Shorts Edit Flashcards
Signs of severity of mitral stenosis?
early opening snap
length of the mid diastolic rumbling murmur
diastolic thrill at apex
presence of pulmonary hypertension
Signs of severity of MR?
small volume pulse signs of LV failure displaced apex beat soft S1 and loud S3 signs of pulmonary hypertension
Signs of severity of aortic regurgitation?
collapsing pulse wide pulse pressure length of decrescendo diastolic murmur S3 soft A2 signs of left ventricular failure Austin flint murmur (diastolic murmur caused by limitation to mitral inflow by the regurgitation jet)
Signs of severity of AS?
small volume slow rising pulse
aortic thrill
length, harshness and lateness of the peak of the systolic murmur
fourth heart sound
reversed splitting of the second heart sound
left ventricular failure
pressure loaded apex beat
Signs of TR?
large v waves on JVP right ventricular heave pansystolic murmur loudest at the lower edge of the sternum, louder on inspiration pulsatile liver ascites peripheral oedema
Causes of TR?
right ventricular failure
rheumatic
infective endocarditis
ebstein’s anomaly
Causes of MR?
degenerative disease mitral valve prolapse rheumatic disease papillary muscle dysfunction (ischaemia) left ventricular dilatation infective endocarditis connective tissue disease cardiomyopathies congenital
Indications for surgery in MR?
class III or IV symptoms left ventricular dysfunction left ventricular dimensions have increased progressively
Causes of AR?
endocarditis congenital abnormalities rheumatic disease radiation induced hypertensive aortopathy connective tissue disease (ankylosing spondylitis, marfan’s syndrome) degenerative aortopathy (including tertiary syphilis) aortic dissection
Indications for surgery in AR?
severe symptomatic AR
asymptomatic with LVEF < 50%
having other cardiac surgery
dilated LV
Signs of severe AS on TTE?
maximum velocity > 4m/s
mean gradient > 40mmHg
aortic valve area < 1cm
index AVA < 0.6cm/m
Signs of hypertrophic cardiomyopathy?
sharp rising jerky pulse prominent a waves on JVP double or triple impulse apex beat late systolic ejection murmur loudest at left lower sternal edge - louder with valsalva fourth heart sound
What are the causes of AS?
degenerative calcification bicuspid aortic valve rheumatic congenital IE
Causes of upper lobe pulmonary fibrosis?
Silicosis, sarcoidosis Miner's (coal) lung Ankylosing spondylitis/APBA Radiation Tuberculosis
Causes of lower lobe pulmonary fibrosis?
Cryptogenic fibrosis alveolitis Asbestosis RA Drugs Scleroderma
Causes of hepatomegaly?
Metastases Alcoholic liver disease with fatty infiltration Myeloproliferative disease Right heart failure Hepatocellular cancer Haemochromatosis Leukaemia/lymphoma Amyloid Hepatitis
Causes of hepatosplenomegaly?
Chronic liver disease with portal hypertension Haematological disease Infection Infiltration - amyloid, sarcoid Connective tissue disease Acromegaly Thyrotoxicosis
Causes of splenomegaly?
Massive (LMLM) - lymphoma - myelofibrosis - leukaemia - malaria Moderate (PLLTS) - portal HTN - leukaemia - lymphoma - thallasemia - storage (gaucher) Mild - myeloproliferative disorders - haemolytic anaemia - infection - EBV, HBV, - CTD - SLE/RA - infiltrate - amyloid, sarcoid
Causes of sensory predominant neuropathy?
B12 Diabetes EtOH Myeloma Paraneoplastic
Causes of motor predominant neuropathy?
AIDP CIDP charcot marie tooth MND MMN
Causes of increased vocal resonance?
consolidation
lobar collapse
tumour
Causes of decreased vocal resonance?
pleural effusion
lobectomy
Differential diagnosis for thoracotomy scar
lobectomy pneumonectomy single lung transplant biopsy bullectomy
Indications for lung transplant
ILD COPD CF (must be bilateral lung) pulmonary hypertension eisenmenger syndrome
Normal value for schober’s test?
> 5cm
Normal value for occiput to wall distance?
< 2cm
Normal value for lateral flexion?
> 10cm
Normal value for chest expansion?
> 5cm
