Heart Random

Question 0

S4

Answer 0

High atrial pressure due to Ventricular hypertrophy

Question 1

S3

Answer 1

Mitral regurgitation
Heart failure
Dilated ventricle
Normal in children and pregnant women

Question 2

S2 splitting - normal

Answer 2

Inspiration and exacerbated in pregnancy

Question 3

S2 splitting - wide

Answer 3

Pulmonic stenosis
RBBB

Due to delayed RV emptying

Question 4

Fixed s2 splitting

Answer 4

ASD - causes left-to-right shunt, causing increased RV volume and increased pulmonic flow so that pulmonic closure is delayed

Question 5

Paradoxical splitting

Answer 5

Aortic stenosis, LBBB - conditions that delay aortic valve closure

Question 6

Carcinoid syndrome

Answer 6

Metastatic small bowel tumor (not in bow, must be past liver) that secrete seratonin (5-HT)

Symptoms: diarrhea, flushing, wheezing

Clinical: right-sided valvulopathy

Labs: Increased 5-hydroxyindoleacetic acid (5-HIAA) in urine

Tx: surgical, Octreotide