Heart

Question 1

Angina

Answer 1

substernal pain
radiate to neck, jaws, arms, particularly the left
pulmonary edema
Reduction of S1
S4

Question 2

Bacterial endocarditis

Answer 2

sudden onset of heart failure
murmur
neurologic dysfunction
Janeway lesion: erythematous/ hemorrhagic macules on palms and soles
Osler nodes: painful red raised lesions on tips of fingers/ toes

Question 3

CHF

Answer 3

Left side- pulmonary congestion, cardiomegaly

Right side: systemic circulation congestion, jugular venous distention

Question 4

Pericarditis

Answer 4

often viral
sharp and stabbing pain worse with chest movement/ lying flat
pain in the back, neck, left shoulder
friction rub heard on left of sternum of 3rd/ 4th intercostal space

Question 5

cardiac tamponade

Answer 5

fluids/ blood between pericardium and heart
Beck triad: jugular venous distention, hypotension, muffled heart sound
swelling of abdomen/ arms/ neck veins

Question 6

Cor Pulmonale

Answer 6

result from chronic COPD and pulmonary hypertension
RV enlargement
hemoptysis
distended neck viens with prominent A/ V waves

Question 7

MI

Answer 7

mostly in LV
S4
soft systolic blowing apical murmur

Question 8

myocarditis

Answer 8

inflammation of myocardium
dyspnea
history of recent flu like symptoms, arthralgias
cardiac enlargement, murmurs
pulsus alternans (alteration of strong and weak arterial pulse)
usually accompanied with pericariditis

Question 9

sick sinus syndrome

Answer 9

secondary to HTN, arteriosclerosis, rheumatic heart
dizzy spells
seizures
palpitation, angina
CHF S/S

Question 10

First degree heart block

Answer 10

conduction takes little longer than usual

PR> 0.2 sec

Question 11

Second degree heart block

Answer 11

Type 1: Wenckebach/ Mobitz 1, PR increases each beat until QRS dropped
Type 2: Mobitz 2, PR stays the same with a dropped QRS

Question 12

third degree heart block

Answer 12

complete heart block

AV node generates a rate by itself.

Question 13

Ventricular septal defect

Answer 13

30-50% close spontaneously by 2y/o
recurrent respiratory infections
holosystolic, loud, coarse, high pitch murmur
best heard on L sternal boarder in 3rd-5th IS

Question 14

Tetralogy of Fallot

Answer 14

Ventricular septal defect
Pulmonic stenosis
Dextroposition of aorta
RV hypertrophy
paroxysmal dyspnea, central cyanosis
systolic murmur over 3rd IS

Question 15

patent ductus arteriosus

Answer 15

blood from aorta to pulmonary artery-> pulmonary hypertension-> RV workload increases
harsh, loud, continuous murmur on 1st-3rd IS

Question 16

Atrial septal defect

Answer 16

often asymptomatic until adults
loud, high pitch, harsh diamond systolic murmur
heard over pulmonic area
Wildly split S2

Question 17

Rheumatic fever

Answer 17

usually just affect mitral/ aortic valve
carditis
polyarthritis
Chorea (brief, abrupt, irregular, unpredictable, non-stereotyped movements)
erythema marginatum (iris lesion)
subcutaneous nodules
increased antistreptolysin antibodies

Question 18

Senile Cardiac amyloidosis

Answer 18

chronic inflammation/ CA-> amyloid fibrillary protein in heart