valve stuff

Question 1

Ms. Ard

Mr. Ass

Answer 1

mitral sten & aortic regurg : diastolic

mitral regurg & aortic sten : systolic

Question 2

pulsus tardus

Answer 2

delayed pulse to carotids because heart is beating harder

associated with aortic stenosis

Question 3

water hammer pulse

Answer 3

associated with aortic regurg

Question 4

de musset’s sign

Answer 4

head bob with heart beat

associated with aortic regurg

Question 5

quincke’s pulse

Answer 5

alternating flush/pallor in nail beds

associated with aortic regurg

Question 6

traube’s sign

Answer 6

pistol shot sound, femoral artery

associated with aortic regurg

Question 7

low, listen with bell

Answer 7

S3, S4, summation gallop, mitral stenosis, tricuspid stenosis

S34, SMarT

Question 8

mitral stenosis associated s/s

Answer 8

won’t open therefore back up: coarse crackles, dyspnea, orthopnea, PND

a fib because atrium struggling - NO ATRIAL KICK

Question 9

what happens to chambers that get regurged into?

Answer 9

dilation - they can’t get it out

Question 10

this valve problem results in LV hypertrophy, dilation, failure

Answer 10

aortic regurgitation

PMI shifts left, fatigue, SOB, syncope, exercise intolerance

Question 11

increased risk with aortic regurg

Answer 11

increased CHF risk (PMI shifts left, fatigue, SOB, syncope, exercise intolerance)

Question 12

commissure

Answer 12

two leaflets abnormally stuck to each other

Question 13

no atrial kick with what valve issue

Answer 13

mitral stenosis

Question 14

may hear a click with late systolic murmur

Answer 14

mitral valve prolapse

Question 15

mitral regurg results + s/s

Answer 15

decreased SV, L atrial dilation

exaggerated PMI, dyspnea, orthopnea, PND, dysphagia (enlarged left atrium), PVC, SVT

Question 16

aortic stenosis s/s

Answer 16

angina (poor coronary artery perfusion)
syncope
exertional dyspnea
exaggerated PMI
pulsus tardus

Question 17

exaggerated PMI in which valve problems

Answer 17

mitral regurgitation (LV dilated)

aortic stenosis (can’t get blood out)

Question 18

valve issue intensifies with dehydration

Answer 18

mitral valve prolapse

Question 19

tricuspid stenosis

Answer 19

usually occurs with systemic problem resulting in mitral stenosis and also some sort of aortic problem

Question 20

physiological splitting S2: what & heard where

Answer 20

↑ venous return to RV = late pulmonic closure

↓ return to LV d/t ↑ pulmonary capacity (inspiration) - early aortic closure

heard: pulmonic

Question 21

heart sound highly suggestive of myocardial failure

Answer 21

summation gallop

Question 22

S3

Answer 22

ventricular gallop

passive filling of blood into non-compliant LV

bell on mitral (left lateral may help)

Question 23

S4

Answer 23

atrial gallop

blood enters non-compliant LV during atrial kick

bell on mitral (left lateral may help)

Question 24

if you have a fib, which heart sound will you NOT hear?

Answer 24

S4

Question 25

murmur grades

Answer 25

I - soft
II - think about it
III - no duh
IV - murmur + thrill
V - louder but needs stethoscope + thrill
VI - no stethoscope needed + thrill

Question 26

systolic vs diastolic

ejection vs regurgitation

Answer 26

systolic:

Question 27

aortic regurg aka

Answer 27

aortic insufficiency

Question 28

PAC picks up pressure as v wave from which valve problem?

Answer 28

mitral regurgitation

Question 29

low decrescendo-crescendo

Answer 29

mitral stenosis

Question 30

high holosystolic

Answer 30

mitral regurgitation

Question 31

medium harsh diamond

Answer 31

aortic stenosis

Question 32

high blowing decrescendo

Answer 32

aortic regurg