Other

Question 1

Pulm interstitial and/or alveolar fluid accumulation

Imbalance in forces trying to keep fluids in and/or out of the pulmonary capillaries

Answer 1

Pulmonary edema

Question 2

Steps in Pulmonary Edema

Answer 2

Inc capillary wedge pressure ->
Cephalization (distribution of pulmonary flow from bases to apices) ->
Kerley B lines (accumul fluid in bases/lines) ->
alveolar edema (alveoli fill up centrally first)->
Pleural eff, costophrenic angles, CHF, CM

Question 3

RBBB - look at leads…

LBBB - look at leads…

Answer 3

= V1, V2

= V5, V6

Question 4

For rate, rhythm, and atrial enlargement look at leads…

Answer 4

= II and V1

Question 5

Heart sound S1 represents…

Answer 5

Onset systole

AV valves close (mitral, tricuspid)

Question 6

Heart sound S2 represents…

Answer 6

Onset diastole

SL valves close (Aortic, Pulmonic)

Question 7

Heard with bell

Diastole

Answer 7

S3 and S4

Question 8

Ventricular Gallup
Assoc c CHF
From rapid filling (MR/TR, thyrotoxicosis, anemia - pregnancy, VSD)
or poor LV fxn (post-MI, stiff wall - dilated CM, dilated LV - CHF)

Answer 8

S3

Question 9

Atrial Gallup
Caused by atrial contraction, prior to S1
2/2 stiff / hypertrophic ventricle (reduced compliance)
Assoc c HOCM, HTN, AS, PS, post-MI
A. fib eliminates this gallup

Answer 9

S4

Question 10

stenosis of valve, does what to preceding chamber?

Answer 10

“pressure overload” = hypertrophy (S4)

Question 11

regurgitation of valve, does what to preceding chamber?

Answer 11

“volume overload” = dilation (S3)

Question 12

Murmur descriptions

Answer 12

Timing / duration
Intensity
Location
Pitch, Pattern, Radiation, Quality - less impt

Question 13

IV/VI murmur offers what new finding

Answer 13

thrill

Question 14

Systolic murmurs =

Diastolic murmurs = opposite

Answer 14

= MR ASTR PS

= MS ARTS PR

Question 15

Most clinical murmurs are ______-sided

______-sided murmurs change with inspiration & expiration 2/2 pulm pressures

Answer 15

Left

Right