Heart murmurs

Question 1

Machinery like murmur

Answer 1

Patent ductus arteriosus, PDA

Question 2

Early diastolic with High pitched quality,

Louder when pt is sitting and leaning forward (at the Base of the heart)

Answer 2

Aortic regurg

Question 3

Base of heart, what murmurs would be heard?

Answer 3

Aortic

Pulmonic

Question 4

Tx for Dilated Cardiomyopathy

Answer 4

ACE-I and B blocker

Question 5

Person w hx of Cocaine use, coming in with Dilated Cardiomyopathy

found unconscious

Answer 5

50% of DCM recover spontaneously, and someone w hx of cocaine use should NOT be given B-blocker

wean off oxygen

Question 6

4 main types of shock

Answer 6

Cardiogenic
Hypovolemic
Distributive
Obstructive

Question 7

Ventricular Septal Defect

-blood flowing between ventricles thru the septum

Answer 7

Normal life expec

but inc risk of bacterial endocarditis

Question 8

Unique trait a/w VSD- ventricular septal defect

Answer 8

The smaller the defect, the LOUDER the murmur (bc the greater the gradient from L to R ventricle)

Question 9

What do you use to Close PDA-patent ductus arteriosus

Answer 9

Indomethacin

Question 10

ASD- atrial septal defect

Answer 10

Definitive tx: Close defect surgically

Large shunt or Heart failure: diuretic, digoxin, ACE-I before surgery

Question 11

HCTZ (thiazide diuretic) to tx HTN is a/w

Answer 11

Hypokalemia
(low K)
muscle weakness, cramping, heart arrhythmia, kidney abn, glucose int

Question 12

IVDU Endocarditis

Answer 12

Tricuspid valve

Tx w Vancomycin

Question 13

after trauma, SOB and Muffled heart sounds

Answer 13

think Pericardial Tamponade

Question 14

Aortic regurg

Answer 14

Wide pulse pressure
Tachycardia

High pitched murmur, loudest at Left sternal border

Loude`r when leaning forward

Question 15

Which type of Cardiomyopathy is a/w Radiation

Answer 15

Restrictive Cardiomyopathy, RCM

Question 16

Restrictive Cardiomyopathy is referred to as

Answer 16

Radiation Cardiomyopathy

more common in pts w hx of Breast or Lung CA that have underwent Radiation to thoracic area

Question 17

Restrictive Cardiomyop has signs of which side Heart failure

Answer 17

Right sided Heart Failure

peripheral edema
ascites

Question 18

Harsh, pansystolic murmur in an A-sx baby

Answer 18

VSD- ventricular septal defect

Question 19

Given at therapeutic doses, _______ can reduce Cholesterol levels

Answer 19

Nicotinic acid

Question 20

Which artery does the Ophthalmic artery branch off of?

Answer 20

Internal carotid

Question 21

Amaurosis Fugax

Answer 21

transient Monocular vision loss d/t Retinal clot or Reduction of blood flow from Retinal, Ophthalmic, or Ciliary artery

Question 22

Monocular vision loss lasting a few min w Complete recovery

Answer 22

Amaurosis fugax

problem w Ophthalmic artery which branches off of Internal carotid

Question 23

What can cause Mitral Regurg

Answer 23

Ichemia following a Myocardial Infarction

Question 24

About 25% of pts that get surgery for Coarcation of the Aorta then have

Answer 24

HTN

d/t changes in the RAAS system

Question 25

Post surgery for Coarctation of the Aorta

Answer 25

HTN | Disproportionate systolic HTN w exercise

Question 26

What risks do ppl who have had surgery to repair Coarctation of the Aorta now have?

Answer 26

Re-coarctation Aortic aneurysm LVH

Question 27

What monitoring do those with surgical repair of Coarcation of Aorta need?

Answer 27

BP monitor! if high, treat aggressively

Question 28

What is Coarctation of Aorta

Answer 28

Narrowing of the Aorta

Question 29

Sx of Coarc of Aorta

Answer 29

Often no sx until adulthood, adult presents with HTN

Question 30

Excessive alcohol use is a/w which type of Cardiomyopathy

Answer 30

Dilated cardiomyopathy

Question 31

S3 gallop

Answer 31

Heart failure

Question 32

6 week old infant Turns blue all over when feeding or crying Cyanosis of lips when crying RVH

Answer 32

Tetralogy of Fallot

Question 33

Most common Cyanotic Congenital Heart defect

Answer 33

Tetralogy of Fallot

Question 34

4 components of Tet of Fallot

Answer 34

Ventricular Septal Defect- VSD Pulm Artery stenosis Overriding aorta (displaced to the R) Right Ventricle Hypertrophy

Question 35

VSD- hold b/w ventricles Pulm artery stenosis- pulm artery is hard Overriding aorta- aorta is displaced to the R RVH

Answer 35

Tet of Fallot

Question 36

Tet of Fallot

Answer 36

Hole in ventricles Pulm artery is hard Aorta is to the R R Ventricle is big

Question 37

Gradual onset of reduced exercise tolerance 3/4 Diastolic murmur best heard at APEX

Answer 37

Mitral stenosis

Question 38

Apex valves would be

Answer 38

Mitral | Tricuspid

Question 39

Diastolic rumbling murmur best heard at apex

Answer 39

Mitral stenosis

Question 40

Harsh, low pitched Crescendo-decrescendo SYSTOLIC murmur starting after S1

Answer 40

Aortic Stenosis

Question 41

K sparing diuretic

Answer 41

Amiloride so if pt w HF has low K levels, can add this one

Question 42

Sx you may see with Coarc of Aorta (other than HTN)

Answer 42

Rib notching Notch in aorta Higher BP in upper extremities than lower Delay b/w brachial and femoral pulses Systolic ejection murmur