Midterm

Question 1

S1

Answer 1

mitral and tricuspid valve closure

Question 2

S2

Answer 2

aortic and pulmonic valve closure

Question 3

S3

Answer 3

in early diastole
associated with mitral regurg., congestive heart failure, and dilated ventricles
normal in children and pregnant women

Question 4

S4

Answer 4

in late diastole

associated with ventricular hypertrophy, scarring from MI, pericardial effusion, cardiac tamponade

Question 5

Normal (physiologic) splitting

Answer 5

on inspiration

Question 6

Wide splitting

Answer 6

Delays in RV emptying such as pulmonic stenosis, right bundle branch block

Question 7

Fixed splitting

Answer 7

Seen in atrial septal defect

Question 8

Paradoxical splitting

Answer 8

Delays in aortic valve closure such as aortic stenosis, left bundle branch block

Question 9

Hand grip

Answer 9

increases intensity of MR, AR, VSD murmurs

later onset of click for MVP

Question 10

Valsalva

Answer 10

increases intensity of hypertrophic cardiomyopathy murmur

earlier onset of click for MVP

Question 11

Rapid squatting

Answer 11

increases intensity of AS murmur

later onset of click for MVP

Question 12

Systolic heart sounds

Answer 12

aortic/pulmonary stenosis, mitral/tricuspid regurg, VSD, MVP

Question 13

Diastolic heart sounds

Answer 13

aortic/pulmonary regurg, mitral tricuspid stenosis

Question 14

Aortic stenosis

Answer 14

Crescendo-decrescendo systolic ejection murmur, “barking”

Can lead to Syncope, Angina, Dyspnea (SAD)

Question 15

Mitral regurgitation

Answer 15

Holosystolic (only chronic MR), high-pitched “blowing murmur” heard loudest at apex and radiates toward axilla
Non-holosystolic in acute MR

Question 16

Tricuspid regurgitation

Answer 16

Holosystolic, high-pitched “blowing murmur” heard loudest at tricuspid area and radiates toward sternal border

Question 17

Mitral valve prolapse

Answer 17

Late systolic crescendo murmur with midsystolic click

Question 18

VSD

Answer 18

Holosystolic, harsh sounding murmur loudest at tricuspid area

Question 19

Aortic regurgitation

Answer 19

High pitched “blowing” early diastolic decrescendo murmur

Question 20

Mitral stenosis

Answer 20

Delayed rumbling late diastolic murmur following opening snap

Question 21

PDA

Answer 21

Continuous machine-like murmur