Pearls Practice

Question 1

What condition results in a right-sided heart sound that decreases with inspiration?

Answer 1

Pulmonary Valve Stenosis

Question 2

A patient presents with hypertension in the arms, but hypotension in the legs

Answer 2

Coarctation of the Aorta

Question 3

A patient presents with a normal radial pulse, but low femoral pulse

Answer 3

Coarctation of the Aorta

Question 4

A patient presents with unexplained migraines with aura, stokes…

Answer 4

Patent Foramen Ovale

Question 5

Flame-sign viewed on echocardiography/doppler

Answer 5

Patent Foramen Ovale

Question 6

Tet Spells

Answer 6

Tetralogy of Fallot

Question 7

Toddler squats during play and refuses to stand up

Answer 7

Tetralogy of Fallot

Question 8

Boot-shaped heart on chest x-ray

Answer 8

Tetralogy of Fallot

Question 9

Patient has clubbed and cyanotic feet, but hands appear normal

Answer 9

Patent Ductus Arteriosus

Question 10

Thin patient (low BMI), with pectus excavatum (sunken or funnel chest) connective tissue disorder, skeletal changes, and an arm-span greater than wing-span

Answer 10

Mitral Valve Prolapse

Question 11

The patient has pulsus parvus es tardus (delayed, weak carotid pulse)

Answer 11

Aortic Stenosis

Question 12

Patient is an immigrant and/or has a history of Rheumatic Fever

Answer 12

Mitral Stenosis, Tricuspid Valve Stenosis, or Aortic Regurgitation

Question 13

Patient presents with left ventricular hypertrophy and has a history of infective endocarditis

Answer 13

Aortic Regurgitation - most common cause in the US is infective endocarditis

Question 14

Patient presents with a wide arterial pulse pressure, nailbed capillary pulsations, head bob with each pulse, and BP that is 40 mm Hg higher in the legs than the arms

Answer 14

Aortic Regurgitation

Question 15

Chest x-ray shows enlarge right atrium and superior vena cava

Answer 15

Tricuspid Stenosis

right atria is being overworked, trying to push blood through the stenosis

back-up of blood in SVC because blood is having trouble leaving the right atrium

Question 16

Chest x-ray shows distention of the azygous vein

Answer 16

Tricuspid Valve Regurgitation

Question 17

elevated JVP with large “v” wave

Answer 17

Tricuspid Valve Regurgitation

Question 18

prominant “a” waves in JVP

Answer 18

Pulmonary Valve Stenosis and Tricuspid Valve Stenosis

Question 19

elevated JVP with large “a” and “v” waves

Answer 19

Pulmonary Valve Regurgitation

Question 20

precordial chest pain lasting less than 3 minutes that is relieved by rest or nitrates

Answer 20

Stable Angina

Question 21

chest pain, sweating, dyspnea, nausea, and fatigue occurring at rest and does not respond to rest or nitrates

Answer 21

Unstable Angina

Question 22

Middle-aged woman wakes up with angina; ECG shows ST-segment elevation, no stenosis visible on electrocardiography

Answer 22

Prinzmetal Angina/ Coronary Vasospasm

Question 23

Patient presents with chest pain, elevated troponin levels, and ST-segment elevation

Answer 23

STEMI

Question 24

Chest X-ray shows enlarged heart and Kerley B lines

Answer 24

Ventricular Heart Failure