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PCM III > Heart OSCE > Flashcards

Heart OSCE Flashcards

1
Q

MR how does it sound?

A

Blowing/holosystolic radiating to left axilla

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2
Q

TR how does it sound?

A

blowing quality/holosystolic

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3
Q

MS how does it sound?

A

rumbling, low pitched

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4
Q

What is associated w/ PS?

A

Increases w/ inspiration

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5
Q

What does expiration do to heart sounds?

A

Left side gets louder, right side gets quieter

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6
Q

Explain how squatting causes MVP and HCM to DECREASE in intensity?

A

Squatting increases venous return, PVR, SV and BP while standing has the opposite effect

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7
Q

When does TS increase in intensity?

A

Inspiration

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8
Q

PS how does it sound?

A

harsh, loud, ejection click radiating into left shoulder

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9
Q

AR what does it sound like?

A

blowing, decrescendo murmur

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10
Q

Aortic Stenosis where?

A

2nd/3rd R ICS

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11
Q

Where is PS?

A

2nd/3rd L ICS

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12
Q

How do you position volume overloaded patients to test for JVP?

A

Elevate head to 60-90*

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13
Q

What does inspiration do to heart sounds?

A

Right side gets louder, left side gets quieter

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14
Q

Where is AR?

A

2nd-4th ICS on LEFT

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15
Q

What is associated w/ TR?

A

Increases w/ inspiration

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16
Q

What conditions, other than HF, is JVP increased in?

A
  • TS
  • Chronic PAH
  • SVC obstruction
  • Tamponade
  • Constrictive pericarditis
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17
Q

What murmur is better heard by leaning forward?

A

AR

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18
Q

When does TS decrease in intensity?

A

Expiration & valsalva

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19
Q

What side of stethoscope to use for MS?

A

BELL

20
Q

What is associated w/ AS?

A

delayed pulses (pulsus tardus et parvus)

21
Q

What side of stethoscope to use for AR?

A

Diaphragm

22
Q

What murmur increases INTENSITY w/ valsalva?

A

HCM

23
Q

Where is MR?

A

Prominent @ apex

24
Q

TR (insufficiency) where?

A

Lower left sternal border

25
Q

MS where?

A

APEX

26
Q

What murmur is better heard by straining/valsalva?

A

MR

27
Q

PR how does it sound?

A

blowing quality

28
Q

What murmur is better heard w/ left lateral decubitus position?

A

MS (and extra heart sounds)

29
Q

What is associated w/ MR?

A

Loudness correlates w/ degree of valve insufficiency

30
Q

What murmur increases DURATION w/ valsalva?

A

MVP

31
Q

What is JVP like in COPD?

A

elevated w/ expiration but collapses on inspiration

32
Q

How do you position septic/hypovolemic patients to test for JVP?

A

Lie them flat

33
Q

AS how does it sound?

A

harsh quality (crescendo/decrescendo) radiating into suprasternal notch and carotids

34
Q

How does VSD sound?

A

Holosystolic murmur @ LLSB

35
Q

What causes fixed splitting?

A

ASD

36
Q

What causes reverse (paradoxical) splitting?

A

LBBB
AS
CoA
PDA

37
Q

What causes widened physiological split?

A

RBBB
PS
VSD
MR

38
Q

What causes A2 w/ increased intensity?

A

Systemic HTN

Aortic root dilation

39
Q

What causes P2 w/ increased intensity?

A

PAH
Dilated pulmonary a.
ASD

40
Q

What causes A2 to be diminished or absent?

A

Calcific AS

41
Q

What causes P2 to be diminished or absent?

A

Increased AP diameter (aging)

PS

42
Q

Where is PDA murmur best heard?

A

LUSB that is continuous throughout systole/diastole (machine-like) and crescendo/decrescendo

43
Q

What murmur can be seen in newborns w/ low Apgar score?

A

TR

44
Q

Where is CoA murmur heard?

A

Posterior chest (b/w scapulae)

45
Q

Where is Still’s murmur heard?

A

Systolic murmur w/ maximum intensity @ LLSB
(musical)
Tends to be louder in hyperdynamic (anxiety/fever) states

46
Q

What does ASD sound like?

A

Rare to have sx, but systolic murmur @ LUSB (fixed/widely split S2)

47
Q

What is single most common heart lesion?

A

Bicuspid aortic valve

PCM III (4 decks)

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