S&S

Question 1

Cardiogenic pulmonary oedema

Answer 1

Tachypnoea, dyspnoea, orthopnoea, cyanosis, cool clammy skin, productive cough with pink frothy sputum (RBC/ protein in alveoli), crackles, restlessness, anxious, tachycardia, hypotension, sense of impending doom

Question 2

Rheumatic fever

Answer 2

Fever, joint pain, joint swelling, rash on trunk and proximal extremities (lesions with clear boarders and blanched centres),

Neurological symptoms are rare but include irritation, clumsiness, inability to concentrate, involuntary muscle spasm,

Question 3

Carditis

Answer 3

Chest pain, tachycardia, pericardial friction rub, S3/4 murmur

Question 4

Infective endocarditis

Answer 4

Fever, flu like symptoms, cough, SOB, joint pain, chills, heart murmur, splenomegaly

Peripheral manifestations are from microemboli- Petechiae, splinter haemorrhages (streaks under fingernails), painful red growths on finger/toe pads, Roth’s spots (white spot on retina)

Complications= emboli, heart failure, abscess, aneurysm

Question 5

Myocarditis

Answer 5

Asymptomatic, fever, fatigue, general malaise, dyspnoea, palpitations, arthralgias

Question 6

Pericarditis

Answer 6

Chest pain ( aggravates by breathing), pericardial friction rub, fever

Question 7

Mitral stenosis

Answer 7

Dyspnoea on exertion, cough, haemoptysis, pulmonary infections, paroxysmal nocturnal dyspnoea, orthopnoea, weakness, fatigue, palpitations

Severe= heart failure- jugular distension, hepatomegaly, ascites, peripheral oedema, loud S1, split S2

Question 8

Mitral regurgitation

Answer 8

Asymptomatic, fatigue, weakness, exercise dyspnoea, orthopnoea, murmur, palpable thrill

Severe- left side heart failure, pulmonary congestion, oedema, right sided failure

Question 9

Mitral valve prolapse

Answer 9

Asymptomatic, mid systolic ejection click or murmur, high pitched late systolic murmur(whoop it honk), atypical chest pain, tachyarrhytmia, palpitations, light headed, syncope

Question 10

Aortic stenosis

Answer 10

Asymptomatic, 50-70 CO decreases, dyspnoea on exertion, angina, exertional syncope, harsh systolic murmur, palpable thrill, murmur may radiate to carotid arteries, S3/4 heart sounds

Late- pulmonary HT, right ventricle heart failure

Question 11

Aortic regurgitation

Answer 11

Asymptomatic, palpitations, throbbing pulse in arteries of neck, dizziness, exercise intolerance, fatigue, exertional dyspnoea, orthopnoea, paroxysmal nocturnal dyspnoea, angina at night, murmur during diastole, palpable thrill, S3/4 heard as heart fails, apical impulse displaced to left, water hammer pulse

Question 12

Tricuspid stenosis

Answer 12

CVP, jugular vein distension, ascites, hepatomegaly, peripheral oedema, fatigue, weakness, low pitched murmur over fourth intercostal space,

Question 13

Pulmonary stenosis

Answer 13

Asymptomatic, dyspnoea on exertion, fatigue, murmur in pulmonary area, peripheral oedema, ascites, hepatomegaly,

Question 14

Dilated cardiomyopathy

Answer 14

Dyspnoea on exertion, orthopnoea, paroxysmal nocturnal dyspnoea, weakness, fatigue, peripheral oedema, ascites, S3/4 heart sounds, AV regurg murmur, arrhythmia (AF, Superventricular tachycardia)

Question 15

Hypertrophic cardiomyopathy

Answer 15

Asymptomatic then dyspnoea, angina, syncope, fatigue, dizziness, palpitations, ventricular arrhythmia, systolic murmur, S4, suddenly cardiac death can be first sign

Question 16

Restrictive cardiomyopathy

Answer 16

Same as heart failure and decrease tissue perfusion

Question 17

Angina pectoris

Answer 17

Women- indigestion, nausea, vomiting, upper back pain

Men- chest pain radiating, dyspnoea, pallor, cool skin, tachycardia, anxiety, fear

