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PCM II Exam 1 > Pitcher > Flashcards

Pitcher Flashcards

1
Q

thrill

A

vibration - valve problem

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2
Q

LLSB

A

tricuspid

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3
Q

apex

A

mitral

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4
Q

2nd ICS right and left

A

aortic and pulmonic

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5
Q

left lateral decubitus

A

accentuates mitral murmurs

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6
Q

murmur

A

turbulence across valve

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7
Q

bruit

A

turbulence outside heart - periphery

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8
Q

grade 4/6

A

thrill palpable

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9
Q

grade 6/6

A

stethoscope OFF chest

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10
Q

grade 5/6

A

stethoscope partially off chest

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11
Q

aortic stenosis

A

radiate to carotid arteries
-bruit

carotid stenosis vs. aortic stenosis - listen to heart - if abnormal - aortic stenosis

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12
Q

atherosclerosis

A

bruit - if 70%

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13
Q

stills murmur

A

innocent

  • mid systolic, louder supine
  • in kids
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14
Q

S1

A

mitral and tricuspid

timed with carotid pulse

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15
Q

S2

A

aortic and pulmonic

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16
Q

split S1

A

normal variant or abnormal from RBBB or PVC

if both split

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17
Q

split S2

A

with inspiration - normal

wide or fixed - delayed pulmonic closure from stenosis, RBBB

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18
Q

S3

A

early diastolic
-kentucky

transition of rapid to slow ventricular filling

LV myocardial damage causing systolic dysfunction from dilated cardiomyopathy**

sudden limitation of normal ventricular relaxation during filling stage in diastole

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19
Q

S3

A

with MI

-to CHF

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20
Q

S4

A

vibration of LV from atrial kick

  • hits less compliant ventricular wall
  • thicker heart**
  • poorly treated HTN

aortic/pulmonic stenosis, HTN, MI wall damage, thick ventricle wall from higher work load, and some stiffening

