

split 1st heart sound-fixed (no variation)

A

ASD or right bundle branch block

51
Q

Splinter hemorrhage

A

subacute bacterial endocarditis

52
Q

systolic murmur in 2nd RICS

A

aortic stenosis

53
Q

systolic murmur in the 5th LICS midclavicular line

A

mitral regurgitation (incompetence)

54
Q

titubation (nodding of head with heart beat)

A

aortic regurgitation (incompetence)

55
Q

tracheal tug (downward pull on trachea)

A

aneurysm of the arch of the aorta

56
Q

xanthelasma (yellow eyelid deposits)

A

hyperlipidemia (50% pts)

57
Q

water hammer pulse (bounding pulse)

A

fever, anemia, hyperthyroidism)

Boards 2 chiroessentials (1) (25 decks)

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