Question 18

Acute coronary syndrome

Answer 18

Chest pain radiating to neck/ left shoulder/left arm. May occur at rest, lasts longer than 10-20min, May have dyspnoea, pallor, cool skin, diaphoresis

Question 19

Myocardial infarction

Answer 19

Severe chest pain (crushing/heavy/squeezing/pressure/burning/tightness), continuous, radiates, >20mins, not relieved by GTN, impending doom, death
SNS symptoms- anxiety, tachycardia, vasoconstriction, cool and clammy, mottled, pale.
Pain and blood Chemistry changes cause tachypnoea. Tissue necrosis causes temp

Women/older people- nausea, indigestion, heartburn, vomiting

Question 20

Sinus tachycardia

Answer 20

SOB, palpitations, dizziness

Question 21

Sinus bradycardia

Answer 21

Decreased LOC, syncope, hypotension

Question 22

Sick sinus syndrome

Answer 22

Intermittent fatigue, dizziness, light headed, syncope

Question 23

Premature atrial contraction

Answer 23

Palpitations/ fluttering

Question 24

Paroxysmal superventricular tachycardia

Answer 24

Palpitations, anxiety, dizziness, dyspnoea, angina pain, diaphoresis, extreme fatigue, polyuria

Question 25

Atrial flutter

Answer 25

Palpitations, fluttering in chest or throat

Question 26

Atrial fibrillation

Answer 26

Hypotension, dyspnoea, fatigue, angina, irregular peripheral pulses

Question 27

Atrioventricular conduction blocks

Answer 27

First- asymptomatic

Second- asymptomatic

Third- syncope, dizziness, fatigue, exercise intolerance, heart failure

AV dissociation-

Question 28

Hypertension

Answer 28

Asymptomatic, vague headache on waking, nocturia, confusion, nausea, vomiting, visual disturbances

Question 29

Aortic aneurysm

Answer 29

Thoracic- (trachea/laryngeal nerve/superior vena cava)- dyspnoea, stridor, cough, painful swallowing, hoarseness, oedema of face/neck, distended neck veins
(Ascending aorta)- angina, dysphagia, dyspnoea, hoarseness, confusion, dizziness

Abdominal- pain mid abdominal region or lower back

Popliteal/femoral- asymptomatic, can cause intermittent cramping in muscles, rest pain, numbness

Question 30

Aortic dissection

Answer 30

Excruciating pain that feels like tearing or riping, chest or back pain, syncope, dyspnoea, weakness, absent peripheral pulses

Question 31

Peripheral vascular disease

Answer 31

Pain, intermittent claudication (cramp/ache in calves/thigh/buttocks, accompanied by weakness and relieved by rest), burning when legs elevated, rest pain, sensation diminished and muscle atrophy, peripheral pulses diminish, bruit over large affected areas, pale legs when elevated/ red when dependant, skin pale, shinny legs, hairless, thickened toenails

Question 32

Acute arterial occlusion

Answer 32

Pain, pale skin, cold, absent distal pulses, parasthesia, cyanosis, mottling

Question 33

Thromboangiitis obliterans

Answer 33

Pain in affected extremity, cramping pain, rest pain, diminished sensation, skin becomes thin and shiny and nails thicken. Digits involved become pale, cynotic, cold, distal pulses difficult to palpate or absent even with Doppler, painful ulcers and gangrene May develop

Question 34

Raynauds

Answer 34

Blue fingers then white then very red when circulation returns, may cause stiffness, decreased sensation, and aching pain

Question 35

Venous thormbous

Answer 35

DVT- calf pain especially of walking, tenderness, swelling, warmth, erythema, oedema, cyanotic limb

SVT- pain, tenderness, redness, heat

Question 36

Chronic venous insufficiency

Answer 36

Lower leg oedema, itching and discomfort, cyanotic, ulcers, thin shiny skin

Question 37

Varicose veins

Answer 37

Severe aching leg pain, leg fatigue, leg heaviness, itching, feelings of heat

Question 38

Lymphangitis

Answer 38

Red streak along inflamed vessel, pain, heat, swelling, fever, chills