decreased ventricular distensibility

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21
Q

transmits to carotids

A

aortic stenosis

-dyspnea on exertion, angina, syncope

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22
Q

aortic stenosis

A

systolic crescendo/decrescendo pattern

often associated S4

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23
Q

gallop rhythm

A

all 4 sounds

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24
Q

ejection click

A

sound occurring moment of max pressure with sudden tensing of a valve root

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25
Q

aortic ejection click

A

early systolic

  • onset of left V ejection
  • aortic root suddenly stretched

dilated aneurysm, coarc, HTN

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26
Q

aortic regurg

A

austin-flint

early diastolic - high pitch blowing decrescendo

dilates LV - S3

high puls pressure

rheumatic disease, congenital bicuspid valve, endocarditis

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27
Q

pulmonic ejection click

A

early systole

pulmonary HTN, aneurysm dilation

sudden root tensioning

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28
Q

pulmonic stenosis

A

systolic crescendo-decrescendo 2nd ICS left

exertional dyspnea, chest pain, syncope

can hear S4

usually congenital

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29
Q

graham steel

A

pulmonic regurg

softer diastolic decrescendo

from pulmonary HTN

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30
Q

tricuspid regurg

A

holosystolic at left sternal border

high pitch, blowing

no radiation

inspiration accentuates murmur

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31
Q

mitral valve opening snap

A

diastole
-snap to LV right before atrial blood flows in

stenotic mitral leaflets

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32
Q

mitral valve stenosis

A

diastolic murmur - opening snap

pulmonary HTN, elevated JVP, RV hypertrophy

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33
Q

group A beta hemolytic strep and strep viridans

A

mitral valve

subacute endocarditis

34
Q

mitral valve prolapse

A

mid systolic click followed by murmur

high pitch / short murmur - mitral regurg

increased with valsalva
decreased with valsalva release

young women, anxious, panic attacks

35
Q

valsalva

A

decreased volume getting to heart

36
Q

mitral valve regurg

A

holosystolic murmur

loud, high pitch, at apex

radiates to left axilla

37
Q

rheumatic heart disease

A

mitral valve

38
Q

machine like

A

patent ductus arteriosus

39
Q

apex

A

mitral murmurs

40
Q

pulmonic area

A

pulmonic murmurs
ASD
PDA

41
Q

obstructive cardiomyopathy

A

thicker IV septum

systolic murmur can be heard

42
Q

leaning forward

A

accentuate aortic murmurs and pericarditis

43
Q

squatting

A

increases venous return

decrease mitral prolapse

increase aortic stenosis

lessens hypertrophic obstructive cardiomyopathy

44
Q

standing

A

decreased venous return

increased mitral prolapse

reduce aortic stenosis

increases hypertrophic cardiomyopathy

45
Q

valsalva

A

decreased venous return

46
Q

IHSS

A

idiopathic hypertrophic subaortic stenosis

hypertrophic obstructive cardiomyopathy

LV and IV septum hypertrophy

sudden cardiac death

exercise induced dyspnea, angina, or syncope

47
Q

hypertrophic obstructive cardiomyopathy

A

systolic ejection murmur

  • left sternal border and apex
  • increased with standing and valsalva (vs. aortic stenosis)

sudden death potential

48
Q

only systolic murmur increasing with valsalva

A

murmur of IHSS

49
Q

PDA

A

fistula - aorta and pulmonary a

machine like murmur
2nd ICS

50
Q

innocent after PDA closes

A

systolic ejection

-majority - benign pulmonary branch stenosis

51
Q

path murmur in kid

A

loud (>grade 3)
harsh
pan systolic

52
Q

pericardial knock

A

constrictive pericarditis

diastolic - blood to ventricles stops abruptly - vibrates wall

53
Q

rub

A

inflamed pericardial surfaces

more in systole

accentuate - lean forward

54
Q

TTE

A

transthoracic echo

55
Q

TEE

A

transesophageal echo

56
Q

third spacing

A

body effort to lower work load on heart by pushing fluid out of artery and vein - often lower legs, lungs

57
Q

tilting disc valve

A

anticoag for life

58
Q

small dense LDL

A

worst

59
Q

intermittent claudication

A

occlusive arterial disease of limbs with walking - goes away when rest

mechanism - ischemia

poor pulses, ulcers, palor, cool, shiny, hairless skin, bruit

A/B ratio <0.9 - Dx**

Tx - stop smoking

60
Q

severe PAD

A

ABI < 0.4

61
Q

normal ABI

A

0.9-1.3

62
Q

pseudoaneurysm

A

dilation or hematoma that may or may not involve layers of vessel wall
-contained and does not dissect

63
Q

true aneurysm

A

involve all three layers of vessel wall

64
Q

aneurysm treatment

A

beta blockers

elective graft

65
Q

raynaud

A

paroxysmal constriction/dilation of small arteries/arterioles

80% women

disease - no association
phenomenon - associated with other disorders - ie/ scleroderma**

66
Q

scleroderma

A

with raynauds

67
Q

vasculitis

A

inflammation and damage to vessels

large vessel - takayasu
medium - polyarteritis nodosa / wegeners
small - henoch schonlein

68
Q

polyarteritis nodosa

A

necrotizing vasculitis of medium arteries

fatigue, weakness, fever, weight loss HA, abdominal pain, elevated ESR, elevated neutrophil WBC count

Dx confirmed by biopsy**

69
Q

4 main risk factors with vascular disease

A

HTN
DM
hyperlipidemia
smoking

70
Q

PAD

A

disease of ischemia in peripheral artery

71
Q

how long listen at each post

A

2-3 beats

72
Q

onset of systole

A

S1 closure of mitral valve

73
Q

open during diastole

A

tricuspid and mitral

74
Q

split S2

A

inspiration

-right heart filling

75
Q

well trained athletes

A

S4

76
Q

early dilated HF

A

S3

77
Q

first to identify when listening to murmur

A

ID S1 and S2

78
Q

crescendo decrescendo

A

aortic

pulmonic

79
Q

common presentation of mitral prolapse

A

palpitations

anxious young woman

at risk for arrhythmia - dilated left atria

80
Q

31yo SOB, bronchitis 5 days ago, lungs CTA, comfy sitting up and leaning forward

A

pericarditis

81
Q

imaging for abdominal aneurysm

A

ultrasound

MRA

PCM II Exam 1 (6 decks)

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