History/Physical Exam

Question 1

In which species is cough not suggestive of cardiovascular disease?

Answer 1

Cat

Question 2

What are two client complaints suggestive of heart failure specific to cats?

Answer 2

Acute blindness and sudden loss of function of backlimbs with pain

Question 3

(T/F) With a bad enough murmur, the chest can be felt vibrating also known as thrill.

Answer 3

True

Question 4

What can occur to the abdomen that may be suggestive of cardiovascular disease?

Answer 4

Abdominal distension

Question 5

(T/F) Your general inspection of an animal should be up close and personal.

Answer 5

F, distance

Question 6

Why is demeanor important to assess in your general inspection?

Answer 6

Impacts how vitals and patient stability will be interpreted

Question 7

(T/F) Heart rate should be taken from the pulse.

Answer 7

F, from auscultation

Question 8

What is the normal heart rate for a dog and what is it typically in a clinic setting?

Answer 8

Normal 60-160 bpm, clinic - 80-130 bpm

Question 9

What is the normal heart rate for a cat and what is it typically in a clinic setting?

Answer 9

Normal 140-220 bpm, clinic - average 200

Question 10

Although we are given preset ranges of normal heart rate, what should you base normal or abnormal instead of just the reference ranges of ‘normal’?

Answer 10

Demeanor of the patient

Question 11

When should the respiratory rate be taken?

Answer 11

During general inspection, from afar

Question 12

Respiratory rate should not be taken in a patient that is actively __________.

Answer 12

Panting

Question 13

What is the typical respiratory rate in clinic versus at home?

Answer 13

Clinic - <48 bpm, home - <36 bpm

Question 14

What is orthopnea?

Answer 14

Open mouth breathing

Question 15

What is stridor?

Answer 15

High pitched wheeze

Question 16

What is stertor?

Answer 16

Snoring

Question 17

What is the term for ‘air hunger’, that indicates an interpretation of a patient to be in distress due to lack of oxygenation, and is an emergency situation?

Answer 17

Dyspnea

Question 18

When a patient has a productive cough (a cough in which they swallow afterward), is this typical of cardiovascular disease?

Answer 18

No, respiratory disease

Question 19

A honking cough is typically indicative of what?

Answer 19

Airway collapse

Question 20

What color and texture of discharge with coughing indicate heart disease (and other diseases) and is an emergency situation?

Answer 20

Pink, foamy liquid

Question 21

Crackles on respiratory auscultation localize the issue to what location?

Answer 21

Bronchoalveolar

Question 22

Loud crackles throughout inspiration is indicative of what?

Answer 22

Bronchitis

Question 23

When would you hear crackles on respiratory auscultation with pneumonia and congestive heart failure? (

Answer 23

End inspiratory crackles

Question 24

Wheezing on respiratory auscultation localizes the issue to what location?

Answer 24

Airway

Question 25

Focal reduced sounds on respiratory auscultation are more typical of what pathology?

Answer 25

Mass

Question 26

Diffuse reduced sounds on respiratory auscultation are more typical of what pathology?

Answer 26

Pleural fluid

Question 27

What is a wider pulse pressure usually due to?

Answer 27

Reduced end diastolic pressure

Question 28

What will a reduced systolic pressure do to pulse pressure?

Answer 28

Lower it

Question 29

What three things is pulse pressure dependent on?

Answer 29

Stroke volume, vascular resistance, and heart rate

Question 30

Listed below are diseases that can cause bounding pulses, give the species they are pertinent to. - Patent ductus arteriosus - Aortic insufficiency - Hyperthyroidism - High sympathetic tone and anemia are not species specific

Answer 30

- Patent ductus arteriosus (Dogs) - Aortic insufficiency (Horse) - Hyperthyroidism (Cats) - High sympathetic tone and anemia are not species specific

Question 31

What changes in preload, contractility, and afterload would cause a weak pulse/smaller pulse pressure?

Answer 31

Reduced preload, reduced contractility, increased afterload

Question 32

An absent arterial pulse is indicative of what?

Answer 32

Thromboembolism

Question 33

Besides arrhythmias, what can cause a variable pulse?

Answer 33

Pulsus paradoxus/pericardial effusion

Question 34

If you are listening to a patient and feeling the pulse concurrently but for an occasional beat of the heart, do not feel a coinciding pulse, what does this indicate?

Answer 34

Premature beats

Question 35

Why do premature beats not have a corresponding pulse?

Answer 35

Decreased preload → decrease stroke volume → decreased cardiac output = decrease pulse pressure → no pulse!

Question 36

What does the presence of a jugular pulse indicate?

Answer 36

Elevated right heart pressure

Question 37

Diffusely blue mucous membranes indicate what two potential causes of deoxygenated blood?

Answer 37

Cardiac or respiratory

Question 38

Focal blue mucous membranes can be potentially caused by what?

Answer 38

Thromboembolism

Question 39

What is the normal capillary refill time?

Answer 39

<2-3 seconds

Question 40

Where should you feel the heartbeat on precordial palpation of the heart?

Answer 40

5th ICS on the left side

Question 41

What does a more easily felt right precordial palpated heartbeat (easier to feel that the left side) indicate?

Answer 41

Right heart enlargement or cardiac displacement

Question 42

Sinus arrhythmias are normal in dogs but not in what species?

Answer 42

Cats

Question 43

What is the period between S1 to S2 heart sounds?

Answer 43

Systole

Question 44

What is indicated by S1 splitting?

Answer 44

Asynchronous AV valve closure

Question 45

How can you tell the difference between a physiologic S2 splitting and a pathologic S2 splitting?

Answer 45

Respiration, if it varies with respiration → physiologic, if it is fixed, pathologic, specifically atrial septal defect

Question 46

What would you hear on cardiac auscultation of a patient with degenerative valve disease?

Answer 46

Clicks-systolic sound → ‘lub’-click-’dub’

Question 47

(T/F) If you can hear S3 or S4 in a dog/cat, it indicates cardiovascular disease.

Answer 47

True

Question 48

What are gallops in terms of abnormal heart sounds?

Answer 48

Extra diastolic sound, a sound in S3 and S4, abnormal for small animals only

Question 49

In general, what do murmurs result from?

Answer 49

Turbulent blood flow

Question 50

Increased ___________ (velocity/viscosity/diameter) explains almost all murmurs.

Answer 50

Velocity

Question 51

What would cause increased viscosity that can cause turbulent blood flow and consequent murmurs?

Answer 51

Anemia

Question 52

Pathologic murmurs are typically related to abnormal AV valve _________ (closure/opening) and abnormal semilunar valve __________ (closure/opening), this means most murmurs are ____________ (diastolic/systolic).

Answer 52

Closure, opening, systolic

Question 53

If you can hear a murmur in 3 of the heart auscultation locations, what would you grade the murmur?

Answer 53

Grade 3

Question 54

What would you grade a murmur that is loud on auscultation and has a palpable thrill?

Answer 54

Grade 5

Question 55

What grades and timing are constant for innocent or non pathologic murmurs?

Answer 55

Soft grade → 2 or less, and always systolic